Zhejiang Provincial Research Center for Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Zhejiang Hospital, Hangzhou, Zhejiang, China.
School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China.
Ecotoxicol Environ Saf. 2023 Aug;261:115115. doi: 10.1016/j.ecoenv.2023.115115. Epub 2023 Jun 7.
Limited studies investigated the effects of long-term ozone exposure on cardiometabolic health. We aimed to examine the association of long-term ozone exposure with a range of cardiometabolic diseases, as well as the subclinical indicators in Eastern China. The study included 202,042 adults living in 11 prefecture-level areas in Zhejiang Province between 2014 and 2021. Using a satellite-based model with a 1 × 1 km spatial resolution, we estimated residential 5-year average ozone exposures for each subject. Mixed-effects logistic and linear regression models were applied to explore the associations of ozone exposure with cardiometabolic diseases and subclinical indicators, respectively. We found that a 9% [95% confidence interval (95% CI): 7-12%] higher in odds of cardiometabolic disease per 10 μg/m increase in ozone exposure. Specifically, we also found higher prevalence of cardiovascular diseases (15%), stroke (19%), hypertension (7%), dyslipidemia (15%), and hypertriglyceridemia (9%) associated with ozone exposure. However, we did not find significant associations between ozone exposure and coronary heart disease, myocardial infarction, or diabetes mellitus. Long-term ozone exposures were also significantly associated with adverse changes in systolic blood pressure, diastolic blood pressure, total serum cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, glucose concentration, and body mass index. Our results showed that people with lower education levels, those over 50 years old, and those who were overweight or obese were more susceptible to the effects of ozone on cardiometabolic diseases. Our findings demonstrated the detrimental effects of long-term ozone exposure on cardiometabolic health, emphasizing the need for ozone control strategies to reduce the burden of cardiometabolic diseases.
在中国东部，已有研究调查了长期臭氧暴露对心血管代谢健康的影响，但仍十分有限。本研究旨在探讨长期臭氧暴露与一系列心血管代谢疾病及亚临床指标的相关性。研究纳入了 2014 年至 2021 年间居住在浙江省 11 个地区的 202042 名成年人。我们采用空间分辨率为 1×1 公里的卫星模型来估计每个研究对象的住宅 5 年平均臭氧暴露量。应用混合效应逻辑回归和线性回归模型分别探讨了臭氧暴露与心血管代谢疾病及亚临床指标的相关性。结果发现，臭氧暴露每增加 10μg/m³，心血管代谢疾病的发生风险增加 9%（95%置信区间：7%-12%）。具体而言，我们还发现心血管疾病（15%）、中风（19%）、高血压（7%）、血脂异常（15%）和高甘油三酯血症（9%）的患病率与臭氧暴露呈正相关。然而，臭氧暴露与冠心病、心肌梗死或糖尿病之间并无显著相关性。长期臭氧暴露与收缩压、舒张压、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、血糖浓度和体重指数的不良变化也显著相关。研究结果表明，教育程度较低、年龄大于 50 岁、超重或肥胖的人群更容易受到臭氧对心血管代谢疾病影响。本研究结果表明，长期臭氧暴露对心血管代谢健康有不良影响，强调了需要采取臭氧控制策略来降低心血管代谢疾病负担。
