Abstract：
The health effects of ultrafine particles (UFPs) are of growing global concern, but the epidemiological evidence remains limited. Sleep-disordered breathing (SDB) characterized by hypoxemia is a prevalent condition linked to many debilitating chronic diseases. However, the role of UFPs in the development of SDB is lacking. Therefore, this prospective panel study was performed to specifically investigate the association of short-term exposure to UFPs with SDB parameters in patients with chronic obstructive pulmonary disease (COPD). Ninety-one COPD patients completed 226 clinical visits in Beijing, China. Personal exposure to ambient UFPs of 0-7 days was estimated based on infiltration factor and time-activity pattern. Real-time monitoring of sleep oxygen saturation, spirometry, respiratory questionnaires and airway inflammation detection were performed at each clinical visit. Generalized estimating equation was used to estimate the effects of UFPs. Exposure to UFPs was significantly associated with increased oxygen desaturation index (ODI) and percent of the time with oxygen saturation below 90 % (T90), with estimates of 21.50 % (95%CI: 6.38 %, 38.76 %) and 18.75 % (95%CI: 2.83 %, 37.14 %), respectively, per 3442 particles/cm3 increment of UFPs at lag 0-3 h. Particularly, UFPs\' exposure within 0-7 days was positively associated with the concentration of alveolar nitric oxide (CaNO), and alveolar eosinophilic inflammation measured by CaNO exceeding 5 ppb was associated with 29.63 % and 33.48 % increases in ODI and T90, respectively. In addition, amplified effects on oxygen desaturation were observed in current smokers. Notably, individuals with better lung function and activity tolerance were more affected by ambient UFPs due to longer time spent outdoors. To our knowledge, this is the first study to link UFPs to hypoxemia during sleep and uncover the key role of alveolar eosinophilic inflammation. Our findings provide new insights into the effect spectrum of UFPs and potential environmental and behavioral intervention strategies to protect susceptible populations.
摘要：
超细颗粒（UFP）对健康的影响日益受到全球关注，但是流行病学证据仍然有限。以低氧血症为特征的睡眠呼吸紊乱（SDB）是与许多使人衰弱的慢性疾病相关的普遍状况。然而,缺乏UFP在SDB发展中的作用。因此,这项前瞻性小组研究旨在专门研究慢性阻塞性肺疾病(COPD)患者短期UFPs暴露与SDB参数的相关性.91例COPD患者在北京完成了226次临床就诊，中国。根据渗透系数和时间活动模式估计个人暴露于0-7天的环境UFP。实时监测睡眠氧饱和度，肺活量测定,每次临床访视时进行呼吸道问卷调查和气道炎症检测.使用广义估计方程来估计UFP的效果。暴露于UFP与氧饱和度降低指数（ODI）和氧饱和度低于90％（T90）的时间百分比显着相关，估计为21.50%（95CI：6.38%，38.76%）和18.75%（95CI：2.83%，37.14%），分别,在滞后0-3小时时，每3442个颗粒/cm3的UFP增量。特别是，UFPs暴露在0-7天内与肺泡一氧化氮(CaNO)浓度呈正相关,通过CaNO超过5ppb测量的肺泡嗜酸性粒细胞炎症分别与ODI和T90的29.63％和33.48％增加相关。此外,在当前吸烟者中观察到对氧饱和度的放大效应。值得注意的是,肺功能和活动耐受性较好的个体由于户外活动时间较长而受到环境UFP的影响更大.据我们所知,这是第一项将UFPs与睡眠期间低氧血症联系起来并揭示肺泡嗜酸性粒细胞炎症的关键作用的研究.我们的发现为UFP的作用谱以及潜在的环境和行为干预策略提供了新的见解，以保护易感人群。
