Social Statistics, Manchester Institute for Collaborative Research on Ageing (MICRA), Cathie Marsh Institute (CMI), School of Social Sciences, The University of Manchester, Oxford Road, M13 9PL, UK.
Department of Economics, The University of Manchester, Oxford Road, M13 9PL, UK.
Health Place. 2021 May;69:102571. doi: 10.1016/j.healthplace.2021.102571. Epub 2021 Apr 19.
Population ageing and air pollution have become two major public health concerns in China. Longitudinal evidence on the body weight impacts of air pollution among older adults is rare. This study aims to investigate the impacts of ambient particulate matter with aerodynamic diameters ≤2.5 μm (PM) on weight status of older adults in China and the potential behavioral and metabolic pathways through which PM influences weight status.
The longitudinal data from the China Health and Retirement Longitudinal Study (body mass index-BMI, n = 9053; waist/height ratio-WHR, n = 9064) were linked to the air pollution data at the city-level with a rural-urban distinction. We used mixed-effects linear models to evaluate the impacts of PM on individual weight status and multiple mediation analysis to examine potential pathways.
After adjusting for relevant socioeconomic and city-level risk factors, significant and robust positive impacts of PM on BMI (0.025, 95%CI: 0.018, 0.031) and WHR*100 (0.058, 95%CI: 0.044, 0.072) were found among older adults in China. The PM-weight status relationship among older adults may be mediated through metabolic and inflammatory dysfunction pathways particularly HbA1c and C-reactive protein (CRP). As PM deteriorates, the detrimental impacts tend to be more severe for rural-urban migrants and rural residents, compared to their urban counterparts. The worsening rural PM profiles in some areas, such as the northern parts of the Central and the Eastern, may leave them particularly vulnerable to air pollution.
PM has an independent and significant detrimental impact on weight status including BMI and WHR of older adults in China, especially among rural adults and rural-urban migrants. PM may affect weight status of older adults through biomarkers such as HbA1c and CRP. More research is needed to confirm our findings.
人口老龄化和空气污染已成为中国两大主要公共卫生关注点。关于老年人暴露于空气污染对体重影响的纵向证据较为缺乏。本研究旨在探究中国大气细颗粒物（PM）对老年人体重状况的影响，以及 PM 影响体重状况的潜在行为和代谢途径。
本研究将中国健康与退休纵向研究（体质指数-BMI，n=9053；腰围/身高比-WHR，n=9064）的纵向数据与城乡划分的城市层面空气污染数据相链接。采用混合效应线性模型评估 PM 对个体体重状况的影响，并进行多重中介分析以检验潜在途径。
在调整了相关社会经济和城市层面的风险因素后，在中国老年人中发现 PM 对 BMI（0.025，95%CI：0.018，0.031）和 WHR*100（0.058，95%CI：0.044，0.072）具有显著且稳健的正向影响。在中国老年人中，PM 与体重状况之间的关系可能通过代谢和炎症功能障碍途径介导，特别是糖化血红蛋白（HbA1c）和 C 反应蛋白（CRP）。随着 PM 恶化，农村-城市移民和农村居民的体重状况受损程度较城市居民更为严重。中国部分地区（如中部和东部的北部地区）农村 PM 状况恶化，可能使他们尤其容易受到空气污染的影响。
PM 对中国老年人的体重状况（包括 BMI 和 WHR）具有独立且显著的不良影响，尤其在农村成年人和农村-城市移民中更为明显。PM 可能通过 HbA1c 和 CRP 等生物标志物影响老年人的体重状况。需要进一步的研究来证实我们的发现。
