TY - JOUR
T1 - Heart rate variability, ambient particulate matter air pollution, and glucose homeostasis
T2 - The environmental epidemiology of arrhythmogenesis in the Women's Health Initiative
AU - Whitsel, Eric A.
AU - Quibrera, P. Miguel
AU - Christ, Sharon L.
AU - Liao, Duanping
AU - Prineas, Ronald J.
AU - Anderson, Garnet L.
AU - Heiss, Gerardo
PY - 2009/3
Y1 - 2009/3
N2 - Metabolic neuropathophysiology underlying the prediabetic state may confer susceptibility to the adverse health effects of ambient particulate matter <10 μm in diameter (PM10). The authors therefore examined whether impaired glucose homeostasis modifies the effect of PM10 on heart rate variability in a stratified, random sample of 4,295 Women's Health Initiative clinical trial participants, among whom electrocardiograms and fasting blood draws were repeated at 3-year intervals from 1993 to 2004. In multilevel, mixed models weighted for sampling design and adjusted for clinical and environmental covariables, PM10 exposure was inversely associated with heart rate variability. Inverse PM10-heart rate variability associations were strongest for the root mean square of successive differences in normal-to-normal RR intervals (RMSSD). Among participants with impaired fasting glucose, there were -8.3% (95% confidence interval: -13.9, -2.4) versus -0.6% (95% confidence interval: -2.4, 1.3), -8.4% (95% confidence interval: -13.8, -2.7) versus -0.3% (95% confidence interval: -2.1, 1.6), and -4.3% (95% confidence interval: -9.4, 1.0) versus -0.8% (95% confidence interval: -2.7, 1.0) decreases in the RMSSD per 10-μg/m3 increase in PM 10 at high versus low levels of insulin (P < 0.01), insulin resistance (P < 0.01), and glucose (P = 0.16), respectively. These associations were stronger among participants with diabetes and weaker among those without diabetes or impaired fasting glucose. The findings suggest that insulin and insulin resistance exacerbate the adverse effect of PM10 on cardiac autonomic control and thus risk of coronary heart disease among nondiabetic, postmenopausal women with impaired fasting glucose.
AB - Metabolic neuropathophysiology underlying the prediabetic state may confer susceptibility to the adverse health effects of ambient particulate matter <10 μm in diameter (PM10). The authors therefore examined whether impaired glucose homeostasis modifies the effect of PM10 on heart rate variability in a stratified, random sample of 4,295 Women's Health Initiative clinical trial participants, among whom electrocardiograms and fasting blood draws were repeated at 3-year intervals from 1993 to 2004. In multilevel, mixed models weighted for sampling design and adjusted for clinical and environmental covariables, PM10 exposure was inversely associated with heart rate variability. Inverse PM10-heart rate variability associations were strongest for the root mean square of successive differences in normal-to-normal RR intervals (RMSSD). Among participants with impaired fasting glucose, there were -8.3% (95% confidence interval: -13.9, -2.4) versus -0.6% (95% confidence interval: -2.4, 1.3), -8.4% (95% confidence interval: -13.8, -2.7) versus -0.3% (95% confidence interval: -2.1, 1.6), and -4.3% (95% confidence interval: -9.4, 1.0) versus -0.8% (95% confidence interval: -2.7, 1.0) decreases in the RMSSD per 10-μg/m3 increase in PM 10 at high versus low levels of insulin (P < 0.01), insulin resistance (P < 0.01), and glucose (P = 0.16), respectively. These associations were stronger among participants with diabetes and weaker among those without diabetes or impaired fasting glucose. The findings suggest that insulin and insulin resistance exacerbate the adverse effect of PM10 on cardiac autonomic control and thus risk of coronary heart disease among nondiabetic, postmenopausal women with impaired fasting glucose.
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U2 - 10.1093/aje/kwn400
DO - 10.1093/aje/kwn400
M3 - Article
C2 - 19208727
AN - SCOPUS:61449169000
SN - 0002-9262
VL - 169
SP - 693
EP - 703
JO - American journal of epidemiology
JF - American journal of epidemiology
IS - 6
ER -