Aims

To examine the associations between environmental determinants of health and blood pressure and whether age, sex, or race moderated the associations among 18,754 adolescents and adults from the type 1 diabetes (T1D) Exchange Clinic Registry.

Methods

We used multivariable linear regression. Environmental determinants included exposure to ambient fine particulate matter (PM_2.5, obtained from an integrated model), nitrogen dioxide (NO₂), noise and light pollution, and the normalized difference vegetation index (NDVI, a marker of green space) at the ZIP code level of residence.

Results

Higher exposure to PM_2.5 and NO₂, and lower NDVI, was associated with higher systolic and diastolic blood pressure, and higher light pollution exposure were similarly associated with higher diastolic blood pressure. These associations between environmental exposures and blood pressure remained significant after accounting for other covariates (age, sex, race/ethnicity, BMI, and T1D duration). With aging, the negative association between NDVI and blood pressure weakened.

Conclusions

These findings emphasize the significance of minimizing exposure to environmental pollutants, including PM_2.5 and NO₂, as well as ensuring access to areas with higher NDVI, to promote cardiovascular health in individuals with T1D.

中文翻译：

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T1D 交换诊所登记处青少年和成人的环境暴露和血压

目标

旨在检查健康的环境决定因素与血压之间的关联，以及年龄、性别或种族是否调节了来自 1 型糖尿病 (T1D) 交换诊所登记处的 18,754 名青少年和成人的关联。

方法

我们使用多元线性回归。环境决定因素包括邮政编码区环境细颗粒物（PM _2.5，通过综合模型获得）、二氧化氮（NO ₂）、噪音和光污染以及标准化差异植被指数（NDVI，绿色空间标记）居住代码级别。

结果

较高的 PM _2.5和 NO ₂暴露以及较低的 NDVI 与较高的收缩压和舒张压相关，较高的光污染暴露同样与较高的舒张压相关。在考虑其他协变量（年龄、性别、种族/民族、BMI 和 T1D 持续时间）后，环境暴露与血压之间的这些关联仍然显着。随着年龄的增长，NDVI 与血压之间的负相关关系减弱。

结论

_{这些发现强调了尽量减少接触环境污染物（包括 PM 2.5}和 NO _{2 ）}以及确保进入 NDVI 较高的地区对于促进 T1D 患者心血管健康的重要性。