Li Kexin, Wang Peihan, Wang Zhenbo, Xu Chengdong, Wang Shaobin, Li Zhiyi, Wang Peng
Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, PR China.
Key Laboratory of Regional Sustainable Development Modelling, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, PR China.
J Glob Health. 2025 May 16;15:04131. doi: 10.7189/jogh.15.04131.
Cardiovascular disease (CVD) remains the leading cause of death in China and worldwide. However, a large proportion of CVD can be prevented by regulating the levels of cardiovascular risk predictors. Despite the contribution of well-established factors to changes in cardiovascular risk predictors, the role of the regional environment and its combined effects with individual factors, which could affect health outcomes, remain unclear.
We included 10 308 middle-aged and older Chinese adults from the 2015 China Health and Retirement Longitudinal Study. High-sensitivity C-reactive protein (hs-CRP) is a cardiovascular risk predictor. Related potential factors including individual characteristics, regional air pollution, and regional socioeconomic status characteristics were also collected. The geographical detector method was used to quantify the explanatory power of individual and regional factors separately and in pairs in the hs-CRP levels according to regions (southern vs. northern China).
Blood triglyceride had the highest explanatory power for hs-CRP levels. Regional environment factors, including air pollution and socioeconomic status, significantly affected hs-CRP levels, and the results differed by region. Indoor air pollution and regional industrial structure had a stronger effect on hs-CRP levels in the south, whereas outdoor air pollution and economic level had a greater effect in the north. The interactions between any two of the paired factors enhanced the effects.
Spatial stratified heterogeneity of the leading risk factors for hs-CRP, a powerful cardiovascular risk predictor, was found. The combined effect of individual factors and regional environment enhanced the explanatory power of each risk factor. The results suggest that policymakers should choose different optimal approaches to regulate the cardiovascular risk predictor levels of middle-aged and older Chinese adults in different regions and the interaction effects between individual factors and the regional environment should be considered.
在中国乃至全球，心血管疾病（CVD）仍是主要死因。然而，通过调节心血管风险预测指标水平，很大一部分心血管疾病是可以预防的。尽管一些已明确的因素对心血管风险预测指标的变化有影响，但区域环境及其与个体因素的综合作用对健康结果的影响仍不明确，而这种综合作用可能会影响健康状况。
我们纳入了来自2015年中国健康与养老追踪调查的10308名中国中老年人。高敏C反应蛋白（hs-CRP）是一种心血管风险预测指标。我们还收集了相关潜在因素，包括个体特征、区域空气污染和区域社会经济状况特征。采用地理探测器方法，根据地区（中国南方与北方）分别和成对地量化个体因素和区域因素对hs-CRP水平的解释力。
血液甘油三酯对hs-CRP水平的解释力最高。包括空气污染和社会经济状况在内的区域环境因素显著影响hs-CRP水平，且结果因地区而异。室内空气污染和区域产业结构对南方hs-CRP水平的影响更强，而室外空气污染和经济水平对北方的影响更大。成对因素中任意两个之间的相互作用增强了这种影响。
我们发现了hs-CRP这一重要心血管风险预测指标的主要危险因素存在空间分层异质性。个体因素和区域环境的综合作用增强了每个风险因素的解释力。结果表明，政策制定者应选择不同的最佳方法来调节不同地区中国中老年人的心血管风险预测指标水平，并且应考虑个体因素与区域环境之间的相互作用。
