Zhu Huanjin, Lin Keng, Liu Weiling, Qin Jiangxia, Zhang Junhao, Wu Yong, Wang Liyun, Liu Weiqi
Department of Clinical Laboratory, The Maternal and Children Health Care Hospital (Huzhong Hospital) of Huadu, Guangzhou, Guangdong, China.
Department of Clinical Laboratory, Foshan Fosun Chancheng Hospital, Foshan, Guangdong, China.
BMJ Open. 2025 Jun 19;15(6):e100236. doi: 10.1136/bmjopen-2025-100236.
To investigate the associations between fine particulate matter (PM) and its components and cardiovascular disease (CVD) and to explore the potential mediating role of the normalised difference vegetation index (NDVI) in mitigating PM exposure and its related health risks.
Using data from the 4th and 5th waves of the China Health and Retirement Longitudinal Study, we included 11 279 eligible participants after strict screening.
A logistic regression model was used to assess the effects of PM and its components on CVD. The logistic regression, combined with restricted cubic splines, was used to explore non-linear associations, and a mediation analysis was performed to assess the role of the NDVI.
Among the 11 279 participants, 775 (14.7%) developed CVD during the follow-up period. The results revealed that every 1 µg/m³ increase in the PM concentration was associated with a 2.1% (95% CI: 1.013 to 1.029) increased risk of CVD, and the sulphate, ammonium, nitrate, organic matter and black carbon components of PM also exhibited significant positive correlations. Mediation analysis revealed that the NDVI significantly mediated the effects of PM and its components on CVD, with mediation proportions ranging from 42.27% to 56.13%. Stratified analyses revealed significant interactions of PM and its components with CVD risk in different settlement types.
Exposure to PM and its constituents increases the risk of CVD. Increasing green space may help mitigate the adverse effects of air pollution on cardiovascular health, particularly in different types of settlements.
研究细颗粒物（PM）及其成分与心血管疾病（CVD）之间的关联，并探讨归一化植被指数（NDVI）在减轻PM暴露及其相关健康风险方面的潜在中介作用。
利用中国健康与养老追踪调查第四轮和第五轮的数据，经过严格筛选，我们纳入了11279名符合条件的参与者。
采用逻辑回归模型评估PM及其成分对CVD的影响。结合受限立方样条的逻辑回归用于探索非线性关联，并进行中介分析以评估NDVI的作用。
在11279名参与者中，775人（14.7%）在随访期间患上了CVD。结果显示，PM浓度每增加1μg/m³，CVD风险增加2.1%（95%CI：1.013至1.029），PM的硫酸盐、铵盐、硝酸盐、有机物和黑碳成分也呈现出显著的正相关。中介分析表明，NDVI显著介导了PM及其成分对CVD的影响，中介比例在42.27%至56.13%之间。分层分析显示，PM及其成分与不同居住类型的CVD风险存在显著交互作用。
暴露于PM及其成分会增加CVD风险。增加绿地面积可能有助于减轻空气污染对心血管健康的不利影响，尤其是在不同类型的居住环境中。
