Particulate air pollution and circulating biomarkers among type 2 diabetic mellitus patients: the roles of particle size and time windows of exposure.
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BACKGROUND: Short-term associations between size-fractionated particulate matter (PM) air pollution and circulating biomarkers are not well established, especially among diabetes patients. METHODS: We conducted a longitudinal panel study involving 6 repeated measurements of 12 circulating biomarkers among 35 diabetes patients from April to June, 2013 in Shanghai, China. Real-time number and mass concentrations of PM with multiple size fractions between 0.25 and 10 m were measured. Linear mixed-effect models were used to explore the associations between size-fractionated PM concentrations and blood biomarkers at different time windows. RESULTS: Short-term exposure to PM was significantly associated with elevated levels of 5 biomarkers of inflammation, 3 biomarkers of coagulation and 1 vasoconstrictor. The effects varied considerably by particle size and time windows. Overall, PM with smaller size had stronger associations, and the most significant size fractions were 0.25-0.40 m. Even 2 h exposure to PM can lead to a significant increase in biomarkers. The effects on biomarkers of inflammation and vasoconstriction were restricted to the first 12h after exposure, but the effects on coagulation persisted for 24-72 h. For example, an interquartile range increase in 2h average exposure to PM(0.25-0.40) was associated with 6-20% increase in biomarkers of inflammation, 19-38% in coagulation and 17% in vasoconstriction. PM had a stronger effect among male patients than female patients. CONCLUSIONS: Our results provided important evidence on the roles of the size and time windows of exposure in the PM-mediated effects on circulating biomarkers of inflammation, coagulation and vasoconstriction in diabetes patients in China.