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He G, Jiang M, Tian S, He L, Bai X, Chen S, Li G, Wang C, Zhang Z, Wu Y, Su M, Li X, Guo X, Yang Y, Zhang X, Cui J, Xu W, Song L, Yang H, He W, Zhang Y, Li X, Gao X, Chen L. Clean air policy reduces the atherogenic lipid profile levels: Results from China Health Evaluation And risk Reduction through nationwide Teamwork (ChinaHEART) Study. JOURNAL OF HAZARDOUS MATERIALS 2024; 478:135394. [PMID: 39128148 DOI: 10.1016/j.jhazmat.2024.135394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 07/16/2024] [Accepted: 07/30/2024] [Indexed: 08/13/2024]
Abstract
Evidence of the associations between long-term exposure to PM2.5 and O3 and human blood lipid concentrations is abundant yet inconclusive. Whether clean air policies could improve lipid profiles remains unclear. In total, 2979312 participants from a Chinese nationwide prospective study were included. For cross-sectional analyses, linear mixed-effects models were utilized to assess the associations of pollutants with lipid profiles (TC, LDL-C, TG, HDL-C). For longitudinal analyses, a quasi-experimental design and difference-in-differences models were employed to investigate the impact of China's Clean Air Act. In the cross-sectional analyses, each IQR increase in PM2.5 was associated with 2.49 % (95 % CI: 2.36 %, 2.62 %), 2.51 % (95 % CI: 2.26 %, 2.75 %), 3.94 % (95 % CI: 3.65 %, 4.23 %), and 1.54 % (95 % CI: 1.38 %, 1.70 %) increases in TC, LDL-C, TG, and HDL-C, respectively. For each IQR increase in O3, TC, LDL-C, TG, and HDL-C changed by 1.06 % (95 % CI: 0.95 %, 1.17 %), 1.21 % (95 % CI: 1.01 %, 1.42 %), 1.78 % (95 % CI: 1.54 %, 2.02 %), and -0.63 % (95 % CI: -0.76 %, -0.49 %), respectively. Longitudinal analyses showed that the intervention group experienced greater TC, LDL-C, and HDL-C reductions (1.77 %, 4.26 %, and 7.70 %, respectively). Our findings suggest that clean air policies could improve lipid metabolism and should be implemented in countries with heavy air pollution burdens.
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Affiliation(s)
- Guangda He
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Meijie Jiang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Sifan Tian
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Linkang He
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xueke Bai
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shi Chen
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guangyu Li
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; 4+4 Medical Doctor Program, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Chunqi Wang
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zenglei Zhang
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi Wu
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mingming Su
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangjie Li
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinxin Guo
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yang Yang
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoyan Zhang
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianlan Cui
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Xu
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lijuan Song
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hao Yang
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenyan He
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Zhang
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xi Li
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xu Gao
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China.
| | - Liang Chen
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Cao Y, Liu Y, Ma M, Cai J, Liu M, Zhang R, Jiang Y, Yan L, Cao Y, Liu Z, Liao J. Moderating effect of a sodium-rich diet on the association between long-term exposure to fine particulate matter and blood lipids in children and adolescents. BMC Pediatr 2024; 24:466. [PMID: 39033297 PMCID: PMC11264876 DOI: 10.1186/s12887-024-04896-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 06/19/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Several studies reported that exposure to higher levels of fine particulate matter (PM2.5) was associated with deteriorated lipid profiles in children and adolescents. However, whether a sodium-rich diet could modify the associations remains unknown. We aimed to examine the associations of long-term exposure to PM2.5 with blood lipids in children and adolescents, and further examine the effect modification by dietary and urinary sodium levels based on a multi-community population in China. METHODS The 3711 study participants were from a cross-sectional study, which interviewed children and adolescents aged 6 to 17 years across Sichuan Province, China between 2015 and 2017. Blood lipid outcomes including blood total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) were assessed. Information on daily dietary sodium consumption was estimated with a semi-quantitative food frequency questionnaire (FFQ), and urinary sodium was used as an internal exposure biomarker. A linear regression model was applied to estimate the associations of prior 2-years' average exposure to ambient PM2.5 with blood lipids. The effect modification by dietary and urinary sodium was examined by stratified analyses. RESULTS The participants from rural areas had higher levels of daily sodium consumptions. The results of multivariable regression analysis indicated that per 10 μg/m3 incremental change in PM2.5 was associated with a 1.56% (95% confidence interval 0.90%-2.23%) and a 2.26% (1.15%-3.38%) higher blood TC and LDL-C levels, respectively. Among the study participants with higher levels of dietary sodium or urinary sodium, exposure to higher levels of PM2.5 was significantly associated with deteriorated lipid profiles. For example, each 10 μg/m3 incremental change in exposure to PM2.5 was correlated with a 2.83 (-4.65 to -0.97) lower percentage decrease in blood HDL-C levels among the participants who were from the highest quartile of urinary sodium levels. While, these associations changed to be nonsignificant in the participants who were from the lowest quartile of dietary sodium levels. CONCLUSION Exposure to higher levels of PM2.5 was associated with deteriorated blood lipid levels in children and adolescents. It is noteworthy that these associations might be ameliorated through the adoption of a low-sodium dietary regimen.
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Affiliation(s)
- YuHeng Cao
- Department of Maternal and Child Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - YunJie Liu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - MengTing Ma
- Sichuan Center for Disease Control and Prevention, Nutrition and Food Hygiene Institute, Chengdu, 610041, Sichuan, China
| | - JiaRui Cai
- School of Public Health, Faculty of Medicine, Imperial College London, SW7 2BX, London, United Kingdom
| | - MengMeng Liu
- Sichuan Center for Disease Control and Prevention, Nutrition and Food Hygiene Institute, Chengdu, 610041, Sichuan, China
| | - Rui Zhang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - YunDi Jiang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Ling Yan
- Sichuan Center for Disease Control and Prevention, Nutrition and Food Hygiene Institute, Chengdu, 610041, Sichuan, China
| | - YueRan Cao
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - ZhenMi Liu
- Department of Maternal and Child Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| | - JiaQiang Liao
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
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Du J, Shao B, Gao Y, Wei Z, Zhang Y, Li H, Li J, Li G. Relationship between exposure to fine particulate matter and cardiovascular risk factors and the modifying effect of socioeconomic status: a cross-sectional study in Beijing, China. Front Public Health 2024; 12:1398396. [PMID: 39100956 PMCID: PMC11294222 DOI: 10.3389/fpubh.2024.1398396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 07/08/2024] [Indexed: 08/06/2024] Open
Abstract
Accumulating research suggested that long-term exposure to fine particulate matter (PM2.5) is related to cardiovascular disease (CVD). However, evidence regarding the relationship between PM2.5 and CVD risk factors remains inconsistent. We hypothesized that this association may be partially modified by socioeconomic status (SES). To investigate the relationships and to test the modifying effect of SES, we included baseline data for 21,018 adults from September 2017 to May 2018. PM2.5 concentrations were determined by employing an amalgamation of linear measurements obtained from monitoring stations located near the participants' residential and workplace addresses. We assessed SES across several domains, including income, education, and occupation levels, as well as through a composite SES index. The results indicated that for every 10 μg/m3 increase in PM2.5 exposure, the risk of hypercholesterolemia, hyperbetalipoproteinemia, diabetes, and hyperhomocysteinemia (HHcy) increased by 7.7% [Odds ratio (OR) = 1.077, 95% Confidence Interval (CI) = 1.011, 1.146], 19.6% (OR = 1.196, 95% CI = 1.091, 1.312), 4.2% (OR = 1.042, 95% CI = 1.002, 1.084), and 17.1% (OR = 1.171, 95% CI = 1.133, 1.209), respectively. Compared to the high SES group, those with low SES are more prone to hypercholesterolemia, hyperbetalipoproteinemia, diabetes, and HHcy. Notably, the disparities in SES appear significant in the relationship between PM2.5 exposure and hypercholesterolemia as well as hyperbetalipoproteinemia. But for diabetes and HHcy, the modification effect of SES on PM2.5 shows an inconsistent pattern. In conclusion, the results confirm the association between PM2.5 and cardiovascular risk factors and low SES significantly amplified the adverse PM2.5 effect on dyslipidemia. It is crucial to emphasize a need to improve the socioeconomic inequality among adults in Beijing and contribute to the understanding of the urgency in protecting the health of vulnerable groups.
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Affiliation(s)
- Jing Du
- Institute of Information and Statistics Center, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Bing Shao
- Beijing Key Laboratory of Diagnostic and Traceability Technologies for Food Poisoning, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Yanlin Gao
- Institute of Information and Statistics Center, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Zaihua Wei
- Institute of Information and Statistics Center, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Yu Zhang
- Hongzheng Medical Technology Co., Ltd., Tianjin, China
| | - Hong Li
- Beijing Key Laboratory of Diagnostic and Traceability Technologies for Food Poisoning, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Jiang Li
- Beijing Key Laboratory of Diagnostic and Traceability Technologies for Food Poisoning, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Gang Li
- Institute of Information and Statistics Center, Beijing Center for Disease Prevention and Control, Beijing, China
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Wu TQ, Han X, Liu CY, Zhao N, Ma J. A causal relationship between particulate matter 2.5 and obesity and its related indicators: a Mendelian randomization study of European ancestry. Front Public Health 2024; 12:1366838. [PMID: 38947357 PMCID: PMC11211571 DOI: 10.3389/fpubh.2024.1366838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 06/03/2024] [Indexed: 07/02/2024] Open
Abstract
Background In recent years, the prevalence of obesity has continued to increase as a global health concern. Numerous epidemiological studies have confirmed the long-term effects of exposure to ambient air pollutant particulate matter 2.5 (PM2.5) on obesity, but their relationship remains ambiguous. Methods Utilizing large-scale publicly available genome-wide association studies (GWAS), we conducted univariate and multivariate Mendelian randomization (MR) analyses to assess the causal effect of PM2.5 exposure on obesity and its related indicators. The primary outcome given for both univariate MR (UVMR) and multivariate MR (MVMR) is the estimation utilizing the inverse variance weighted (IVW) method. The weighted median, MR-Egger, and maximum likelihood techniques were employed for UVMR, while the MVMR-Lasso method was applied for MVMR in the supplementary analyses. In addition, we conducted a series of thorough sensitivity studies to determine the accuracy of our MR findings. Results The UVMR analysis demonstrated a significant association between PM2.5 exposure and an increased risk of obesity, as indicated by the IVW model (odds ratio [OR]: 6.427; 95% confidence interval [CI]: 1.881-21.968; P FDR = 0.005). Additionally, PM2.5 concentrations were positively associated with fat distribution metrics, including visceral adipose tissue (VAT) (OR: 1.861; 95% CI: 1.244-2.776; P FDR = 0.004), particularly pancreatic fat (OR: 3.499; 95% CI: 2.092-5.855; PFDR =1.28E-05), and abdominal subcutaneous adipose tissue (ASAT) volume (OR: 1.773; 95% CI: 1.106-2.841; P FDR = 0.019). Furthermore, PM2.5 exposure correlated positively with markers of glucose and lipid metabolism, specifically triglycerides (TG) (OR: 19.959; 95% CI: 1.269-3.022; P FDR = 0.004) and glycated hemoglobin (HbA1c) (OR: 2.462; 95% CI: 1.34-4.649; P FDR = 0.007). Finally, a significant negative association was observed between PM2.5 concentrations and levels of the novel obesity-related biomarker fibroblast growth factor 21 (FGF-21) (OR: 0.148; 95% CI: 0.025-0.89; P FDR = 0.037). After adjusting for confounding factors, including external smoke exposure, physical activity, educational attainment (EA), participation in sports clubs or gym leisure activities, and Townsend deprivation index at recruitment (TDI), the MVMR analysis revealed that PM2.5 levels maintained significant associations with pancreatic fat, HbA1c, and FGF-21. Conclusion Our MR study demonstrates conclusively that higher PM2.5 concentrations are associated with an increased risk of obesity-related indicators such as pancreatic fat content, HbA1c, and FGF-21. The potential mechanisms require additional investigation.
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Affiliation(s)
- Tian qiang Wu
- Department of First Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xinyu Han
- Department of First Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Chun yan Liu
- Department of Endocrinology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Na Zhao
- Department of Endocrinology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jian Ma
- Department of Endocrinology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
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Darras-Hostens M, Degrendel M, Amouyel P, Dauchet L. Association between residential air pollution exposure and cardiovascular risk factors in adults living in northern France. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2024; 46:232. [PMID: 38849665 DOI: 10.1007/s10653-024-02006-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/22/2024] [Indexed: 06/09/2024]
Abstract
Air pollution is associated with elevated cardiovascular mortality and an increase in cardiovascular risk factors. However, the literature data on associations between air pollution and cardiovascular risk factors are contradictory. To explore the relationship between residential exposure to atmospheric pollutants and cardiovascular risk factors (lipid biomarker and blood pressure levels). We studied a sample of 2339 adult participants in the ELISABET study from the Dunkirk and Lille urban areas of France. The mean annual exposure to atmospheric pollutants (PM10, NO2 and SO2) at the home address was estimated via an air dispersion model. The associations were probed in multivariate linear regression models. The mean NO2 level was 26.05 μg/m3 in Lille and 19.96 µg/m3 in Dunkirk. The mean PM10 level was 27.02 μg/m3 in Lille and 26.53 μg/m3 in Dunkirk. We detected a significant association between exposure to air pollutants and the high-density lipoprotein (HDL) (which is a protective factor against cardiovascular diseases) level: for a 2 µg/m3 increment in PM10, the HDL level decreased by 1.72% (p = 0.0037). None of the associations with other lipid variables or with blood pressure were significant. We didn't find evidence significant associations for most of the risk factors but, long-term exposure of adults to moderate levels of ambient air pollution was associated with a decrement in HDL.
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Affiliation(s)
- Marion Darras-Hostens
- Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de Risque Et Déterminants Moléculaires Des Maladies Liées Au Vieillissement, University of Lille, 59000, Lille, France
| | - Maxime Degrendel
- Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de Risque Et Déterminants Moléculaires Des Maladies Liées Au Vieillissement, University of Lille, 59000, Lille, France
| | - Philippe Amouyel
- Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de Risque Et Déterminants Moléculaires Des Maladies Liées Au Vieillissement, University of Lille, 59000, Lille, France
| | - Luc Dauchet
- Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de Risque Et Déterminants Moléculaires Des Maladies Liées Au Vieillissement, University of Lille, 59000, Lille, France.
- Epidemiology Unit, 2 Rue du Pr. Laguesse (MRRC), Lille University Medical Center, 59037, Lille Cedex, France.
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Zhu W, Al-Kindi SG, Rajagopalan S, Rao X. Air Pollution in Cardio-Oncology and Unraveling the Environmental Nexus: JACC: CardioOncology State-of-the-Art Review. JACC CardioOncol 2024; 6:347-362. [PMID: 38983383 PMCID: PMC11229557 DOI: 10.1016/j.jaccao.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/26/2024] [Accepted: 04/04/2024] [Indexed: 07/11/2024] Open
Abstract
Although recent advancements in cancer therapies have extended the lifespan of patients with cancer, they have also introduced new challenges, including chronic health issues such as cardiovascular disease arising from pre-existing risk factors or cancer therapies. Consequently, cardiovascular disease has become a leading cause of non-cancer-related death among cancer patients, driving the rapid evolution of the cardio-oncology field. Environmental factors, particularly air pollution, significantly contribute to deaths associated with cardiovascular disease and specific cancers, such as lung cancer. Despite these statistics, the health impact of air pollution in the context of cardio-oncology has been largely overlooked in patient care and research. Notably, the impact of air pollution varies widely across geographic areas and among individuals, leading to diverse exposure consequences. This review aims to consolidate epidemiologic and preclinical evidence linking air pollution to cardio-oncology while also exploring associated health disparities and environmental justice issues.
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Affiliation(s)
- Wenqiang Zhu
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Sadeer G Al-Kindi
- Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
| | - Sanjay Rajagopalan
- Harrington Heart and Vascular Institute, University Hospitals, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Xiaoquan Rao
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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7
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Shi W, Schooling CM, Leung GM, Zhao JV. Early-life exposure to ambient air pollution with cardiovascular risk factors in adolescents: Findings from the "Children of 1997" Hong Kong birth cohort. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 921:171119. [PMID: 38382602 DOI: 10.1016/j.scitotenv.2024.171119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/27/2024] [Accepted: 02/18/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Long-term exposure to ambient air pollution is associated with cardiovascular disease (CVD) risk. Little is known about the impact of early-life exposure to air pollutants on CVD risk factors in late adolescence, which may track into adulthood. To clarify, we examined this question in a unique setting with high air pollution and a high level of economic development. METHODS This study leveraged the "Children of 1997" Hong Kong birth cohort (N = 8327), including here 3350 participants. We estimated ambient air pollutant exposure including inhalable particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2) and nitrogen monoxide (NO) by growth phase (in utero, infancy, childhood) and overall based on residential address. Generalized linear regression was used to assess the associations of air pollutants exposure by growth phase and sex with CVD risk factors (fasting blood glucose, glycosylated hemoglobin, lipid profile, blood pressure, and body mass index) at 17.6 years. We also assessed whether associations varied by sex. RESULTS Early life exposed had little association with glucose metabolism, blood pressure or body mass index, but after considering multiple comparisons early exposure to PM10 was associated with low density lipoprotein (LDL) in boys, with β and 95 % confidence intervals (95 % CI) of 0.184 (0.069 to 0.298) mmol/l, 0.151 (0.056 to 0.248) mmol/l, and 0.157 (0.063 to 0.252) mmol/l by per interquartile range (IQR) increment of PM10 for in utero, infancy, and overall, respectively. No such associations were evident for girls, differences by sex were evident. CONCLUSIONS Our study suggested sex-specific associations of early-life PM10 exposure with elevated LDL in adolescence, especially exposure in utero and infancy.
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Affiliation(s)
- Wenming Shi
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Gabriel M Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Jie V Zhao
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
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Valdés S, Doulatram-Gamgaram V, Maldonado-Araque C, García-Escobar E, García-Serrano S, Oualla-Bachiri W, García-Vivanco M, Garrido JL, Gil V, Martín-Llorente F, Calle-Pascual A, Castaño L, Delgado E, Menéndez E, Franch-Nadal J, Gaztambide S, Girbés J, Chaves FJ, Galán-García JL, Aguilera-Venegas G, Vallvé JC, Amigó N, Guardiola M, Ribalta J, Rojo-Martínez G. Association between exposure to air pollution and blood lipids in the general population of Spain. Eur J Clin Invest 2024; 54:e14101. [PMID: 37795744 DOI: 10.1111/eci.14101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/13/2023] [Accepted: 09/23/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND AND AIMS We aimed to assess the associations of exposure to air pollutants and standard and advanced lipoprotein measures, in a nationwide sample representative of the adult population of Spain. METHODS We included 4647 adults (>18 years), participants in the national, cross-sectional, population-based di@bet.es study, conducted in 2008-2010. Standard lipid measurements were analysed on an Architect C8000 Analyzer (Abbott Laboratories SA). Lipoprotein analysis was made by an advanced 1 H-NMR lipoprotein test (Liposcale®). Participants were assigned air pollution concentrations for particulate matter <10 μm (PM10 ), <2.5 μm (PM2.5 ) and nitrogen dioxide (NO2 ), corresponding to the health examination year, obtained by modelling combined with measurements taken at air quality stations (CHIMERE chemistry-transport model). RESULTS In multivariate linear regression models, each IQR increase in PM10 , PM2.5 and NO2 was associated with 3.3%, 3.3% and 3% lower levels of HDL-c and 1.3%, 1.4% and 1.1% lower HDL particle (HDL-p) concentrations (p < .001 for all associations). In multivariate logistic regression, there was a significant association between PM10 , PM2.5 and NO2 concentrations and the odds of presenting low HDL-c (<40 mg/dL), low HDL-p ( CONCLUSIONS Our study shows an association between the exposure to air pollutants and blood lipids in the general population of Spain, suggesting a link to atherosclerosis.
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Affiliation(s)
- Sergio Valdés
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Viyey Doulatram-Gamgaram
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
| | - Cristina Maldonado-Araque
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Eva García-Escobar
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Sara García-Serrano
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Wasima Oualla-Bachiri
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta García-Vivanco
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT) - División de Contaminación Atmosférica, Madrid, Spain
| | - Juan Luis Garrido
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT) - División de Contaminación Atmosférica, Madrid, Spain
| | - Victoria Gil
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT) - División de Contaminación Atmosférica, Madrid, Spain
| | - Fernando Martín-Llorente
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT) - División de Contaminación Atmosférica, Madrid, Spain
| | - Alfonso Calle-Pascual
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition and Instituto de Investigación Sanitaria University Hospital S. Carlos (IdISSC), Department Medicine II, Universidad Complutense (UCM), Madrid, Spain
| | - Luis Castaño
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitario Cruces, BioCruces, UPV/EHU, Barakaldo, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Elías Delgado
- Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias/University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Edelmiro Menéndez
- Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias/University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Josep Franch-Nadal
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Primary Care, Unitat de Suport a la Recerca (IDIAP - Fundació Jordi Gol), Barcelona, Spain
| | - Sonia Gaztambide
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Cruces - BioCruces Bizkaia - UPV-EHU, Baracaldo, Barcelona, Spain
| | - Joan Girbés
- Diabetes Unit, Hospital Arnau de Vilanova, Valencia, Spain
| | - F Javier Chaves
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Genomic Studies and Genetic Diagnosis Unit, Fundación de Investigación del Hospital Clínico de Valencia - INCLIVA, Valencia, Spain
| | | | | | - Joan Carles Vallvé
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Research Unit on Lipids and Atherosclerosis, Sant Joan University Hospital, Rovira i Virgili University, IISPV, Reus, Spain
| | - Núria Amigó
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Metabolomics Platform, Universitat Rovira i Virgili, IISRV, Reus, Spain
- Biosfer Teslab, Reus, Spain
| | - Montse Guardiola
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Research Unit on Lipids and Atherosclerosis, Sant Joan University Hospital, Rovira i Virgili University, IISPV, Reus, Spain
| | - Josep Ribalta
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Research Unit on Lipids and Atherosclerosis, Sant Joan University Hospital, Rovira i Virgili University, IISPV, Reus, Spain
| | - Gemma Rojo-Martínez
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
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9
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Zhou Q, Li X, Zhang J, Duan Z, Mao S, Wei J, Han S, Niu Z. Long-term exposure to PM 1 is associated with increased prevalence of metabolic diseases: evidence from a nationwide study in 123 Chinese cities. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:549-563. [PMID: 38015390 DOI: 10.1007/s11356-023-31098-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Abstract
Exposure to particulate matter (PM) has been linked to metabolic diseases. However, the effects of PM with an aerodynamic diameter ≤ 1.0 µm (PM1) on metabolic diseases remain unclear. This study is aimed at assessing the associations of PM1 with metabolic disease risk and quantifying the concentration-response (C-R) relationship of PM1 with metabolic disease risk. A national cross-sectional study was conducted, including 12,495 middle-aged and older adults in 123 Chinese cities. The two-year average concentration of PM1 was evaluated using satellite-based spatiotemporal models. Metabolic diseases, including abdominal obesity, diabetes, hypertension, dyslipidemia, and metabolic syndrome, were identified based on physical examination, blood standard biochemistry examination, and self-reported disease histories. Generalized linear models and C-R curves were used to evaluate the associations of PM1 with metabolic diseases. A total of 12,495 participants were included in this study, with a prevalence of 45.73% for abdominal obesity, 20.22% for diabetes, 42.46% for hypertension, 41.01% for dyslipidemia, and 33.78% for metabolic syndrome. The mean ± standard deviation age of participants was 58.79 ± 13.14 years. In addition to dyslipidemia, exposure to PM1 was associated with increased risks of abdominal obesity, diabetes, hypertension, and metabolic syndrome. Each 10 μg/m3 increase in PM1 concentrations was associated with 39% (odds ratio (OR) = 1.39, 95% confidence interval (CI) 1.33, 1.46) increase in abdominal obesity, 18% (OR = 1.18, 95%CI 1.12, 1.25) increase in diabetes, 11% (OR = 1.11, 95%CI 1.06, 1.16) increase in hypertension, and 25% (OR = 1.25, 95%CI 1.19, 1.31) in metabolic syndrome, respectively. C-R curves showed that the OR values of abdominal obesity, diabetes, hypertension, and metabolic syndrome were increased gradually with the increase of PM1 concentrations. Subgroup analysis indicated that exposure to PM1 was associated with increased metabolic disease risks among participants with different lifestyles and found that solid fuel users were more susceptible to PM1 than clean fuel users. This national cross-sectional study indicated that exposure to higher PM1 might increase abdominal obesity, diabetes, hypertension, and metabolic syndrome risk, and solid fuel use might accelerate the adverse effects of PM1 on metabolic syndrome risk. Further longitudinal cohort studies are warranted to establish a causal inference between PM1 exposure and metabolic disease risk.
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Affiliation(s)
- Qin Zhou
- Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, No. 98 XiWu Road, Xi'an, 710004, Shaanxi, China
| | - Xianfeng Li
- Department of Reproductive Service Technology, Urumqi Maternal and Child Health Hospital, No. 344 Jiefang South Road, Tianshan District, Urumqi, 830000, China
| | - Jinglong Zhang
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, 127 West Changle Road, Xi'an, 710032, China
| | - Zhizhou Duan
- Preventive Health Service, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, 152 Aiguo Road, Nanchang, Jiangxi, China
| | - Shuyuan Mao
- The Third Affiliated Hospital of Zhengzhou University, 7 Kangfu Road, Zhengzhou, 450000, Henan, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, USA
| | - Shichao Han
- Department of Urology, Xijing Hospital, The Fourth Military Medical University, 127 West Changle Road, Xi'an, 710032, China
| | - Zhiping Niu
- Department of Environmental Health, School of Public Health, Fudan University, 196 Xietu Road, Shanghai, 200032, China.
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10
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Han X, Guo B, Wang L, Chen K, Zhou H, Huang S, Xu H, Pan X, Chen J, Gao X, Wang Z, Yang L, Laba C, Meng Q, Guo Y, Chen G, Hong F, Zhao X. The mediation role of blood lipids on the path from air pollution exposure to MAFLD: A longitudinal cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 904:166347. [PMID: 37591384 DOI: 10.1016/j.scitotenv.2023.166347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/12/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND & AIMS Recent cross-sectional studies found that exposure to ambient air pollution (AP) was associated with an increased risk of metabolic dysfunction-associated fatty liver disease (MAFLD). The alternation of blood lipids may explain the association, but epidemiological evidence is lacking. We aimed to examine whether and to what extent the association between long-term exposure to AP and incident MAFLD is mediated by blood lipids and dyslipidemia in a prospective cohort. METHODS We included 6350 participants from the China Multi-Ethnic Cohort (CMEC, baseline 2018-2019, follow-up 2020-2021). Three-year average (2016-2018) of AP (PM1, PM2.5, PM10, NO2), blood lipids (TC, LDL-C, HDL-C, TG with their combinations) and incident MAFLD for each individual were assessed chronologically. Linear and logistic regression was used to assess the associations among AP, blood lipids, and MAFLD, and the potential mediation effects of blood lipids were evaluated using causal mediation analysis. RESULTS A total of 744 participants were newly diagnosed with MAFLD at follow-up. The odds ratios of MAFLD associated with a 10 μm increase in PM1, PM2.5, and NO2 were 1.35 (95 % CI: 1.14, 1.58), 1.34 (1.10, 1.65) and 1.28 (1.14, 1.44), respectively. Blood lipids are important mediators between AP and incident MAFLD. LDL-C (Proportion Mediated: 6.9 %), non-HDL (13.4 %), HDL-C (20.7 %), LDL/HDL (30.1 %), and dyslipidemia (6.5 %) significantly mediated the association between PM2.5 and MAFLD. For PM1, the indirect effects were similar to those for PM2.5, with a larger value for the direct effect, and the mediation proportion by blood lipids was less for NO2. CONCLUSION Blood lipids are important mediators between AP and MAFLD, and can explain 5 %-30 % of the association between AP and incident MAFLD, particularly cholesterol-related variables, indicating that AP could lead to MAFLD through the alternation of blood lipids. These findings provided mechanical evidence of AP leading to MAFLD in epidemiological studies.
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Affiliation(s)
- Xinyu Han
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bing Guo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lele Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kejun Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hanwen Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shourui Huang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Huan Xu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China; Institute for Disaster Management and Reconstruction, Sichuan University-The Hongkong Polytechnic University, Chengdu, Sichuan, China
| | - Xianmou Pan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jinyao Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xufang Gao
- Chengdu Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Zhenghong Wang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - La Yang
- Tibet University, Lhasa, Tibet, China
| | - Ciren Laba
- Tibet Center for Disease Control and Prevention CN, Lhasa, Tibet, China
| | - Qiong Meng
- Department of Epidemiology and Health Statistics, School of public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Gongbo Chen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Feng Hong
- School of Public Health, the key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China.
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
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11
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Guo H, Wang M, Ye Y, Huang C, Wang S, Peng H, Wang X, Fan M, Hou T, Wu X, Huang X, Yan Y, Zheng K, Wu T, Li L. Short-Term Exposure to Nitrogen Dioxide Modifies Genetic Predisposition in Blood Lipid and Fasting Plasma Glucose: A Pedigree-Based Study. BIOLOGY 2023; 12:1470. [PMID: 38132296 PMCID: PMC10740487 DOI: 10.3390/biology12121470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/13/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023]
Abstract
(1) Background: Previous studies suggest that exposure to nitrogen dioxide (NO2) has a negative impact on health. But few studies have explored the association between NO2 and blood lipids or fasting plasma glucose (FPG), as well as gene-air pollution interactions. This study aims to fill this knowledge gap based on a pedigree cohort in southern China. (2) Methods: Employing a pedigree-based design, 1563 individuals from 452 families participated in this study. Serum levels of triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDLC), high-density lipoprotein cholesterol (HDLC), and FPG were measured. We investigated the associations between short-term NO2 exposure and lipid profiles or FPG using linear mixed regression models. The genotype-environment interaction (GenoXE) for each trait was estimated using variance component models. (3) Results: NO2 was inversely associated with HDLC but directly associated with TG and FPG. The results showed that each 1 μg/m3 increase in NO2 on day lag0 corresponded to a 1.926% (95%CI: 1.428-2.421%) decrease in HDLC and a 1.400% (95%CI: 0.341-2.470%) increase in FPG. Moreover, we observed a significant genotype-NO2 interaction with HDLC and FPG. (4) Conclusion: This study highlighted the association between NO2 exposure and blood lipid profiles or FPG. Additionally, our investigation suggested the presence of genotype-NO2 interactions in HDLC and FPG, indicating potential loci-specific interaction effects. These findings have the potential to inform and enhance the interpretation of studies that are focused on specific gene-environment interactions.
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Affiliation(s)
- Huangda Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (H.G.)
| | - Mengying Wang
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - Ying Ye
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350012, China
| | - Chunlan Huang
- Department of Hygiene, Nanjing Country Center for Disease Control and Prevention, Nanjing 363600, China
| | - Siyue Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (H.G.)
| | - Hexiang Peng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (H.G.)
| | - Xueheng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (H.G.)
| | - Meng Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (H.G.)
| | - Tianjiao Hou
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (H.G.)
| | - Xiaoling Wu
- Department of Hygiene, Nanjing Country Center for Disease Control and Prevention, Nanjing 363600, China
| | - Xiaoming Huang
- Department of Hygiene, Nanjing Country Center for Disease Control and Prevention, Nanjing 363600, China
| | - Yansheng Yan
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350012, China
| | - Kuicheng Zheng
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350012, China
| | - Tao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (H.G.)
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
- Key Laboratory of Reproductive Health, Ministry of Health, Beijing 100191, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (H.G.)
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
- Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing 100191, China
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12
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Yang X, Xu D, Wen B, Ji J, Zhang Z, Li L, Zhang S, Zhi H, Kong J, Wang C, Wang J, Ruan H, Zhang M, Wei L, Dong B, Wang Q. The mediating role of exhaled breath condensate metabolites in the effect of particulate matter on pulmonary function in schoolchildren: A crossover intervention study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 898:165517. [PMID: 37459994 DOI: 10.1016/j.scitotenv.2023.165517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 07/27/2023]
Abstract
The role played by metabolites in exhaled breath condensate (EBC) in the effect of PM on schoolchildren's pulmonary function has received little attention. Accordingly, we examined whether metabolites in EBC mediated the effect of PM10, PM2.5, and PM1 on the pulmonary function of schoolchildren at a residential primary school who had received an air-cleaner cross-over intervention. Samples of EBC were collected from a total of 60 schoolchildren and subjected to metabolomics analysis. We found that the effect of PM on six pulmonary function indicators was mediated by the following nine lipid peroxidation-related and energy metabolism-related metabolites present in EBC: 4-hydroxynonenal, arachidoyl ethanolamide, dl-pyroglutamic acid, 5-deoxy-d-glucose, myristic acid, lauric acid, linoleic acid, l-proline, and palmitic acid. However, while all nine of these metabolites mediated the effects of PM on boys' pulmonary function, only 4-hydroxynonenal, arachidoyl ethanolamide, and dl-pyroglutamic acid mediated the effects of PM on girls' pulmonary function. Overall, our results show that (1) short-term exposure to PM affected the schoolchildren's pulmonary function by causing an imbalance between lipid peroxidation and glutathione-based antioxidant activity and by perturbing energy metabolism in respiratory system and (2) there was a sex-dependent antioxidant response to PM exposure, with boys being less resistant than girls.
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Affiliation(s)
- Xiaoyan Yang
- Key Laboratory of Environment and Human Health, Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; Department of Environmental Toxicology, Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Dongqun Xu
- Key Laboratory of Environment and Human Health, Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; Department of Air Quality and Health Monitoring, Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China.
| | - Bo Wen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
| | - Jian Ji
- Hazard Screening and Omic Platform, Analysis and Testing Center, Jiangnan University, Wuxi, Jiangsu 214122, China
| | - Zeyu Zhang
- Jiangxi Academy of Clinical Medical Sciences, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China
| | - Li Li
- Department of Environmental Toxicology, Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Shaoping Zhang
- Department of Environmental Toxicology, Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Hong Zhi
- Department of Environmental Toxicology, Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Jian Kong
- Department of Environmental Toxicology, Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Chong Wang
- Department of Environmental Toxicology, Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Jun Wang
- Key Laboratory of Environment and Human Health, Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Hongjie Ruan
- Department of Environmental Toxicology, Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Ming Zhang
- Department of Environmental Toxicology, Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Lan Wei
- Department of Environmental Toxicology, Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Bin Dong
- Department of Air Quality and Health Monitoring, Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Qin Wang
- Key Laboratory of Environment and Human Health, Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China.
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13
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Zhang Y, Shi J, Ma Y, Yu N, Zheng P, Chen Z, Wang T, Jia G. Association between Air Pollution and Lipid Profiles. TOXICS 2023; 11:894. [PMID: 37999546 PMCID: PMC10675150 DOI: 10.3390/toxics11110894] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/30/2023] [Accepted: 10/28/2023] [Indexed: 11/25/2023]
Abstract
Dyslipidemia is a critical factor in the development of atherosclerosis and consequent cardiovascular disease. Numerous pieces of evidence demonstrate the association between air pollution and abnormal blood lipids. Although the results of epidemiological studies on the link between air pollution and blood lipids are unsettled due to different research methods and conditions, most of them corroborate the harmful effects of air pollution on blood lipids. Mechanism studies have revealed that air pollution may affect blood lipids via oxidative stress, inflammation, insulin resistance, mitochondrial dysfunction, and hypothalamic hormone and epigenetic changes. Moreover, there is a risk of metabolic diseases associated with air pollution, including fatty liver disease, diabetes mellitus, and obesity, which are often accompanied by dyslipidemia. Therefore, it is biologically plausible that air pollution affects blood lipids. The overall evidence supports that air pollution has a deleterious effect on blood lipid health. However, further research into susceptibility, indoor air pollution, and gaseous pollutants is required, and the issue of assessing the effects of mixtures of air pollutants remains an obstacle for the future.
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Affiliation(s)
- Yi Zhang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China; (Y.Z.); (J.S.); (Y.M.); (N.Y.); (P.Z.); (G.J.)
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, School of Public Health, Peking University, Beijing 100083, China
| | - Jiaqi Shi
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China; (Y.Z.); (J.S.); (Y.M.); (N.Y.); (P.Z.); (G.J.)
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, School of Public Health, Peking University, Beijing 100083, China
| | - Ying Ma
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China; (Y.Z.); (J.S.); (Y.M.); (N.Y.); (P.Z.); (G.J.)
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, School of Public Health, Peking University, Beijing 100083, China
| | - Nairui Yu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China; (Y.Z.); (J.S.); (Y.M.); (N.Y.); (P.Z.); (G.J.)
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, School of Public Health, Peking University, Beijing 100083, China
| | - Pai Zheng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China; (Y.Z.); (J.S.); (Y.M.); (N.Y.); (P.Z.); (G.J.)
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, School of Public Health, Peking University, Beijing 100083, China
| | - Zhangjian Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China; (Y.Z.); (J.S.); (Y.M.); (N.Y.); (P.Z.); (G.J.)
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, School of Public Health, Peking University, Beijing 100083, China
| | - Tiancheng Wang
- Department of Laboratory Medicine, Peking University Third Hospital, Beijing 100191, China;
| | - Guang Jia
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China; (Y.Z.); (J.S.); (Y.M.); (N.Y.); (P.Z.); (G.J.)
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, School of Public Health, Peking University, Beijing 100083, China
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Zhao Y, Shen G, Lin X, Zhang L, Fan F, Zhang Y, Li J. Identifying the Relationship between PM 2.5 and Hyperlipidemia Using Mendelian Randomization, RNA-seq Data and Model Mice Subjected to Air Pollution. TOXICS 2023; 11:823. [PMID: 37888673 PMCID: PMC10611378 DOI: 10.3390/toxics11100823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/19/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023]
Abstract
Air pollution is an important public health problem that endangers human health. However, the casual association and pathogenesis between particles < 2.5 μm (PM2.5) and hyperlipidemia remains incompletely unknown. Mendelian randomization (MR) and transcriptomic data analysis were performed, and an air pollution model using mice was constructed to investigate the association between PM2.5 and hyperlipidemia. MR analysis demonstrated that PM2.5 is associated with hyperlipidemia and the triglyceride (TG) level in the European population (IVW method of hyperlipidemia: OR: 1.0063, 95%CI: 1.0010-1.0118, p = 0.0210; IVW method of TG level: OR: 1.1004, 95%CI: 1.0067-1.2028, p = 0.0350). Mest, Adipoq, Ccl2, and Pcsk9 emerged in the differentially expressed genes of the liver and plasma of PM2.5 model mice, which might mediate atherosclerosis accelerated by PM2.5. The studied animal model shows that the Paigen Diet (PD)-fed male LDLR-/- mice had higher total cholesterol (TC), TG, and CM/VLDL cholesterol levels than the control group did after 10 times 5 mg/kg PM2.5 intranasal instillation once every three days. Our study revealed that PM2.5 had causality with hyperlipidemia, and PM2.5 might affect liver secretion, which could further regulate atherosclerosis. The lipid profile of PD-fed Familial Hypercholesterolemia (FH) model mice is more likely to be jeopardized by PM2.5 exposure.
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Affiliation(s)
- Yixue Zhao
- Division of Cardiology, Peking University First Hospital, Beijing 100034, China; (Y.Z.); (G.S.); (X.L.); (L.Z.); (F.F.); (Y.Z.)
| | - Geng Shen
- Division of Cardiology, Peking University First Hospital, Beijing 100034, China; (Y.Z.); (G.S.); (X.L.); (L.Z.); (F.F.); (Y.Z.)
| | - Xipeng Lin
- Division of Cardiology, Peking University First Hospital, Beijing 100034, China; (Y.Z.); (G.S.); (X.L.); (L.Z.); (F.F.); (Y.Z.)
| | - Long Zhang
- Division of Cardiology, Peking University First Hospital, Beijing 100034, China; (Y.Z.); (G.S.); (X.L.); (L.Z.); (F.F.); (Y.Z.)
| | - Fangfang Fan
- Division of Cardiology, Peking University First Hospital, Beijing 100034, China; (Y.Z.); (G.S.); (X.L.); (L.Z.); (F.F.); (Y.Z.)
| | - Yan Zhang
- Division of Cardiology, Peking University First Hospital, Beijing 100034, China; (Y.Z.); (G.S.); (X.L.); (L.Z.); (F.F.); (Y.Z.)
| | - Jianping Li
- Division of Cardiology, Peking University First Hospital, Beijing 100034, China; (Y.Z.); (G.S.); (X.L.); (L.Z.); (F.F.); (Y.Z.)
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing 100034, China
- State Key Laboratory of Vascular Homeostasis and Remodeling, Beijing 100191, China
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Pan X, Hong F, Li S, Wu J, Xu H, Yang S, Chen K, Baima K, Nima Q, Meng Q, Xia J, Xu J, Guo B, Lin H, Xie L, Zhang J, Zhao X. Long-term exposure to ambient PM 2.5 constituents is associated with dyslipidemia in Chinese adults. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 263:115384. [PMID: 37603926 DOI: 10.1016/j.ecoenv.2023.115384] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Ambient particulate matter with aerodynamic diameter ≤ 2.5 µm (PM2.5) consists of various toxic constituents. However, the health effect of PM2.5 may differ depending on its constituents, but the joint effect of PM2.5 constituents remains incompletely understood. OBJECTIVE Our goal was to evaluate the joint effect of long-term PM2.5 constituent exposures on dyslipidemia and identify the most hazardous chemical constituent. METHODS This study included 67,015 participants from the China Multi-Ethnic Cohort study. The average yearly levels of PM2.5 constituents for all individuals at their residences were assessed through satellite remote sensing and chemical transport modeling. Dyslipidemia was defined as one or more following abnormal blood lipid concentrations: total cholesterol (TC) ≥ 6.22 mmol/L, triglycerides (TG) ≥ 2.26 mmol/L, high-density lipoprotein cholesterol (HDL-C) < 1.04 mmol/L, and low-density lipoprotein cholesterol (LDL-C) ≥ 4.14 mmol/L. The logistic regression model was utilized to examine the single effect of PM2.5 constituents on dyslipidemia, while the weighted quantile sum regression model for the joint effect. RESULTS The odds ratio with a 95 % confidence interval for dyslipidemia positively related to per-SD increase in the three-year average was 1.29 (1.20-1.38) for PM2.5 mass, 1.25 (1.17-1.34) for black carbon, 1.24 (1.16-1.33) for ammonium, 1.33 (1.24-1.43) for nitrate, 1.34 (1.25-1.44) for organic matter, 1.15 (1.08-1.23) for sulfate, 1.30 (1.22-1.38) for soil particles, and 1.12 (1.05-1.92) for sea salt. Stronger associations were observed in individuals < 65 years of age, males, and those with low physical activity. Joint exposure to PM2.5 constituents was positively related to dyslipidemia (OR: 1.09, 95 %CI: 1.05-1.14). Nitrate was identified as the constituent with the largest weight (weighted at 0.387). CONCLUSIONS Long-term exposure to PM2.5 constituents poses a significant risk to dyslipidemia and nitrate might be the most responsible for the risk. These findings indicate that reducing PM2.5 constituent exposures, especially nitrate, could be beneficial to alleviate the burden of disease attributed to PM2.5-related dyslipidemia.
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Affiliation(s)
- Xianmou Pan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Feng Hong
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Sicheng Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jialong Wu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Huan Xu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China; Institute for Disaster Management and Reconstruction, Sichuan University-The Hongkong Polytechnic University, Chengdu, Sichuan, China
| | - Shaokun Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kejun Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kangzhuo Baima
- School of Medicine, Tibet University, Lhasa, Tibet, China
| | - Qucuo Nima
- Tibet Center for Disease Control and Prevention, Lhasa, Tibet, China
| | - Qiong Meng
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Jinjie Xia
- Chengdu Center for Disease Control & Prevention, China
| | - Jingru Xu
- Chongqing Municipal Center for Disease Control and Prevention, China
| | - Bing Guo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Linshen Xie
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Juying Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
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16
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Wang Q, Wang Z, Chen M, Mu W, Xu Z, Xue M. Causality of particulate matter on cardiovascular diseases and cardiovascular biomarkers. Front Public Health 2023; 11:1201479. [PMID: 37732088 PMCID: PMC10507646 DOI: 10.3389/fpubh.2023.1201479] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/31/2023] [Indexed: 09/22/2023] Open
Abstract
Background Previous observational studies have shown that the prevalence of cardiovascular diseases (CVDs) is related to particulate matter (PM). However, given the methodological limitations of conventional observational research, it is difficult to identify causality conclusively. To explore the causality of PM on CVDs and cardiovascular biomarkers, we conducted a Mendelian randomization (MR) analysis. Method In this study, we obtained summary-level data for CVDs and cardiovascular biomarkers including atrial fibrillation (AF), heart failure (HF), myocardial infarction (MI), ischemic stroke (IS), stroke subtypes, body mass index (BMI), lipid traits, fasting glucose, fasting insulin, and blood pressure from several large genome-wide association studies (GWASs). Then we used two-sample MR to assess the causality of PM on CVDs and cardiovascular biomarkers, 16 single nucleotide polymorphisms (SNPs) for PM2.5 and 6 SNPs for PM10 were obtained from UK Biobank participants. Inverse variance weighting (IVW) analyses under the fixed effects model were used as the main analytical method to calculate MR Estimates, followed by multiple sensitivity analyses to confirm the robustness of the results. Results Our study revealed increases in PM2.5 concentration were significantly related to a higher risk of MI (odds ratio (OR), 2.578; 95% confidence interval (CI), 1.611-4.127; p = 7.920 × 10-5). Suggestive evidence was found between PM10 concentration and HF (OR, 2.015; 95% CI, 1.082-3.753; p = 0.027) and IS (OR, 2.279; 95% CI,1.099-4.723; p = 0.027). There was no evidence for an effect of PM concentration on other CVDs. Furthermore, PM2.5 concentration increases were significantly associated with increases in triglyceride (TG) (OR, 1.426; 95% CI, 1.133-1.795; p = 2.469 × 10-3) and decreases in high-density lipoprotein cholesterol (HDL-C) (OR, 0.779; 95% CI, 0.615-0.986; p = 0.038). The PM10 concentration increases were also closely related to the decreases in HDL-C (OR, 0.563; 95% CI, 0.366-0.865; p = 8.756 × 10-3). We observed no causal effect of PM on other cardiovascular biomarkers. Conclusion At the genetic level, our study suggested the causality of PM2.5 on MI, TG, as well HDL-C, and revealed the causality of PM10 on HF, IS, and HDL-C. Our findings indicated the need for continued improvements in air pollution abatement for CVDs prevention.
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Affiliation(s)
- Qiubo Wang
- Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Cardiac Electrophysiology and Arrhythmia, Jinan, China
- Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Zhimiao Wang
- Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Cardiac Electrophysiology and Arrhythmia, Jinan, China
| | - Mingyou Chen
- Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Cardiac Electrophysiology and Arrhythmia, Jinan, China
| | - Wei Mu
- Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Cardiac Electrophysiology and Arrhythmia, Jinan, China
| | - Zhenxing Xu
- Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Cardiac Electrophysiology and Arrhythmia, Jinan, China
| | - Mei Xue
- Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Cardiac Electrophysiology and Arrhythmia, Jinan, China
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Abstract
As the world's population becomes increasingly urbanized, there is growing concern about the impact of urban environments on cardiovascular health. Urban residents are exposed to a variety of adverse environmental exposures throughout their lives, including air pollution, built environment, and lack of green space, which may contribute to the development of early cardiovascular disease and related risk factors. While epidemiological studies have examined the role of a few environmental factors with early cardiovascular disease, the relationship with the broader environment remains poorly defined. In this article, we provide a brief overview of studies that have examined the impact of the environment including the built physical environment, discuss current challenges in the field, and suggest potential directions for future research. Additionally, we highlight the clinical implications of these findings and propose multilevel interventions to promote cardiovascular health among children and young adults.
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Affiliation(s)
- Kai Zhang
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA
| | - Robert D Brook
- Division of Cardiovascular Diseases, Department of Internal Medicine, Wayne State University, Detroit, MI, USA
| | - Yuanfei Li
- Department of Sociology, University at Albany, State University of New York, Albany, NY, USA
| | - Sanjay Rajagopalan
- Cardiovascular Research Institute, University Hospitals Harrington Heart and Vascular Institute, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Juyong Brian Kim
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, CA, USA; Stanford Cardiovascular Institute, Stanford University, Stanford, CA, USA
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Jiang Q, Luo X, Zheng R, Xiang Z, Zhu K, Feng Y, Xiao P, Zhang Q, Wu X, Fan Y, Song R. Exposure to ambient air pollution with depressive symptoms and anxiety symptoms among adolescents: A national population-based study in China. J Psychiatr Res 2023; 164:1-7. [PMID: 37290272 DOI: 10.1016/j.jpsychires.2023.05.077] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 05/08/2023] [Accepted: 05/26/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Air pollution threatens adolescents' physical health and adversely affects adolescents' mental health. Previous studies mostly focused on the effects of air pollution on physical health, but there were few studies on the effects of air pollution on mental health. METHODS We collected scores of depressive symptoms and anxiety symptoms from 15,331 adolescents from 43 schools in eleven provinces in September and November 2017. The data on air pollution comes from the China High Air Pollutants dataset, which included concentrations of particulate matter with diameters of ≤1.0 μm (PM1), diameters of ≤2.5 μm (PM2.5), and diameters of ≤10 μm (PM10), as well as nitrogen dioxide (NO2). The associations between air pollution and depressive and anxiety symptoms among adolescents were estimated using generalized linear mixed models. RESULTS Depressive and anxiety symptoms among Chinese adolescents were 16% and 32%, respectively. In the adjusted model, an interquartile range (IQR) increase from PM2.5 was associated with the odds of anxiety symptoms [odds ratio (OR) = 1.01; 95% confidence interval (CI): 1.00, 1.01, P = 0.002]. Also, an IQR increase in PM10 was significantly associated with the odds of anxiety symptoms (OR = 1.01; 95% CI: 1.00, 1.01, P = 0.029). Compared with the lowest quartile, the adjusted OR of anxiety symptoms for the highest quartile of PM2.5 and PM10 were 1.29 (1.15, 1.44) and 1.23 (1.06, 1.42), respectively. In addition, the association between PM2.5 and depressive symptoms was significant. The robustness of the results was also confirmed by stratification and sensitivity analyses. CONCLUSIONS Exposure values for airborne particulate matter were associated with depressive symptoms and anxiety symptoms in adolescents, particularly for PM2.5 and PM10 with anxiety symptoms among adolescents.
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Affiliation(s)
- Qi Jiang
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaomin Luo
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, China
| | - Ruimin Zheng
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, China.
| | - Zhen Xiang
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kaiheng Zhu
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanan Feng
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pei Xiao
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Quan Zhang
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xufang Wu
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yixi Fan
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ranran Song
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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19
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Mei Y, Li A, Zhao J, Zhou Q, Zhao M, Xu J, Li Y, Li K, Xu Q. Association of Long-term exposure to air pollution and residential greenness with lipid profile: Mediating role of inflammation. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 257:114920. [PMID: 37105095 DOI: 10.1016/j.ecoenv.2023.114920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/22/2023] [Accepted: 04/15/2023] [Indexed: 05/08/2023]
Abstract
Lipidemic effect of air pollutants are still inconsistent and their joint effects are neglected. Meanwhile, identified inflammation pathways in animal have not been applied in epidemiological studies, and beneficial effect of residential greenness remained unclear. Therefore, we used data from typically air-polluted Chinese cities to answer these questions. Particulate matter (PM) with a diameter of ≤ 1 µm (PM1), PM with a diameter of ≤ 2.5 µm (PM2.5), PM with a diameter of ≤ 10 µm (PM10), sulphur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3) were predicted by space-time extremely randomized trees model. Residential greenness was reflected by Normalized Difference Vegetation Index (NDVI). Total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were measured, and atherogenic coefficient (AC) and TG/HDL-C (TGH) ratio were calculated to indicate lipid metabolism. Generalized additive mixed model and quantile g-computation were respectively conducted to investigate individual and joint lipidemic effect of air pollutants. Covariates including demographical characteristics, living habits, meteorological factors, time trends, and disease information were considered to avoid confounding our results. Complement C3 and high-sensitivity C-reactive protein (hsCRP) were analyzed as potential mediators. Finally, association between NDVI and lipid markers were explored. We found that long-term air pollutants exposure were positively associated with lipid markers. Complement C3 mediated 54.72% (95% CI: 0.30, 63.10) and 72.53% (95% CI: 0.65, 77.61) of the association between PM1 and TC and LDL-C, respectively. We found some significant associations of lipid markers with NDVI1000 m rather than NDVI500 m. BMI, disease status, smoke/drink habits are important effect modifiers. Results are robust in sensitive analysis. Our study indicated that air pollutants exposure may detriment lipid metabolism and inflammation may be the potential triggering pathways, while greenness may exert beneficial effects. This study provided insights for the lipidemic effects of air pollution and greenness.
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Affiliation(s)
- Yayuan Mei
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Ang Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Jiaxin Zhao
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Quan Zhou
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Meiduo Zhao
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Jing Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Yanbing Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Kai Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Qun Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China.
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20
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Liu Q, Wang Z, Lu J, Li Z, Martinez L, Tao B, Wang C, Zhu L, Lu W, Zhu B, Pei X, Mao X. Effects of short-term PM 2.5 exposure on blood lipids among 197,957 people in eastern China. Sci Rep 2023; 13:4505. [PMID: 36934119 PMCID: PMC10024762 DOI: 10.1038/s41598-023-31513-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 03/13/2023] [Indexed: 03/20/2023] Open
Abstract
Globally, air pollution is amongst the most significant causes of premature death. Nevertheless, studies on the relationship between fine particulate matter (PM2.5) exposure and blood lipids have typically not been population-based. In a large, community-based sample of residents in Yixing city, we assessed the relationship between short-term outdoor PM2.5 exposure and blood lipid concentrations. Participants who attended the physical examination were enrolled from Yixing People's hospital from 2015 to 2020. We collected general characteristics of participants, including gender and age, as well as test results of indicators of blood lipids. Data on daily meteorological factors were collected from the National Meteorological Data Sharing Center ( http://data.cma.cn/ ) and air pollutant concentrations were collected from the China Air Quality Online Monitoring and Analysis Platform ( https://www.aqistudy.cn/ ) during this period. We applied generalized additive models to estimate short-term effects of ambient PM2.5 exposure on each measured blood lipid-related indicators and converted these indicators into dichotomous variables (non- hyperlipidemia and hyperlipidemia) to calculate risks of hyperlipidemia associated with PM2.5 exposure. A total of 197,957 participants were included in the analysis with mean age 47.90 years (± SD, 14.28). The increase in PM2.5 was significantly associated with hyperlipidemia (odds ratio (OR) 1.003, 95% CI 1.001-1.004), and it was still significant in subgroups of males and age < 60 years. For every 10 μg/m3 increase in PM2.5, triglyceride levels decreased by 0.5447% (95% CI - 0.7873, - 0.3015), the low-density lipoprotein cholesterol concentration increased by 0.0127 mmol/L (95% CI 0.0099, 0.0156), the total cholesterol concentration increased by 0.0095 mmol/L (95% CI 0.0053, 0.0136), and no significant association was observed between PM2.5 and the high-density lipoprotein cholesterol concentration. After excluding people with abnormal blood lipid concentrations, the associations remained significant except for the high-density lipoprotein cholesterol concentration. PM2.5 was positively correlated with low-density lipoprotein cholesterol and total cholesterol, and negatively correlated with triglyceride, indicating PM2.5 can potentially affect health through blood lipid levels.
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Affiliation(s)
- Qiao Liu
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu Province, People's Republic of China
| | - Zhan Wang
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu Province, People's Republic of China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China
| | - Junjie Lu
- Department of Critical Care Medicine, Affiliated Yixing People's Hospital, Jiangsu University, Wuxi, People's Republic of China
| | - Zhongqi Li
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China
| | - Leonardo Martinez
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA, USA
| | - Bilin Tao
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China
| | - Chunlai Wang
- Department of Physical Examination Center, Affiliated Yixing People's Hospital, Jiangsu University, Wuxi, People's Republic of China
| | - Limei Zhu
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu Province, People's Republic of China
| | - Wei Lu
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu Province, People's Republic of China
| | - Baoli Zhu
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu Province, People's Republic of China
| | - Xiaohua Pei
- Divison of Geriatric Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China.
| | - Xuhua Mao
- Department of Clinical Laboratory, Affiliated Yixing People's Hospital, Jiangsu University, Wuxi, Jiangsu Province, People's Republic of China.
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21
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Li J, Song Y, Shi L, Jiang J, Wan X, Wang Y, Ma Y, Dong Y, Zou Z, Ma J. Long-term effects of ambient PM 2.5 constituents on metabolic syndrome in Chinese children and adolescents. ENVIRONMENTAL RESEARCH 2023; 220:115238. [PMID: 36621550 DOI: 10.1016/j.envres.2023.115238] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Metabolic syndrome (MetS) is considered a main public health issue as it remarkably adds the risk of cardiovascular disease, leading to a heavy burden of disease. There is growing evidence linking fine particulate matter (PM2.5) exposure to MetS. However, the influences of PM2.5 constituents, especially in children and adolescents, remain unclear. Our study was according to a national analysis among Chinese children and adolescents to examine the associations between long-term exposure to PM2.5 main constituents and MetS. A total of 10,066 children and adolescents aged 10-18 years were recruited in 7 provinces in China, with blood tests, health exams, and questionnaire surveys. We estimated long-term exposures to PM2.5 mass and its five constituents, containing black carbon (BC), organic matter (OM), inorganic nitrate (NO3-), sulfate (SO42-), and soil particles (SOIL) from multi-source data fusion models. Mixed-effects logistic regression models were used with the adjustment of a variety of covariates. In the surveyed populations, 2.9% were classified as MetS. From the single-pollutant models, we discovered that long-term exposures to PM2.5 mass, BC, OM, NO3-, as well as SO42-, were significantly associated with the prevalence of MetS, with odds ratios (ORs) per 1 μg/m3 that were 1.02 (95% confidence interval (CI): 1.01, 1.03) for PM2.5 mass, 1.24 (95% CI: 1.14, 1.35) for BC, 1.07 (95% CI: 1.04, 1.11) for OM, 1.09 (95% CI: 1.04, 1.13) for NO3-, and 1.14 (95% CI:1.04, 1.24) for SO42-. The influence of BC on the prevalence of MetS was robust in both the multi-pollutant model and the PM2.5-constituent joint model. The paper indicates long-term exposure to PM2.5 mass and specific PM2.5 constituents, particularly for BC, was significantly associated with a higher MetS prevalence among children and adolescents in China. Our results highlight the significance of establishing further regulations on PM2.5 constituents.
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Affiliation(s)
- Jing Li
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Liuhua Shi
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Jun Jiang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Xiaoyu Wan
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Yaqi Wang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Yinghua Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China.
| | - Zhiyong Zou
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China.
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
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Hu M, Wei J, Hu Y, Guo X, Li Z, Liu Y, Li S, Xue Y, Li Y, Liu M, Wang L, Liu X. Long-term effect of submicronic particulate matter (PM 1) and intermodal particulate matter (PM 1-2.5) on incident dyslipidemia in China: A nationwide 5-year cohort study. ENVIRONMENTAL RESEARCH 2023; 217:114860. [PMID: 36423667 DOI: 10.1016/j.envres.2022.114860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 11/15/2022] [Accepted: 11/18/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND There is insufficient evidence of associations between incident dyslipidemia with PM1 (submicronic particulate matter) and PM1-2.5 (intermodal particulate matter) in the middle-aged and elderly. We aimed to determine the long-term effects of PM1 and PM1-2.5 on incident dyslipidemia respectively. METHODS We studied 6976 individuals aged ≥45 from the China Health and Retirement Longitudinal Study from 2013 to 2018. The concentrations of particular matter (PM) for every individual's address were evaluated using a satellite-based spatiotemporal model. Dyslipidemia was evaluated by self-reported. The generalized linear mixed model was applied to quantify the correlations between PM and incident dyslipidemia. RESULTS After a 5-year follow-up, 333 (4.77%) participants developed dyslipidemia. Per 10 μg/m³ uptick in four-year average concentrations of PMs (PM1 and PM1-2.5) corresponded to 1.11 [95% confidence interval (CI): 1.01-1.23)] and 1.23 (95% CI: 1.06-1.43) fold risks of incident dyslipidemia. Nonlinear exposure-response curves were observed between PM and incident dyslipidemia. The effect size of PM1 on incident dyslipidemia was slightly higher in males [1.14 (95% CI: 0.98-1.32) vs. 1.04 (95% CI: 0.89-1.21)], the elderly [1.23 (95% CI: 1.04-1.45) vs. 1.03 (95% CI: 0.91-1.17)], people with less than primary school education [1.12 (95% CI: 0.94-1.33) vs. 1.08 (95% CI: 0.94-1.23)], and solid cooking fuel users [1.17 (95% CI: 1.00-1.36) vs. 1.06 (95% CI: 0.93-1.21)], however, the difference was not statistically significant (Z = -0.82, P = 0.413; Z = -1.66, P = 0.097; Z = 0.32, P = 0.752; Z = -0.89, P = 0.372). CONCLUSIONS Long-term exposure to PM1 and PM1-2.5 were linked with an increased morbidity of dyslipidemia in the middle-aged and elderly population. Males, the elderly, and solid cooking fuel users had higher risk. Further studies would be warranted to establish an accurate reference value of PM to mitigate growing dyslipidemia.
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Affiliation(s)
- Meiling Hu
- School of Public Health, Capital Medical University, Beijing, 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, USA.
| | - Yaoyu Hu
- School of Public Health, Capital Medical University, Beijing, 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
| | - Xiuhua Guo
- School of Public Health, Capital Medical University, Beijing, 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China; National Institute for Data Science in Health and Medicine, Capital Medical University, China; Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Australia.
| | - Zhiwei Li
- School of Public Health, Capital Medical University, Beijing, 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
| | - Yuhong Liu
- School of Public Health, Capital Medical University, Beijing, 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
| | - Shuting Li
- School of Public Health, Capital Medical University, Beijing, 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
| | - Yongxi Xue
- School of Public Health, Capital Medical University, Beijing, 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
| | - Yuan Li
- School of Public Health, Capital Medical University, Beijing, 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
| | - Mengmeng Liu
- School of Public Health, Capital Medical University, Beijing, 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
| | - Lei Wang
- Department of Food and Nutritional Hygiene, School of Public Health, Capital Medical University, China.
| | - Xiangtong Liu
- School of Public Health, Capital Medical University, Beijing, 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
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Hu LX, Fan S, Ma Y, Liu XX, Bao WW, Guo Y, Hu LW, Chen G, Zeng XW, Zou Z, Yang BY, Ma J, Yang Z, Chen YJ, Dong GH. Associations between greenspace surrounding schools and lipid levels in Chinese children and teenagers. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 317:120746. [PMID: 36457224 DOI: 10.1016/j.envpol.2022.120746] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 11/18/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Little evidence exists concerning the associations of greenspace with childhood lipid profiles and dyslipidemias, especially in developing countries and regions. We aimed to investigate the associations of greenspace surrounding schools with lipid levels and dyslipidemia prevalence among Chinese children and teenagers. We obtained baseline information and health data of 10,408 children and teenagers (aged 6-18 years) who studied from 94 schools in China. We measured levels of four blood lipids: triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Dyslipidemias were defined using standard recommendations. Greenness surrounding schools were assessed using two satellite-based greenness indices, Normalized Difference Vegetation Index (NDVI) and Soil Adjusted Vegetation Index (SAVI) at 300-, 500-, and 1000-m circular buffers based on each school's latitude and longitude. We used random forest model combined with meteorological and remote sensing data to estimate air pollution levels surrounding each school. We used generalized linear mixed models to estimate the associations of greenness with lipid levels and dyslipidemias prevalence. We also performed sub-group and mediation analyses. An interquartile range (IQR) increase in NDVI500m was significantly associated with a 0.064 mmol/L (95% confidence interval [CI]: 0.083, -0.045) and 0.049 mmol/L (95% CI: 0.065, -0.033) decreased TC and LDL-C levels, respectively, as well as a 0.13-fold (95% CI: 0.01, 0.23) and 0.17-fold (95% CI: 0.01, 0.30) decreased odds of hypercholesterolemia and hyperbetalipoproteinemia, respectively. Associations were stronger in students aged ≤12 years and born to parents having lower education levels compared to their counterparts. Particle with aerodynamic diameter ≤2.5 μm (PM2.5) mediated 61.5% and 16.7% of the association of greenness with TG and LDL-C levels, respectively. In summary, higher school-based greenness exposure was beneficially associated with lipid levels among Chinese children and adolescents, and part of the association can be explained by lowed PM2.5 levels.
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Affiliation(s)
- Li-Xin Hu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Shujun Fan
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
| | - Yinghua Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Xiao-Xuan Liu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Wen-Wen Bao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Li-Wen Hu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Gongbo Chen
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Xiao-Wen Zeng
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Zhiyong Zou
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Bo-Yi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Zhicong Yang
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
| | - Ya-Jun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Guang-Hui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
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Ossoli A, Cetti F, Gomaraschi M. Air Pollution: Another Threat to HDL Function. Int J Mol Sci 2022; 24:ijms24010317. [PMID: 36613760 PMCID: PMC9820244 DOI: 10.3390/ijms24010317] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
Epidemiological studies have consistently demonstrated a positive association between exposure to air pollutants and the incidence of cardiovascular disease, with the strongest evidence for particles with a diameter < 2.5 μm (PM2.5). Therefore, air pollution has been included among the modifiable risk factor for cardiovascular outcomes as cardiovascular mortality, acute coronary syndrome, stroke, heart failure, and arrhythmias. Interestingly, the adverse effects of air pollution are more pronounced at higher levels of exposure but were also shown in countries with low levels of air pollution, indicating no apparent safe threshold. It is generally believed that exposure to air pollution in the long-term can accelerate atherosclerosis progression by promoting dyslipidemia, hypertension, and other metabolic disorders due to systemic inflammation and oxidative stress. Regarding high density lipoproteins (HDL), the impact of air pollution on plasma HDL-cholesterol levels is still debated, but there is accumulating evidence that HDL function can be impaired. In particular, the exposure to air pollution has been variably associated with a reduction in their cholesterol efflux capacity, antioxidant and anti-inflammatory potential, and ability to promote the release of nitric oxide. Further studies are needed to fully address the impact of various air pollutants on HDL functions and to elucidate the mechanisms responsible for HDL dysfunction.
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25
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Li H, Ge M, Pei Z, He J, Wang C. Associations of environmental factors with total cholesterol level of middle-aged and elderly people in China. BMC Public Health 2022; 22:2423. [PMID: 36564736 PMCID: PMC9783789 DOI: 10.1186/s12889-022-14922-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Dyslipidemia is a key factor causing cardio cerebrovascular diseases, and the total cholesterol (TC) is an important lipid indicator among them. Studies have shown that environmental factors have a strong association with TC levels. Previous studies only focused on the seasonal variation of TC level and the short-term effects of some environmental factors on TC level over time, and few studies explored the geographical distribution of TC level and quantified the impact of environmental factors in space. METHODS Based on blood test data which was from China Health and Retirement Longitudinal Study (Charls) database, this study selected the TC level test data of middle-aged and elderly people in China in 2011 and 2015, and collected data from 665 meteorological stations and 1496 air pollutant monitoring stations in China. After pretreatment, the spatial distribution map of TC level was prepared and the regional statistics were made. GeoDetector and geographically weighted regression (GWR) were used to measure the relationship between environmental factors and TC level. RESULTS The TC level of middle-aged and elderly in China was higher in females than in males, and higher in urban areas than in rural areas, showing a clustered distribution. The high values were mainly in South China, Southwest China and North China. Temperature, humidity, PM10 and PM2.5 were significant environmental factors affecting TC level of middle-aged and elderly people. The impact of pollutants was more severe in northern China, and TC level in southern China was mainly affected by meteorological factors. CONCLUSIONS There were gender and urban-rural differences in TC levels among the middle-aged and elderly population in China, showing aggregation in geographical distribution. Meteorological factors and air pollutants may be very important control factors, and their influencing mechanism needs further study.
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Affiliation(s)
- Hao Li
- grid.412498.20000 0004 1759 8395Institute of Healthy Geography, School of Geography and Tourism, Shaanxi Normal University, 620 West Chang’an Street, Chang’an District, Xi’an, 710119 China
| | - Miao Ge
- grid.412498.20000 0004 1759 8395Institute of Healthy Geography, School of Geography and Tourism, Shaanxi Normal University, 620 West Chang’an Street, Chang’an District, Xi’an, 710119 China
| | - Zehua Pei
- grid.412498.20000 0004 1759 8395Institute of Healthy Geography, School of Geography and Tourism, Shaanxi Normal University, 620 West Chang’an Street, Chang’an District, Xi’an, 710119 China
| | - Jinwei He
- grid.440747.40000 0001 0473 0092Medical School, Yan’an University, 580 Shengdi Road, Yan’an, 716000 China
| | - Congxia Wang
- grid.43169.390000 0001 0599 1243Department of Cardiology, the Second Affiliated Hospital of Medical College, Xi’an Jiaotong University, No. 157, Xiwu Road, Xi’an, 710004 China
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Sun J, Peng S, Li Z, Liu F, Wu C, Lu Y, Xiang H. Association of Short-Term Exposure to PM 2.5 with Blood Lipids and the Modification Effects of Insulin Resistance: A Panel Study in Wuhan. TOXICS 2022; 10:663. [PMID: 36355954 PMCID: PMC9698404 DOI: 10.3390/toxics10110663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
Results of previous studies about the acute effects of fine particulate matter (PM2.5) on blood lipids were inconsistent. This study aimed to quantify the short-term effects of PM2.5 on blood lipids and estimate the modifying role of insulin resistance, reflected by the homeostasis model assessment of insulin resistance (HOMA-IR). From September 2019 to January 2020, the study recruited 70 healthy adults from Wuhan University for a total of eight repeated data collections. At each visit, three consecutive days were monitored for personal exposure to PM2.5, and then a physical examination was carried out on the fourth day. The linear mixed-effect models were operated to investigate the impact of PM2.5 over diverse exposure windows on blood lipids. With the median of the HOMA-IR 1.820 as the cut-off point, participants were assigned to two groups for the interaction analyses. We found the overall mean level (standard deviation, SD) of PM2.5 was 38.34 (18.33) μg/m3. Additionally, with a 10 μg/m3 rise in PM2.5, the corresponding largest responses in triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), as well as high-density lipoprotein cholesterol (HDL-C), were −0.91% (95% confidence interval (CI): −1.63%, −0.18%), −0.33% (95% CI: −0.64%, −0.01%,), −0.94% (95% CI: −1.53%, −0.35%), and 0.67% (95% CI: 0.32%, 1.02%), respectively. The interaction analyses revealed that a significantly greater reduction in the four lipids corresponded to PM2.5 exposure when in the group with the lower HOMA-IR (<1.820). In conclusion, short-term PM2.5 exposure over specific time windows among healthy adults was associated with reduced TG, TC, as well as LDL-C levels, and elevated HDL-C. Additionally, the association of PM2.5−lipids may be modulated by insulin resistance.
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Affiliation(s)
- Jinhui Sun
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China
| | - Shouxin Peng
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China
| | - Zhaoyuan Li
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China
| | - Feifei Liu
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China
| | - Chuangxin Wu
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China
| | - Yuanan Lu
- Environmental Health Laboratory, Department of Public Health Sciences, University of Hawaii at Manoa, 1960 East West Rd., Biomed Bldg D105, Honolulu, HI 96822, USA
| | - Hao Xiang
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China
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Shi J, He L, Yu D, Ju L, Guo Q, Piao W, Xu X, Zhao L, Yuan X, Cao Q, Fang H. Prevalence and Correlates of Metabolic Syndrome and Its Components in Chinese Children and Adolescents Aged 7–17: The China National Nutrition and Health Survey of Children and Lactating Mothers from 2016–2017. Nutrients 2022; 14:nu14163348. [PMID: 36014854 PMCID: PMC9415182 DOI: 10.3390/nu14163348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/04/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
This descriptive study aimed to determine the prevalence of metabolic syndrome (MetS) and its components among Chinese children and adolescents aged 7–17 from 2016–2017 according to the Cook’s criteria modified for age on the basis of the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) and to evaluate the associations between the factors of interest (especially vitamin A, vitamin D and hyperuricemia) of MetS and its components, using data from the China National Nutrition and Health Survey of Children and Lactating Mothers from 2016–2017. A total of 54,269 school-aged children and adolescents were ultimately included in this study. Anthropometric measurements and laboratory examinations of the subjects and their relevant information were also collected. A multivariate logistic regression analysis model was applied to analyze the relationships between relevant factors associated with MetS and its components. In the present study, the prevalence of MetS in children and adolescents was 5.98%. Among the five components of MetS, elevated blood pressure (BP) and abdominal obesity were the most prevalent (39.52% and 17.30%), and 58.36% of the subjects had at least one of these components. In the multivariate logistic regression, an overweight condition, obesity and hyperuricemia were positively correlated with the incidence of MetS and all five components. There was also a positive association observed between vitamin A and the risk of MetS and some components of MetS (abdominal obesity and high triglycerides (TG)) and vitamin A was negatively associated with the risk of low high-density lipoprotein cholesterol (HDL-C). Subjects with vitamin D inadequacy had a higher risk of MetS (OR = 1.364, 95%CI: 1.240–1.500) and four of its components, excepting elevated FBG (fast blood glucose). Vitamin D deficiency was positively associated with MetS (OR = 1.646, 95%CI: 1.468–1.845) and all five of its components. Well-designed, large-scale prospective studies are also needed in the future.
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28
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Yan L, Pang Y, Wang Z, Luo H, Han Y, Ma S, Li L, Yuan J, Niu Y, Zhang R. Abnormal fasting blood glucose enhances the risk of long-term exposure to air pollution on dyslipidemia: A cross-sectional study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 237:113537. [PMID: 35468441 DOI: 10.1016/j.ecoenv.2022.113537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/16/2022] [Accepted: 04/16/2022] [Indexed: 06/14/2023]
Abstract
Both long-term exposure to air pollution and abnormal fasting blood glucose (FBG) are linked to dyslipidemia prevalence. However, the joint role of air pollution and FBG on dyslipidemia remains unknown clearly. In this study, we aimed to test whether abnormal FBG could enhance the risks of long-term exposure to air pollutants on dyslipidemia in general Chinese adult population. The present study recruited 8917 participants from 4 cities in Hebei province, China. Participants' individual exposure to air pollutants was evaluated by the Empirical Bayesian Kriging statistical model in ArcGIS10.2 geographic information system. Dyslipidemia was defined according to Guidelines for the Prevention and Treatment of Dyslipidemia in Chinese Adults. Subjects were grouped into normal, prediabetes, diabetes according to FBG level. Generalized linear models were applied to analyze the interaction of air pollutants and FBG on dyslipidemia prevalence. The prevalence of dyslipidemia was 43.83% in our investigation. After adjusting all covariates, we found the risk of four air pollutants (PM2.5, PM10, NO2, SO2) on dyslipidemia prevalence was stronger as higher FBG level, and the adjusted odd ratio of interaction (ORinter (95% CI)) between PM2.5, PM10, NO2, SO2 and FBG levels on dyslipidemia was 1.171 (1.162, 1.189), 1.119 (1.111, 1.127), 1.124 (1.115, 1.130), 1.107 (1.098, 1.115), respectively. Stratified analyses indicated the modifying effects of FBG on the association of air pollution with dyslipidemia were stronger among male, less than 65 years old, overweight/obesity (all Pinter<0.1). Our study concluded that high FBG levels strengthened the risk of long-term exposure to air pollution on dyslipidemia, especially more noticeable in male, less than 65 years old, overweight.
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Affiliation(s)
- Lina Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR China; Hebei Key Laboratory of Environment and Human Health, Shijiazhuang 050017, PR China
| | - Yaxian Pang
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR China; Hebei Key Laboratory of Environment and Human Health, Shijiazhuang 050017, PR China
| | - Zhikun Wang
- Office of Academic Affairs, The First Affiliated Hospital of Hebei College of Traditional Chinese Medicine, Shijiazhuang 050017, PR China
| | - Haixia Luo
- Department of Cardiology, Shijiazhuang No.1 Hospital, Shijiazhuang 050011, PR China
| | - Yuquan Han
- Emergency Department, People's Hospital of Qingdao West Coast New Area, Shandong 266400, PR China
| | - Shitao Ma
- Department of Hospital Infection Control, The People's Hospital of Luanzhou, Luanzhou 063700, PR China
| | - Lipeng Li
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, PR China
| | - Jing Yuan
- Department of Biostatistics,Clinical Development Division of CSPC, Shijiazhuang 050035, PR China
| | - Yujie Niu
- Hebei Key Laboratory of Environment and Human Health, Shijiazhuang 050017, PR China; Department occupational Health and Environmental Health, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR China.
| | - Rong Zhang
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR China; Hebei Key Laboratory of Environment and Human Health, Shijiazhuang 050017, PR China.
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Zhang Z, Su Y, Jing R, Qi J, Qi X, Xie Z, Cui B. Acute and lag effects of ambient fine particulate matter on the incidence of dyslipidemia in Chengdu, China: A time-series study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:37919-37929. [PMID: 35072876 DOI: 10.1007/s11356-021-18400-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 12/25/2021] [Indexed: 06/14/2023]
Abstract
High levels of ambient fine particulate matter (PM2.5) might increase the risk of death due to cardiovascular diseases (CVDs). As a critical risk factor for CVDs, dyslipidemia can cause CVDs or exacerbate pre-existing ones. This study aimed to investigate whether a short-time exposure to PM2.5 leads to dyslipidemia (HyperTC, HyperLDL-C, HyperTG and HypoHDL-C) in adults. The serum lipid data were provided by the Sichuan Provincial People's Hospital Medical Examination Center. We included 309,654 subjects aged 18-79 between May 10, 2015, and May 10, 2017. An advanced distributed lag nonlinear model (DLNM) was applied to investigate the acute and lag effects of ambient PM2.5 on the risk of dyslipidemia. This study was also stratified by sex, age, BMI and season to examine potential effect modification. We observed that the associations between an interquartile increase in PM2.5 (43 μg/m3) and dyslipidemia were [relative risk (RR); 95% confidence interval (CI)]: 1.042 (1.013, 1.071) for HyperLDL-C and 1.027 (1.006, 1.049) for HyperTC at lag0 day. The lag effects were found at lag6 day for HyperLDL-C, in lag4-6 days for HyperTC and lag4-7 days for HyperTG. Short-term exposure to ambient PM2.5 was related to dyslipidemia and the effect modification was observed in the subgroup analysis. The female and normal-weight populations were more susceptible to the risks of PM2.5 on HyperLDL-C and HyperTC.
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Affiliation(s)
- Zizheng Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yang Su
- Clinical Laboratory, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Renjie Jing
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiying Qi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaohui Qi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhen Xie
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
- Department of Dermatology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Bin Cui
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Kim KN, Ha B, Seog W, Hwang IU. Long-term exposure to air pollution and the blood lipid levels of healthy young men. ENVIRONMENT INTERNATIONAL 2022; 161:107119. [PMID: 35123376 DOI: 10.1016/j.envint.2022.107119] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/11/2022] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND There is insufficient evidence of an association between long-term exposure to air pollution and changes in blood lipid levels, and assessments may be influenced by residual confounding factors, such as socioeconomic status. OBJECTIVES To investigate the associations between long-term exposure to air pollution and blood lipid profiles while controlling for the risk of residual confounding factors. METHODS We conducted a study involving conscripted Korean soldiers to assess the associations between air pollution and blood lipid levels. The soldiers, who were randomly distributed among military units throughout the country, led homogenous lives and were subjected to health checkups 8-12 months post-enlistment. We analyzed data pertaining to those who enlisted and underwent health checkups in 2019 (n = 12,778) using linear mixed models. Additionally, we evaluated quantile-specific associations using quantile regression models. We also assessed interactions based on body mass index (BMI) at the time of enlistment (≥25.0 vs. < 25.0 kg/m2). RESULTS The linear mixed models revealed that a 10-µg/m3 increase in fine particulate matter ≤ 2.5 μm (PM2.5) decreased high-density lipoprotein cholesterol (HDL-C) levels by -0.66% (95% confidence interval [CI]: -1.21, -0.10), and a 10-ppb increase in nitrogen dioxide (NO2) increased total cholesterol (TC) levels by 1.04% (95% CI: 0.24, 1.84). In the quantile regression models, associations were also found at specific deciles. PM2.5 exposure contributed to higher TC, NO2 resulted in higher triglycerides and lower HDL-C, and ozone (O3) led to lower HDL-C. The association between O3 and TC differed according to BMI (p-value for interaction = 0.03); among those with a BMI ≥ 25.0 kg/m2, a 10-ppb increase in O3 increased TC by 1.09% (95% CI: 0.20, 1.09). DISCUSSION These results shed new light on the importance of controlling air pollution, which can contribute to abnormal blood lipid levels, an independent risk factor for cardiovascular disease.
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Affiliation(s)
- Kyoung-Nam Kim
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Beomman Ha
- The Republic of Korea Army Headquarter, Kyeryong, Republic of Korea
| | - Woong Seog
- The Armed Forces Capital Hospital, Seongnam, Republic of Korea
| | - Il-Ung Hwang
- Division of Public Health and Medical Care, Seoul National University Hospital, Seoul, Republic of Korea.
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Liu K, Cao H, Li B, Guo C, Zhao W, Han X, Zhang H, Wang Z, Tang N, Niu K, Pan L, He H, Cui Z, Sun J, Shan G, Zhang L. Long-term exposure to ambient nitrogen dioxide and ozone modifies systematic low-grade inflammation: The CHCN-BTH study. Int J Hyg Environ Health 2021; 239:113875. [PMID: 34757279 DOI: 10.1016/j.ijheh.2021.113875] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 12/26/2022]
Abstract
The potential effect of long-term exposure to ambient air pollutants on low-grade systematic inflammation has seldom been evaluated taking indoor air pollution and self-protection behaviors on smog days into account. A total of 24,346 participants at baseline were included to conduct a cross-sectional study. The annual (2016) average pollutant concentrations were assessed by air monitoring stations for PM2.5, PM10, SO2, NO2, O3 and CO. Associations between annual ambient air pollution and low-grade systematic inflammation (hsCRP>3 mg/L) were estimated by generalized linear mixed models. Stratification analysis was also performed based on demographic characteristics, health-related behaviors and disease status. Annual ambient NO2 and O3 were all associated with low-grade systematic inflammation in single-pollutant models after adjusting for age, sex, blood lipids, blood pressure, lifestyle risk factors, cooking fuel, heating fuel and habits during smog days (NO2 per 10 μg/m3: OR = 1.057, P = 0.018; O3 per 10 μg/m3: OR = 0.953, P = 0.012). The 2-year and 3-year ozone concentrations were consistently associated with lower systematic inflammation (2-year O3 per 10 μg/m3: OR = 0.959, P = 0.004; 3-year O3 per 10 μg/m3: OR = 0.961, P = 0.014). In two-pollutant models, the estimated effects of annual NO2 and O3 on low-grade systematic inflammation remained stable. The effect size of annual pollutants on inflammation increased in participants without air-purifier usage (NO2 per 10 μg/m3: OR = 1.079, P = 0.009; O3 per 10 μg/m3: OR = 0.925, P = 0.001), while the association was null in the air-purifier usage group. Thus, long-term exposure to ambient NO2 and O3 was associated with low-grade systemic inflammation, and the results were generally stable after sensitivity analysis. The usage of air purifiers on smog days can modify the association between gaseous pollutants and systematic inflammation.
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Affiliation(s)
- Kuo Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Han Cao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Bingxiao Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Chunyue Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Wei Zhao
- Department of Chronic and Noncommunicable Disease Prevention and Control, Chaoyang District Center for Disease Prevention and Control, Beijing, China
| | - Xiaoyan Han
- Department of Chronic and Noncommunicable Disease Prevention and Control, Chaoyang District Center for Disease Prevention and Control, Beijing, China
| | - Han Zhang
- Health Management Center, Beijing Aerospace General Hospital, Beijing, China
| | - Zhengfang Wang
- Health Management Center, Beijing Aerospace General Hospital, Beijing, China
| | - Naijun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Ze Cui
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hebei Provincial Center for Disease Prevention and Control, Shijiazhuang, Hebei, China
| | - Jixin Sun
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hebei Provincial Center for Disease Prevention and Control, Shijiazhuang, Hebei, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Ling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
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Di Ciaula A. Bioaccumulation of Toxic Metals in Children Exposed to Urban Pollution and to Cement Plant Emissions. EXPOSURE AND HEALTH 2021; 13:681-695. [PMID: 34189342 PMCID: PMC8229267 DOI: 10.1007/s12403-021-00412-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 06/10/2021] [Accepted: 06/14/2021] [Indexed: 02/07/2023]
Abstract
Cement plants located in urban areas can increase health risk. Although children are particularly vulnerable, biomonitoring studies are lacking. Toenail concentration of 24 metals was measured in 366 children (6-10 years), who live and attend school in a city hosting a cement plant. Living addresses and schools were geocoded and attributed to exposed or control areas, according to modeled ground concentrations of PM10 generated by the cement plant. Air levels of PM10 and NO2 were monitored. PM10 levels were higher in the exposed, than in the control area. The highest mean PM10 concentration was recorded close to the cement plant. Conversely, the highest NO2 concentration was in the control area, where vehicular traffic and home heating were the prevalent sources of pollutants. Exposed children had higher concentrations of Nickel (Ni), Cadmium (Cd), Mercury (Hg), and Arsenic (As) than controls. These concentrations correlated each other, indicating a common source. Toenail Barium (Ba) concentration was higher in the control- than in the exposed area. The location of the attended school was a predictor of Cd, Hg, Ni, Ba concentrations, after adjusting for confounders. In conclusion, children living and attending school in an urban area exposed to cement plant emissions show a chronic bioaccumulation of toxic metals, and a significant exposure to PM10 pollution. Cement plants located in populous urban areas seem therefore harmful, and primary prevention policies to protect children health are needed.
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Liu Y, Li L, Xie J, Jiao X, Hu H, Zhang Y, Tao R, Tao F, Zhu P. Foetal 25-hydroxyvitamin D moderates the association of prenatal air pollution exposure with foetal glucolipid metabolism disorder and systemic inflammatory responses. ENVIRONMENT INTERNATIONAL 2021; 151:106460. [PMID: 33662886 DOI: 10.1016/j.envint.2021.106460] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/25/2021] [Accepted: 02/06/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Previous studies have indicated that systemic inflammation may play an important role in the association between air pollution exposure and glucolipid metabolism disorders, and vitamin D supplementation was beneficial in improving systemic inflammation and glucolipid metabolism. However, the role of foetal 25-hydroxyvitamin D (25(OH)D) and high-sensitivity C-reactive protein (hs-CRP) in the association between prenatal air pollution exposure and foetal glucolipid metabolism disorders is still not clear. OBJECTIVE To verify whether foetal 25(OH)D can improve glucolipid metabolism disorders induced by prenatal air pollution exposure by inhibiting the systemic inflammation. METHODS A total of 2,754 mother-newborn pairs were enrolled from three hospitals in Hefei city, China, between 2015 and 2019. We obtained air pollutants (PM2.5, PM10, SO2, CO, and NO2) data from the Hefei City Ecology and Environment Bureau. Cord blood biomarkers (25(OH)D, hs-CRP, C-peptide, HDL-C, LDL-C, TC, and TG) were measured. RESULTS We found that prenatal air pollution exposure was positively associated with foetal glucolipid metabolic index levels after adjusting for confounders. Additionally, an IQR increase in exposure to PM2.5, PM10, SO2, and CO was associated with 20.0% (95% confidence interval (CI): 16.9, 23.6), 20.1% (16.8, 23.3), 22.9% (20.6, 25.3), and 16.7% (14.4, 19.0) higher cord blood hs-CRP levels, respectively, and an SD increase in hs-CRP was associated with 1.4% (0.1, 2.8), 2.2% (1.6, 2.9), 1.4% (0.9, 2.0), and 3.9% (2.8, 4.9) higher C-peptide, LDL-C, TC, and TG levels in the cord blood, respectively. However, there was a monotonic decrease in βs between cord blood 25(OH)D and biomarkers (P for trend < 0.001). Furthermore, mediation analysis revealed that the association between air pollution exposure and foetal glucolipid metabolic indexes mediated by hs-CRP and 25(OH)D was 19.35%. In stratified analyses, the significant negative association between cord blood 25(OH)D with foetal hs-CRP and glucolipid metabolic indexes was observed only at low-medium levels of air pollution exposure. CONCLUSIONS Prenatal air pollution exposure could damage foetal glucolipid metabolic function through systemic inflammation. High foetal 25(OH)D levels may improve foetal systemic inflammation and glucolipid metabolism at low-medium levels of prenatal air pollution exposure.
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Affiliation(s)
- Yang Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Lei Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Jun Xie
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Xuechun Jiao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Honglin Hu
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ying Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ruixue Tao
- Department of Gynecology and Obstetrics, Hefei First People's Hospital, Hefei, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.
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Zhang JS, Gui ZH, Zou ZY, Yang BY, Ma J, Jing J, Wang HJ, Luo JY, Zhang X, Luo CY, Wang H, Zhao HP, Pan DH, Bao WW, Guo YM, Ma YH, Dong GH, Chen YJ. Long-term exposure to ambient air pollution and metabolic syndrome in children and adolescents: A national cross-sectional study in China. ENVIRONMENT INTERNATIONAL 2021; 148:106383. [PMID: 33465664 DOI: 10.1016/j.envint.2021.106383] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/28/2020] [Accepted: 01/05/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The prevalence of metabolic syndrome (MetS) rapidly increased over the past decades. However, little evidence exists about the effects of long-term exposure to ambient air pollution on MetS in children and adolescents. OBJECTIVE This study aims to assess the association between long-term ambient air pollution and the prevalence of MetS in a large population of Chinese children and adolescents. METHODS In 2013, a total of 9,897 children and adolescents aged 10 to 18 years were recruited from seven provinces/municipalities in China. MetS was defined based on the recommendation by the International Diabetes Federation (IDF). Satellite based spatio-temporal models were used to estimate exposure to ambient air pollution (including particles with diameters ≤1.0 µm (PM1), ≤2.5 µm (PM2.5), and ≤10 µm (PM10), and nitrogen dioxide (NO2)). Individual exposure was calculated according to 94 schools addresses. After adjustment for a range of covariates, generalized linear mixed-effects models were utilized to evaluate the associations between air pollutants and the prevalence of MetS and its components. In addition, several stratified analyses were examined according to sex, weight status, outdoor physical activity time, and sugar-sweetened beverages (SSBs) intake. RESULTS The prevalence of MetS was 2.8%. The odds ratio of MetS associated with a 10 μg/m3 increase in PM1, PM2.5, PM10 and NO2 was 1.20 (95%CI: 0.99, 1.46), 1.31 (95%CI: 1.05, 1.64), 1.32 (95%CI: 1.08, 1.62), and 1.33 (95%CI: 1.03, 1.72), respectively. Regarding the MetS components, we observed associations between all pollutants and abdominal obesity. In addition, long-term PM1 and NO2 exposures were associated with the prevalence of elevated fasting blood glucose. Stratified analyses detected that the associations between air pollutants and the prevalence of MetS were stronger in boys (Pinteraction < 0.05). CONCLUSIONS We found that long-term exposure to PM2.5, PM10, and NO2 were positively associated with the prevalence of MetS in children and adolescents. Our findings may have certain public health implications for some comprehensive strategy of environment improvement and lifestyles changes in order to reduce the burden of non-communicable disease.
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Affiliation(s)
- Jing-Shu Zhang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Zhao-Huan Gui
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Zhi-Yong Zou
- Institute of Child and Adolescent Health, Peking University, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Bo-Yi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Jun Ma
- Institute of Child and Adolescent Health, Peking University, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Hai-Jun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China
| | - Jia-You Luo
- Department of Maternal and Child Health, School of Public Health, Central South University, Changsha 410078, China
| | - Xin Zhang
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Chun-Yan Luo
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai Institutes of Preventive Medicine, Shanghai 200336, China
| | - Hong Wang
- Department of Maternal and Child Health, School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China
| | - Hai-Ping Zhao
- School of Public Health and Management, Ningxia Medical University, Ningxia, 750004, China
| | - De-Hong Pan
- Liaoning Health Supervision Bureau, Shenyang 110005, China
| | - Wen-Wen Bao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yu-Ming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Ying-Hua Ma
- Institute of Child and Adolescent Health, Peking University, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China.
| | - Guang-Hui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Ya-Jun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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