Study On The Influence Of Atmospheric PM_2.5 And Its Different Components On Blood Pressure In The Elderly And Apelin/SIRT3/VEGF Mediation Effect

Objective:The Exploring atmospheric fine particulate matter(fine particulate matter,PM_2.5)and different components including black carbon（BC）,organic matter（OM）,sulfate(SO₄^2-),nitrate（NO₃^-）,ammonium salt（NH₄⁺）on blood pressure（BP）related indicators in the elderly,Apelin,Silencing information regulatory factor protein3（Silencing information regulatory factor protein3,SIRT3）and Vascular endothelial growth factor（VEGF）have a greater ability to regulate the effects of atmospheric PM_2.5exposure on blood pressure.Methods:In 2021,elderly volunteers were recruited in several communities in Taiyuan,and 147elderly hypertension patients and 237 healthy people were recruited by the current situation study method.A unified self-made questionnaire was used to collect general information,living habits and other data of the two groups of people.Meanwhile,peripheral blood was collected to detect lipid biochemical and other indicators.The mass concentration and meteorological data of PM_2.5and different components BC,OM,SO₄^2-,NO₃^-and NH₄⁺during the same period and 7 days before the survey were matched according to the home addresses of the subjects.logistic regression was used to analyze the influence of general data on the risk of hypertension in the elderly.The generalized linear model（GLM）was used to analyze the relationship between PM_2.5and its components and blood pressure（BP）,and the influence of exposure concentration of PM_2.5and its components on BP of different subgroups was analyzed.By enzym-linked immunosorbent assay（ELISA）,plasma levels of Apelin,SIRT3 and VEGF in the two groups were determined in 60 patients with hypertension and 60 healthy subjects respectively.The generalized linear model was used to analyze the correlation between PM_2.5short-term exposure and plasma Apelin,SIRT3and VEGF levels in the elderly population,and the multiple linear regression model was used to analyze the correlation between plasma Apelin,SIRT3,VEGF and BP.The mediating effects of Apelin,SIRT3 and VEGF on the effects of PM_2.5exposure on blood pressure were analyzed by mediating effect method.Results:Univariate analysis showed that there were statistically significant differences in family history of hypertension,BMI,taking antihypertensive drugs,sleep quality,TG,HDL-C,SBP,DBP,PP and MAP between hypertension patients and healthy people（P<0.05）.Multivariate Logistic regression analysis showed that family history,BMI and HDL-C were risk factors for hypertension OR=（2.624,1.73,1.73）.The short-term exposure to atmospheric PM_2.5was associated with the increase of SBP,DBP and MAP of the total population（P<0.05）,and the effect values reached the maximum at Lag05d,Lag06d and Lag06d,respectively.It was associated with the increase of SBP,DBP,PP and MAP in hypertensive patients（P<0.05）,and the effect value reached the maximum in Lag06d,Lag3d,Lag05d and Lag06d.It was associated with the increase of DBP and MAP in healthy population（P<0.05）,and the effect values reached the maximum at Lag06d and Lag04d,respectively.Short-term exposure to SO₄^2-was associated with increased SBP,DBP and MAP in the general population and hypertensive patients（P<0.05）,and the effect value reached its maximum at Lag06d.Short-term NO₃^-exposure was correlated with the increase of SBP,DBP,PP and MAP in the total population（P<0.05）,and the effect values reached their maximum at Lag06d,Lag06d,Lag5d and Lag06d,respectively.It was associated with the increase of SBP,DBP,PP and MAP in hypertensive patients（P<0.05）,and the effect values reached the maximum at Lag06d,Lag06d,Lag05d and Lag06d,respectively.It was associated with the increase of DBP and MAP in healthy population（P<0.05）,and the effect value reached the maximum at Lag5d and Lag06d.Short-term NH₄⁺exposure was associated with the increase of SBP,DBP and MAP in the total population（P<0.05）,and the effect value reached its maximum at Lag06d.It was associated with the increase of SBP,DBP and MAP in patients with hypertension（P<0.05）,and the effect values reached the maximum at Lag06d,Lag07d and Lag06d,respectively.It was associated with the increase of DBP and MAP in healthy population（P<0.05）,and the effect value reached its maximum at Lag5d.OM short-term exposure was associated with the increase of SBP,DBP and MAP in the general population and hypertension patients（P<0.05）,and the effect value reached its maximum at Lag06d.It was associated with the increase of SBP and DBP in healthy population（P<0.05）,and the effect value reached the maximum in Lag5d and Lag7d.Short-term BC exposure was associated with the increase of SBP,DBP and MAP in the total population（P<0.05）,and the effect values reached their maximum at Lag06d,Lag07d and Lag06d,respectively.It was associated with the increase of SBP,DBP and MAP in hypertensive patients（P<0.05）,and its effect value Lag06d reached the maximum.In a stratified analysis,male students,those who drank alcohol,slept poorly and never exercised appeared to be more vulnerable to the adverse effects of PM_2.5and its various components on blood pressure.The contents of Apelin and SIRT3 in plasma of the elderly hypertension group were significantly lower than those of the healthy group（P<0.05）,and the content of VEGF in plasma of the elderly hypertension group was significantly higher than that of the healthy group（P<0.05）.Apelin and VEGF were negatively correlated with BP,and SIRT3 was negatively correlated with DBP and MAP.PM_2.5was associated with the decrease of Apelin in the total population（P<0.05）,and its effect value Lag2d reached the maximum,decreasing by-2.19（95%CI:-3.20～-1.17）ng/L.PM_2.5exposure in Lag3d and Lag4d can reduce SIRT3 in the total population,and the effect values are-0.10（95%CI:-0.17～-0.03）ng/L and-0.04（95%CI:-0.17～-0.03）ng/L respectively.PM_2.5short-term exposure can cause the decrease of VEGF in the total population,and its effect value was the highest at Lag06d,which decreased by-19.22（95%CI:-27.25～-11.19）pq/ml.PM_2.5mediated Lag2d with SBP,DBP and MAP,and Apelin played an intermediary role in the process of PM_2.5affecting DBP and MAP,accounting for 29.79%and 36.34%,respectively.The mediation analysis of PM_2.5in Lag3d,DBP and MAP showed that SIRT3 played an intermediary role in the process of PM_2.5affecting DBP and MAP,accounting for 30.28%and 33.62%（P<0.05）,respectively.PM_2.5was mediated in Lag06d,SBP,DBP and MAP,and VEGF played a mediating role in the process of PM_2.5affecting DBP and MAP,accounting for 22.75%and 19.44%,respectively.Conclusions:The short-term exposure of PM_2.5and its components was significantly correlated with the increase of SBP,DBP and MAP in the general population.In PM_2.5components,BC exposure has a greater effect on SBP,DBP and MAP than SO₄^2-,NO₃^-,NH₄⁺and OM.Men,people who drink alcohol,have poor sleep quality and never exercise seem to be more vulnerable to the adverse effects of PM_2.5and its different components on blood pressure.Apelin,SIRT3 and VEGF in plasma play mediating effects on blood pressure changes in the elderly caused by PM_2.5.