Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China; Healthcare Associated Infection Control Department, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi 445000, China.
Sci Total Environ. 2023 Apr 15;869:161895. doi: 10.1016/j.scitotenv.2023.161895. Epub 2023 Jan 26.
INTRODUCTION: Emerging research suggested a nexus between air pollution exposure and risks of overweight and obesity, while existing longitudinal evidence was extensively sparse, particularly in densely populated regions. This study aimed to quantify concentration-response associations of changes in weight and waist circumference (WC) related to air pollution in Chinese adults. METHODS: We conceived a nationally representative longitudinal study from 2011 to 2015, by collecting 34,854 observations from 13,757 middle-aged and older adults in 28 provincial regions of China. Participants' height, weight and WC were measured by interviewers using standardized devices. Concentrations of major air pollutants including fine particulate matter (PM), nitrogen dioxide (NO) and ozone (O) predicted by well-validated spatiotemporal models were assigned to participants according to their residential cities. Possible exposure biases were checked through 1000 random simulated exposure at individual level, using a Monte Carlo simulation approach. Linear mixed-effects models were applied to estimate the relationships of air pollution with weight and WC changes, and restricted cubic spline functions were adopted to smooth concentration-response (C-R) curves. RESULTS: Each 10-μg/m rise in PM, NO and O was associated with an increase of 0.825 (95% confidence interval: 0.740, 0.910), 0.921 (0.811, 1.032) and 1.379 (1.141, 1.616) kg in weight, respectively, corresponding to WC gains of 0.688 (0.592, 0.784), 1.189 (1.040, 1.337) and 0.740 (0.478, 1.002) cm. Non-significant violation for linear C-R relationships was observed with exception of NO-weight and PM/NO-WC associations. Sex-stratified analyses revealed elevated vulnerability in women to gain of weight in exposure to PM and NO. Sensitive analyses largely supported our primary findings via assessing exposure estimates from 1000 random simulations, and performing reanalysis based on non-imputed covariates and non-obese participants, as well as alternative indicators (i.e., body mass index and waist-to-height ratio). CONCLUSIONS: We found positively robust associations of later-life exposure to air pollutants with gains in weight and WC based on a national sample of Chinese adult men and women. Our findings suggested that mitigation of air pollution may be an efficient intervention to relieve obesity burden.
简介:新出现的研究表明,空气污染暴露与超重和肥胖风险之间存在关联,而现有的纵向证据则非常有限,尤其是在人口密集的地区。本研究旨在量化中国成年人体重和腰围(WC)变化与空气污染之间的浓度-反应关系。
方法:我们设计了一项 2011 年至 2015 年的全国代表性纵向研究,从中国 28 个省级地区的 13757 名中老年参与者中收集了 34854 个观测值。由调查员使用标准化设备通过访谈来测量参与者的身高、体重和 WC。根据参与者的居住城市,将经过良好验证的时空模型预测的主要空气污染物(包括细颗粒物 PM、二氧化氮 NO 和臭氧 O)浓度分配给参与者。通过使用蒙特卡罗模拟方法在个体水平上进行 1000 次随机模拟暴露检查可能存在的暴露偏倚。采用线性混合效应模型估计空气污染与体重和 WC 变化的关系,并采用限制立方样条函数来平滑浓度-反应(C-R)曲线。
结果:PM、NO 和 O 每增加 10μg/m,体重分别增加 0.825(95%置信区间:0.740,0.910)、0.921(0.811,1.032)和 1.379(1.141,1.616)kg,对应的 WC 增加 0.688(0.592,0.784)、1.189(1.040,1.337)和 0.740(0.478,1.002)cm。除了 NO-体重和 PM/NO-WC 关联外,未观察到线性 C-R 关系的明显违反。性别分层分析表明,女性在接触 PM 和 NO 时体重增加的脆弱性更高。敏感性分析通过评估来自 1000 次随机模拟的暴露估计值、基于未插补协变量和非肥胖参与者以及替代指标(即体重指数和腰高比)进行重新分析,以及评估暴露估计值在 1000 次随机模拟、基于未插补协变量和非肥胖参与者以及替代指标(即体重指数和腰高比)上的评估,在很大程度上支持了我们的主要发现。
结论:基于中国成年男女的全国样本,我们发现老年人暴露于空气污染物与体重和 WC 增加之间存在正相关关系。我们的研究结果表明,减轻空气污染可能是缓解肥胖负担的有效干预措施。
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