Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
Department of Neurosurgery, Henan Provincial People's Hospital, PR China.
Clin Nutr. 2021 Apr;40(4):1442-1450. doi: 10.1016/j.clnu.2021.02.029. Epub 2021 Mar 4.
Although obesity reflected by BMI can enhance the association of air pollution with increase blood pressures (BP) and prevalent hypertension in susceptible population, there remains lack evidence on interactive effects of different obesity indices and air pollutants on BP and prevalent hypertension in rural adults. 39,259 individuals were recruited from the Henan Rural Cohort. Concentrations of air pollutants (PM, PM, PM and NO) were evaluated by a spatio-temporal model based on satellites data. Independent associations of air pollutants and obesity reflected by BMI, WC, WHR, WHtR, BFP and VFI on BP indicators (SBP, DBP, MAP and PP) and prevalent hypertension were analyzed by linear regression and logistic regression models, respectively. Furthermore, their additive effects were quantified by RERI, AP and S. Six obesity indices enhanced the associations of four air pollutants and BP indicators. Individuals with high PM concentrations plus obesity classified by BMI, WC, WHR, WHtR, BFP and VFI had a 4.18-fold (95% CI: 3.86, 4.53), 3.58-fold (95% CI: 3.34, 3.84), 3.53-fold (95% CI: 3.28, 3.81), 4.02-fold (95% CI: 3.72, 4.35), 3.89-fold (95% CI: 3.59, 4.23), 3.87-fold (95% CI: 3.62, 4.14) increase in prevalent hypertension, respectively, compared to non-obese individuals with low PM concentrations; similar results were observed for combined effect of PM, PM or NO and obesity indices on prevalent hypertension. The significant values of RERI, AP and S indicated additive effects of air pollutants and obesity indices on hypertension. Obesity amplified the effects of exposure to high levels of air pollutants on increased BP values and prevalent hypertension, implying that obese individuals may be susceptible to elevate BP and prevalent hypertension in relation to air pollution exposure. CLINICAL TRIAL REGISTRATION: The Henan Rural Cohort study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699, http://www.chictr.org.cn/showproj.aspx?proj=11375).
尽管 BMI 所反映的肥胖与易感人群的血压升高和高血压患病率增加有关，但关于不同肥胖指数与空气污染物对农村成年人血压和高血压患病率的交互作用仍缺乏证据。该研究共纳入了 39259 名来自河南农村队列的研究对象。利用基于卫星数据的时空模型评估空气污染物（PM、PM、PM 和 NO）浓度。采用线性回归和 logistic 回归模型分别分析空气污染物与 BMI、WC、WHR、WHtR、BFP 和 VFI 所反映的肥胖对血压指标（SBP、DBP、MAP 和 PP）和高血压患病率的独立关联。进一步采用相对效应值（RERI）、归因百分比（AP）和交互作用指数（S）来量化两者的相加效应。六个肥胖指数增强了四个空气污染物与血压指标的关联。与低 PM 浓度结合非肥胖个体相比，高 PM 浓度结合 BMI、WC、WHR、WHtR、BFP 和 VFI 肥胖个体的高血压患病率分别增加了 4.18 倍（95%CI：3.86，4.53）、3.58 倍（95%CI：3.34，3.84）、3.53 倍（95%CI：3.28，3.81）、4.02 倍（95%CI：3.72，4.35）、3.89 倍（95%CI：3.59，4.23）和 3.87 倍（95%CI：3.62，4.14）。类似的结果也观察到 PM、PM 或 NO 与肥胖指数对高血压患病率的联合作用。RERI、AP 和 S 的显著值表明空气污染物和肥胖指数对高血压有相加作用。肥胖加剧了暴露于高水平空气污染物对血压升高和高血压患病率的影响，这意味着肥胖个体可能更容易因空气污染暴露而导致血压升高和高血压患病率增加。临床试验注册：河南农村队列研究已在中国临床试验注册中心（注册号：ChiCTR-OOC-15006699，http://www.chictr.org.cn/showproj.aspx?proj=11375）注册。
