危地马拉、印度、秘鲁和卢旺达农村地区妇女家庭空气污染与体重指数的暴露-反应关系：家庭空气污染干预网络试验

Exposure-response relationship of household air pollution on body mass index among women in rural areas of Guatemala, India, Peru and Rwanda: household air pollution intervention network trial.

作者信息

Ndikubwimana Adolphe, Checkley William, Chen Yunyun, Clasen Thomas, Contreras Carmen Lucía, Diaz-Artiga Anaite, Dusabimana Ephrem, de Las Fuentes Lisa, Jabbarzadeh Shirin, Johnson Michael, Kalisa Egide, Karakwende Patrick, Kirby Miles, Lovvorn Amy E, McCracken John P, Ndagijimana Florien, Ntakirutimana Theoneste, Ntivuguruzwa Jean Dieu, Peel Jennifer L, Pillarisetti Ajay, Dávila-Román Victor G, Rosa Ghislaine, Garg Sarada S, Thompson Lisa, Waller Lance A, Wang Jiantong, Clark Maggie L, Young Bonnie N

机构信息

School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, KG11, Rwanda.

Division of Pulmonary and Critical Care, and the Center for Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.

出版信息

BMC Public Health. 2025 Jun 10;25(1):2163. doi: 10.1186/s12889-025-23380-1.

DOI:10.1186/s12889-025-23380-1

PMID:40495115

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12150507/

Abstract

BACKGROUND

Household air pollution from burning biomass materials, the main cooking fuel in low- and middle-income countries, may be linked to metabolic dysfunction. We assessed cross-sectional associations between household air pollution and body mass index (BMI), expecting to see increased BMI with higher pollution concentrations.

METHODS

We analyzed data from 414 women aged 40 to 79 years who resided in the households using biomass fuel and were enrolled in the multi-country Household Air Pollution Intervention Network (HAPIN) Trial. We explored associations of 24-h average personal exposure to fine particulate matter (PM), black carbon (BC), and carbon monoxide (CO) with BMI through single pollutant linear and logistic models adjusted for potential confounders (i.e., age, socioeconomic indicators, education, dietary diversity, secondhand smoke exposure, alcohol and grain consumption).Sensitivity analyses explored air pollutants as quartiles, and other variables as potential confounders, such as physical activity, enrollment site, and dietary items. We examined effect modification of research site on the associations.

RESULTS

We observed mixed evidence of associations between household air pollution and BMI in linear regression. There was no association with BMI and PM₂.₅ (1-unit increase in log-transformed PM₂.₅ estimate 0.02 kg/m [95% CI: -0.51, 0.54]) or CO (1-unit increase in log-transformed CO estimate 0.42 kg/m [95% CI -0.31, 1.14]). However, a 1-unit increase in log-transformed BC showed an association in the opposite direction as hypothesized (BC estimate -0.59 kg/m [95% CI -1.17, -0.003]). Using logistic regression models, we found that only CO significantly increased the odds of overweight/obesity: a 1-unit increase in log-transformed CO led to an odds ratio of 1.66 (95% CI: 1.10, 2.51). Effect modification showed inverse association between BC exposure and BMI in Peru.

CONCLUSIONS

Evidence suggests a significant association between CO exposure and increased odds of being overweight/obese, whereas impacts of PM and BC on BMI had null or inverse effects.

摘要

背景

在低收入和中等收入国家，燃烧生物质材料作为主要烹饪燃料所造成的家庭空气污染可能与代谢功能障碍有关。我们评估了家庭空气污染与体重指数（BMI）之间的横断面关联，预计污染浓度越高，BMI越高。

方法

我们分析了414名年龄在40至79岁之间、居住在使用生物质燃料家庭中的女性的数据，这些女性参与了多国家庭空气污染干预网络（HAPIN）试验。我们通过单污染物线性和逻辑模型，在对潜在混杂因素（即年龄、社会经济指标、教育程度、饮食多样性、二手烟暴露、酒精和谷物消费）进行调整后，探讨了24小时平均个人暴露于细颗粒物（PM）、黑碳（BC）和一氧化碳（CO）与BMI之间的关联。敏感性分析将空气污染物作为四分位数进行探讨，将其他变量作为潜在混杂因素，如身体活动、入组地点和饮食项目。我们研究了研究地点对这些关联的效应修正作用。

结果

我们在线性回归中观察到家庭空气污染与BMI之间关联的证据不一。BMI与PM₂.₅（对数转换后的PM₂.₅每增加1个单位，估计为0.02 kg/m [95%可信区间：-0.51, 0.54]）或CO（对数转换后的CO每增加1个单位，估计为0.42 kg/m [95%可信区间 -0.31, 1.14]）均无关联。然而，对数转换后的BC每增加1个单位，显示出与假设相反方向的关联（BC估计值为-0.59 kg/m [95%可信区间 -1.17, -0.003]）。使用逻辑回归模型，我们发现只有CO显著增加了超重/肥胖的几率：对数转换后的CO每增加1个单位，导致比值比为1.66（95%可信区间：1.10, 2.51）。效应修正显示在秘鲁，BC暴露与BMI之间存在负相关。