Liu Yang, Wu Bing Jie, Fan Bing Bing, Li Chun Xia, Su Chang, Liu Ai Dong, Zhang Tao
Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China.
National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Biomed Environ Sci. 2025 Jun 20;38(6):653-665. doi: 10.3967/bes2025.022.
Burning solid cooking fuel contributes to household air pollution and is associated with frailty. However, how solid cooking fuel use contributes to the development of frailty has not been well illustrated.
This study recruited 8,947 participants aged ≥ 45 years from the China Health and Retirement Longitudinal Study, 2011-2018. Group-based trajectory modeling was employed to identify frailty trajectories. Multinomial logistic regression was used to assess the association between solid cooking fuel use and frailty trajectories. Population-attributable fractions were used to estimate the frailty burden from solid fuel use.
We identified three frailty trajectories: low-stable ( = 5,789), moderate-increasing ( = 2,603), and fast-increasing ( = 555). Solid fuel use was associated with higher odds of being in the moderate-increasing ( : 1.24, 95% : 1.08-1.42) and fast-increasing ( : 1.48, 95% : 1.14-1.92) trajectories. These associations were strengthened by longer solid fuel use ( for trend < 0.001). Switching to clean fuel significantly reduced the risk of being in these trajectories compared with persistent solid fuel users. Without solid fuel, 8% of moderate- and 19% of fast-increasing trajectories demonstrated frailty development like the low-stable group.
Solid cooking fuel use is associated with frailty trajectories in middle-aged and older Chinese populations.
燃烧固体烹饪燃料会导致家庭空气污染，并与身体虚弱有关。然而，固体烹饪燃料的使用如何导致身体虚弱的发展尚未得到充分阐明。
本研究从2011 - 2018年中国健康与养老追踪调查中招募了8947名年龄≥45岁的参与者。采用基于群组的轨迹模型来识别虚弱轨迹。使用多项逻辑回归来评估固体烹饪燃料使用与虚弱轨迹之间的关联。采用人群归因分数来估计固体燃料使用导致的虚弱负担。
我们识别出三种虚弱轨迹：低稳定型（n = 5789）、中度上升型（n = 2603）和快速上升型（n = 555）。使用固体燃料与处于中度上升型（比值比：1.24，95%置信区间：1.08 - 1.42）和快速上升型（比值比：1.48，95%置信区间：1.14 - 1.92）轨迹的较高几率相关。这些关联因固体燃料使用时间更长而增强（趋势的p值<0.001）。与持续使用固体燃料的用户相比，改用清洁燃料显著降低了处于这些轨迹的风险。如果不使用固体燃料，8%的中度上升型和19%的快速上升型轨迹表现出与低稳定型组类似的虚弱发展。
在中国中老年人群中，使用固体烹饪燃料与虚弱轨迹有关。
