Abstract
BackgroundThis study aimed to assess the relationship of air pollution and plasma surrogate markers of endothelial dysfunction in the pediatric age group.MethodsThis cross-sectional study was conducted in 2009-2010 among 125 participants aged 10-18 years. They were randomly selected from different areas of Isfahan city, the second large and air-polluted city in Iran. The association of air pollutants' levels with serum thrombomodulin (TM) and tissue factor (TF) was determined after adjustment for age, gender, anthropometric measures, dietary and physical activity habits.ResultsData of 118 participants was complete and was analyzed. The mean age was 12.79 (2.35) years. The mean pollution standards index (PSI) value was at moderate level, the mean particular matter measuring up to 10 μm (PM10) was more than twice the normal level. Multiple linear regression analysis showed that TF had significant relationship with all air pollutants except than carbon monoxide, and TM had significant inverse relationship with ozone. The odds ratio of elevated TF was significantly higher in the upper vs. the lowest quartiles of PM10, ozone and PSI. The corresponding figures were in opposite direction for TM.ConclusionsThe relationship of air pollutants with endothelial dysfunction and pro-coagulant state can be an important factor in the development of atherosclerosis from early life. This finding should be confirmed in future longitudinal studies. Concerns about the harmful effects of air pollution on children's health should be considered a top priority for public health policy; it should be underscored in primordial and primary prevention of chronic diseases.
Highlights
This study aimed to assess the relationship of air pollution and plasma surrogate markers of endothelial dysfunction in the pediatric age group
Results of the Pearson correlation analyses of air pollutants level with serum markers showed that pollution standards index (PSI) and particular matter measuring up to 10 μm (PM10) had significant correlation with tissue factor (TF) (r = 0.3, p = 0.001) and non-significant inverse correlation with TM
The odds ratio (OR) of elevated TF increased as the quartiles of PM10, O3 and PSI increased; these associations reached to significant level only in the highest quartile of PM10 and PSI
Summary
This study aimed to assess the relationship of air pollution and plasma surrogate markers of endothelial dysfunction in the pediatric age group. Air pollution is one of the major health threats both in developing and developed countries [1]. Children are more sensitive than adults to health effects of air pollutants; this might be because of the developmental changes in their respiratory system and their higher number of breaths per minute than adults. The harmful effects of air pollution on cardiovascular system are well-documented, but the underlying mechanisms remain to be determined. The human blood vessel endothelium is a sensitive target for air pollutants [5]. The interactions of the inflammation and coagulation systems are of the main mechanisms involved in impairment of endothelial function and eventually cardiovascular diseases [6]
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