Liu Dong, Luo Xiaoyan, Zhou Kunyan
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, China.
PLoS One. 2025 Jul 17;20(7):e0325524. doi: 10.1371/journal.pone.0325524. eCollection 2025.
Outdoor air pollutants, particularly particulate matter (PM) and nitrogen dioxide (NO2), have been closely linked to diabetes mellitus, other metabolic disorders, and cardiovascular diseases. Visceral adiposity, a common high-risk factor for these conditions, may mediate the impact of air pollution on disease development. However, the potential role of outdoor air pollution on visceral adiposity remains unclear, especially in the Asian population and in older adults (> 60 years). Given the high levels of air pollution and the rising prevalence of visceral obesity in China, this study investigated whether there is a linear and/or non-linear association between the Chinese Visceral Adiposity Index (cVAI) and exposure to individual and combined air pollutants in 7,552 participants aged ≥ 45 years in China. Data on air pollutants were acquired from the ChinaHighAirPollution dataset. These included PM with an aerodynamic diameter ≤ 2.5 μm (PM2.5), PM10, NO2, ozone (O3), and sulfur dioxide (SO2). Our results demonstrate that exposure to all of these pollutants (PM2.5, PM10, NO2, O3, and SO2) was significantly and positively associated with the cVAI, with dose-response relationships observed in trends test across pollutants. In subgroup anslysis, the associations were particularly pronounced in men and active smokers. Specifically, smokers in the highest quartile of PM2.5 exposure had a β coefficient of 16.89 (95%CI:11.00, 22.78), while males had a β coefficient of 14.38 (95%CI:9.68, 19.07). NO2 and PM2.5 were identified as the primary contributors to the total effect of outdoor air pollution exposure. In conclusion, this study is the first to reveal that outdoor air pollutants, particularly PM2.5 and NO2, are significantly associated with increased visceral adiposity in middle-aged and older Chinese adults. Males and active smokers could be high risk groups, when compared with females and non-smokers. This study highlights an urgent need for public health policies mitigating visceral obesity through the reduction of outdoor air pollution exposure.
室外空气污染物，尤其是颗粒物（PM）和二氧化氮（NO₂），与糖尿病、其他代谢紊乱以及心血管疾病密切相关。内脏肥胖是这些疾病的常见高危因素，可能介导空气污染对疾病发展的影响。然而，室外空气污染对内脏肥胖的潜在作用仍不明确，尤其是在亚洲人群和老年人（>60岁）中。鉴于中国的高空气污染水平和内脏肥胖患病率的上升，本研究调查了中国内脏脂肪指数（cVAI）与中国7552名年龄≥45岁参与者接触单一和混合空气污染物之间是否存在线性和/或非线性关联。空气污染物数据来自ChinaHighAirPollution数据集。这些污染物包括空气动力学直径≤2.5μm的颗粒物（PM2.5）、PM10、NO₂、臭氧（O₃）和二氧化硫（SO₂）。我们的结果表明，接触所有这些污染物（PM2.5、PM10、NO₂、O₃和SO₂）均与cVAI显著正相关，在各污染物的趋势检验中观察到剂量反应关系。在亚组分析中，这种关联在男性和现吸烟者中尤为明显。具体而言，PM2.5暴露最高四分位数的吸烟者β系数为16.89（95%CI：11.00，22.78），而男性的β系数为14.38（95%CI：9.68，19.07）。NO₂和PM2.5被确定为室外空气污染暴露总效应的主要贡献因素。总之，本研究首次揭示，室外空气污染物，尤其是PM2.5和NO₂，与中国中老年成年人内脏肥胖增加显著相关。与女性和非吸烟者相比，男性和现吸烟者可能是高危人群。本研究强调迫切需要通过减少室外空气污染暴露来制定减轻内脏肥胖的公共卫生政策。
