Air pollution and inflammation in type 2 diabetes: a mechanism for susceptibility

Background: Particulate air pollution has been associated with several adverse cardiovascular health outcomes, and people with diabetes may be especially vulnerable. One potential pathway is inflammation and endothelial dysfunction—processes in which cell adhesion molecules and inflammatory markers play important roles. Aim: To examine whether plasma levels of soluble intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1) and von Willebrand factor (vWF) were associated with particle exposure in 92 Boston area residents with type 2 diabetes. Methods: Daily average ambient levels of air pollution (fine particles (PM2.5), black carbon (BC) and sulphates) were measured approximately 500 m from the patient examination site and evaluated for associations with ICAM-1, VCAM-1 and vWF. Linear regressions were fit to plasma levels of ICAM-1, VCAM-1 and vWF, with the particulate pollutant index, apparent temperature, season, age, race, sex, glycosylated haemoglobin, cholesterol, smoking history and body mass index as predictors. Results: Air pollutant exposure measures showed consistently positive point estimates of association with the inflammatory markers. Among participants not taking statins and those with a history of smoking, associations between PM2.5, BC and VCAM-1 were particularly strong. Conclusions: These results corroborate evidence suggesting that inflammatory mechanisms may explain the increased risk of air pollution-associated cardiovascular events among those with diabetes.

[1]  G. Lip,et al.  Plasma von Willebrand Factor and Soluble P-Selectin as Indices of Endothelial Damage and Platelet Activation in 1321 Patients With Nonvalvular Atrial Fibrillation: Relationship to Stroke Risk Factors , 2002, Circulation.

[2]  P. Ridker,et al.  Soluble Intercellular Adhesion Molecule-1, Soluble Vascular Adhesion Molecule-1, and the Development of Symptomatic Peripheral Arterial Disease in Men , 2002, Circulation.

[3]  R. Burnett,et al.  Spatial Analysis of Air Pollution and Mortality in Los Angeles , 2005, Epidemiology.

[4]  F. Ashcroft,et al.  Identification of a functionally important negatively charged residue within the second catalytic site of the SUR1 nucleotide-binding domains. , 2004, Diabetes.

[5]  A. Folsom,et al.  Prospective study of hemostatic factors and incidence of coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) Study. , 1997, Circulation.

[6]  F. Logerfo,et al.  Soluble intercellular adhesion molecule, vascular cell adhesion molecule, and impaired microvascular reactivity are early markers of vasculopathy in type 2 diabetic individuals without microalbuminuria. , 1999, Diabetes care.

[7]  M. Bots,et al.  Soluble intercellular adhesion molecule 1 and flow-mediated dilatation are related to the estimated risk of coronary heart disease independently from each other. , 2003, Atherosclerosis.

[8]  M. Entman,et al.  Soluble adhesion molecules and the search for biomarkers for atherosclerosis. , 2002, Circulation.

[9]  G. Lip,et al.  Inflammation, cell adhesion molecules, and stroke: tools in pathophysiology and epidemiology? , 2002, Stroke.

[10]  D. Tanné,et al.  Soluble intercellular adhesion molecule-1 and long-term risk of acute coronary events in patients with chronic coronary heart disease. Data from the Bezafibrate Infarction Prevention (BIP) Study. , 2002, Journal of the American College of Cardiology.

[11]  W. Burch,et al.  Passage of inhaled particles into the blood circulation in humans. , 2002, Circulation.

[12]  T. Holford,et al.  Association of low-level ozone and fine particles with respiratory symptoms in children with asthma. , 2003, JAMA.

[13]  Antonella Zanobetti,et al.  Diabetes Enhances Vulnerability to Particulate Air Pollution–Associated Impairment in Vascular Reactivity and Endothelial Function , 2004, Circulation.

[14]  Paxticulate Xir Polll.  The Association between Daily Morta ’ lity and Ambient Air Particle Pollution in Montreal , Quebec , 2002 .

[15]  S. Salvi,et al.  Different airway inflammatory responses in asthmatic and healthy humans exposed to diesel , 2004, European Respiratory Journal.

[16]  F. Logerfo,et al.  The effects of troglitazone, an insulin-sensitizing agent, on the endothelial function in early and late type 2 diabetes: a placebo-controlled randomized clinical trial. , 2003, Metabolism: clinical and experimental.

[17]  Alexandra Schneider,et al.  Air pollution and markers of inflammation and coagulation in patients with coronary heart disease. , 2006, American journal of respiratory and critical care medicine.

[18]  L. Khaodhiar,et al.  The effects of atorvastatin on endothelial function in diabetic patients and subjects at risk for type 2 diabetes. , 2004, The Journal of clinical endocrinology and metabolism.

[19]  John D. Spengler,et al.  A QUANTITATIVE ASSESSMENT OF SOURCE CONTRIBUTIONS TO INHALABLE PARTICULATE MATTER POLLUTION IN METROPOLITAN BOSTON , 1985 .

[20]  Antonella Zanobetti,et al.  Cardiovascular Damage by Airborne Particles: Are Diabetics More Susceptible? , 2002, Epidemiology.

[21]  R. Elton,et al.  Particulate air pollution and the blood , 1999, Thorax.

[22]  William R. Gaffrey.  Cause-Specific Mortality , 1975 .

[23]  J. Danesh,et al.  Soluble adhesion molecules and prediction of coronary heart disease: a prospective study and meta-analysis , 2001, The Lancet.

[24]  J. Godleski,et al.  N-acetylcysteine prevents lung inflammation after short-term inhalation exposure to concentrated ambient particles. , 2004, Toxicological sciences : an official journal of the Society of Toxicology.

[25]  J C Bailar,et al.  The association between daily mortality and ambient air particle pollution in Montreal, Quebec. 2. Cause-specific mortality. , 2001, Environmental research.

[26]  S. Blankenberg,et al.  Circulating Cell Adhesion Molecules and Death in Patients With Coronary Artery Disease , 2001, Circulation.

[27]  Thomas Sandström,et al.  Health effects of acute exposure to air pollution. Part I: Healthy and asthmatic subjects exposed to diesel exhaust. , 2003, Research report.

[28]  Ronald W. Williams,et al.  Particulate matter exposure in cars is associated with cardiovascular effects in healthy young men. , 2004, American journal of respiratory and critical care medicine.

[29]  M. Green.  Air pollution and health , 1995 .

[30]  Joel Schwartz,et al.  Diabetes, Obesity, and Hypertension May Enhance Associations between Air Pollution and Markers of Systemic Inflammation , 2006, Environmental health perspectives.

[31]  G. Lip,et al.  Predictive value of indexes of inflammation and hypercoagulability on success of cardioversion of persistent atrial fibrillation. , 2004, The American journal of cardiology.

[32]  J C Bailar,et al.  The association between daily mortality and ambient air particle pollution in Montreal, Quebec. 1. Nonaccidental mortality. , 2001, Environmental research.

[33]  V. Salomaa,et al.  Association of criteria pollutants with plasma hemostatic/inflammatory markers: a population-based study , 2005, Journal of Exposure Analysis and Environmental Epidemiology.

[34]  S T Holgate,et al.  Acute inflammatory responses in the airways and peripheral blood after short-term exposure to diesel exhaust in healthy human volunteers. , 1999, American journal of respiratory and critical care medicine.

[35]  A. Evans,et al.  Circulating soluble adhesion molecules ICAM-1 and VCAM-1 and incident coronary heart disease: the PRIME Study. , 2003, Atherosclerosis.

[36]  S. Bursell,et al.  The effect of vitamin E on endothelial function of micro- and macrocirculation and left ventricular function in type 1 and type 2 diabetic patients. , 2005, Diabetes.

[37]  P. Vokonas,et al.  Glutathione-S-transferase M1, obesity, statins, and autonomic effects of particles: gene-by-drug-by-environment interaction. , 2005, American journal of respiratory and critical care medicine.

[38]  Brent Coull,et al.  Rapid increases in the steady-state concentration of reactive oxygen species in the lungs and heart after particulate air pollution inhalation. , 2002, Environmental health perspectives.

[39]  Susan J Wilson,et al.  Health effects of acute exposure to air pollution. Part II: Healthy subjects exposed to concentrated ambient particles. , 2003, Research report.

[40]  J. Samet,et al.  Air Pollution and Cardiovascular Disease: A Statement for Healthcare Professionals From the Expert Panel on Population and Prevention Science of the American Heart Association , 2004, Circulation.

[41]  J. Manson,et al.  Biomarkers of endothelial dysfunction and risk of type 2 diabetes mellitus. , 2004, JAMA.

[42]  J. Danesh,et al.  von Willebrand factor and coronary heart disease: prospective study and meta-analysis. , 2002, European heart journal.