West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China.
Chengdu Center for Disease Control and Prevention, Chengdu, China.
Sci Total Environ. 2022 Sep 10;838(Pt 1):155940. doi: 10.1016/j.scitotenv.2022.155940. Epub 2022 May 14.
Long-term exposure to ambient air pollution has been associated with cardiometabolic abnormalities (CAs), which, however, may be stronger in vulnerable populations, such as minorities. The variation of the association between ambient air pollution and CAs between the majority (Han) and minority populations in China have been poorly studied.
We aimed to estimate and compare the Hans' and minorities' risks for CAs associated with long-term exposure to ambient air pollution in Southwest China.
A cross-sectional study was conducted on the basis of the China Multi-Ethnic Cohort. CAs were defined by the presence of at least three pre-defined metabolic dysfunctions (central obesity, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure, and elevated fasting glucose). The concentrations of ambient air pollutants, including particulate matters (PM, PM, and PM) and nitrogen dioxide (NO), were generated from random forest models on the basis of multi-source data. One- and two-pollutant regression models were fit to assess associations between air pollutant exposure and CA risks. Sensitivity analyses were performed to examine the robustness of the associations.
The final sample included 51,037 Hans and 28,702 minority participants. The prevalence of CAs was 25.0%, slightly higher in the minorities (25.5%) than the Hans (24.4%). The higher risks for CAs in the overall population were associated with each 10 μg/m increase in the exposure to PM (OR = 1.07 [1.05-1.09]), PM (OR = 1.11 [1.06-1.17]), PM (OR = 1.04 [1.03-1.06]), and NO (OR = 1.04 [1.03-1.07]). Compared to the Hans, the higher risks for CAs were observed in the minorities for PM (OR = 1.35 [1.18-1.53]), PM (OR = 1.61 [1.34-1.93]), and PM (OR = 1.15 [1.07-1.23]). The associations of metabolic dysfunctions (CA components) with ambient air pollution also varied between the Han and minority populations.
The associations between exposure to ambient air pollution and CA risks were stronger in the minorities than Hans. Our findings provide a better understanding of ethnic disparities in CA risks when being exposed to ambient air pollution in China, which also have important implications for other low- and middle-income countries where less health resources (e.g., cohort populations) are available to conduct such studies.
长期暴露于环境空气污染与心脏代谢异常（CAs）有关，但在弱势群体（如少数民族）中，这种关联可能更强。在中国，环境空气污染与 CAs 之间的关联在多数人群（汉族）和少数民族之间的差异尚未得到充分研究。
我们旨在估计和比较中国西南地区汉族和少数民族人群长期暴露于环境空气污染与 CAs 相关的风险。
本研究基于中国多民族队列进行了一项横断面研究。CAs 定义为至少存在三种预先定义的代谢功能障碍（中心性肥胖、甘油三酯升高、高密度脂蛋白胆固醇降低、血压升高和空腹血糖升高）。环境空气污染物（包括颗粒物[PM 、PM 和 PM]和二氧化氮[NO]）的浓度是根据多源数据利用随机森林模型生成的。采用单污染物和双污染物回归模型评估空气污染物暴露与 CA 风险之间的关联。进行敏感性分析以检验关联的稳健性。
最终纳入了 51037 名汉族和 28702 名少数民族参与者。CAs 的患病率为 25.0%，少数民族（25.5%）略高于汉族（24.4%）。整体人群中 CAs 风险增加与 PM 暴露每增加 10 μg/m（OR = 1.07 [1.05-1.09]）、PM（OR = 1.11 [1.06-1.17]）、PM（OR = 1.04 [1.03-1.06]）和 NO（OR = 1.04 [1.03-1.07]）呈正相关。与汉族相比，少数民族人群中 PM（OR = 1.35 [1.18-1.53]）、PM（OR = 1.61 [1.34-1.93]）和 PM（OR = 1.15 [1.07-1.23]）与 CAs 风险增加的相关性更强。代谢功能障碍（CA 成分）与环境空气污染之间的关联在汉族和少数民族人群之间也存在差异。
与汉族相比，少数民族人群中暴露于环境空气污染与 CAs 风险之间的关联更强。我们的研究结果提供了对中国少数民族在暴露于环境空气污染时心脏代谢异常风险种族差异的更好理解，这对其他中低收入国家也具有重要意义，因为这些国家在进行此类研究时可用的健康资源（例如队列人群）较少。
