Department of Nephrology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
BMC Public Health. 2021 Dec 10;21(1):2241. doi: 10.1186/s12889-021-12163-z.
Long-term exposure to ambient air pollution is related to major cardiovascular risk factors including diabetes, hypertension, hyperlipidemia and overweight, but with few studies in high-concentration nations like China so far. We aimed to investigate the association between long-term exposure to ambient fine particulate matter (particles with an aerodynamic diameter ≤ 2.5 μm, PM) and major cardiovascular risk factors in China.
Adult participants with selected biochemical tests were recruited from the Chinese Physiological Constant and Health Condition (CPCHC) survey conducted from 2007 to 2011. Gridded PM data used were derived from satellite-observed data with adjustment of ground-observed data. District-level PM data were generated to estimate the association using multivariate logistic regression model and generalized additive model.
A total of 19,236 participants from the CPCHC survey were included with an average age of 42.8 ± 16.1 years, of which nearly half were male (47.0%). The annual average PM exposure before the CPCHC survey was 33.4 (14.8-53.4) μg/m, ranging from 8.0 μg/m (Xiwuqi) to 94.7 μg/m (Chengdu). Elevated PM was associated with increased prevalence of hypertension (odds ratio (OR) =1.022, 95% confidence interval (95%CI): 1.001, 1.043) and decreased prevalence of overweight (OR = 0.926, 95%CI: 0.910, 0.942). Education significantly interacted with PM in association with all the interesting risk factors. Each 10 μg/m increment of PM was associated with increased prevalence of diabetes (OR = 1.118, 95%CI: 1.037, 1.206), hypertension (OR = 1.101, 95%CI: 1.056, 1.147), overweight (OR = 1.071, 95%CI: 1.030, 1.114) in participants with poor education, but not in well-educated population. PM exposure was negatively associated with hyperlipidemia in all participants (OR = 0.939, 95%CI: 0.921, 0.957). The results were robust in all the sensitivity analyses.
Association between long-term PM exposure and cardiovascular risk factors might be modified by education. PM was associated with a higher prevalence of diabetes, hypertension, and overweight in a less-educated population with time-expose dependency. Long-term exposure to PM might be associated with a lower prevalence of hyperlipidemia.
长期暴露于环境空气中的污染物与包括糖尿病、高血压、高血脂和超重在内的主要心血管风险因素有关，但目前在中国等高浓度国家的研究较少。本研究旨在探讨长期暴露于环境细颗粒物（空气动力学直径≤2.5μm 的颗粒，PM）与中国主要心血管风险因素之间的关系。
从 2007 年至 2011 年进行的中国生理常数与健康状况调查（CPCHC）中招募了具有选定生化检测的成年参与者。使用源自卫星观测数据并经过地面观测数据调整的网格化 PM 数据。生成区县级 PM 数据，以使用多元逻辑回归模型和广义加性模型估计关联。
CPCHC 调查共纳入 19236 名参与者，平均年龄为 42.8±16.1 岁，其中近一半为男性（47.0%）。CPCHC 调查前的年均 PM 暴露量为 33.4（14.8-53.4）μg/m，范围为 8.0μg/m（西坞旗）至 94.7μg/m（成都）。PM 升高与高血压患病率升高相关（比值比（OR）=1.022，95%置信区间（95%CI）：1.001，1.043），与超重患病率降低相关（OR=0.926，95%CI：0.910，0.942）。教育水平与 PM 显著相互作用，与所有感兴趣的风险因素相关。PM 每增加 10μg/m，与糖尿病（OR=1.118，95%CI：1.037，1.206）、高血压（OR=1.101，95%CI：1.056，1.147）和超重（OR=1.071，95%CI：1.030，1.114）的患病率增加相关，而在教育程度较好的人群中则无此关联。PM 暴露与所有参与者的高血脂呈负相关（OR=0.939，95%CI：0.921，0.957）。所有敏感性分析结果均稳健。
长期 PM 暴露与心血管风险因素之间的关联可能受教育水平的影响。在具有时间暴露依赖性的受教育程度较低的人群中，PM 与糖尿病、高血压和超重的患病率较高相关。长期暴露于 PM 可能与高血脂的患病率较低有关。
