Association of long-term exposure to PM2.5 with blood lipids in the Chinese population: Findings from a longitudinal quasi-experiment

Jiajianghui Li; Yao Yao; Wuxiang Xie; Bin Wang; Tianjia Guan; Yiqun Han; Huiyu Wang; Tong Zhu; Tao Xue

doi:10.1016/j.envint.2021.106454

Association of long-term exposure to PM_2.5 with blood lipids in the Chinese population: Findings from a longitudinal quasi-experiment

Environ Int. 2021 Jun:151:106454. doi: 10.1016/j.envint.2021.106454. Epub 2021 Mar 3.

Authors

Jiajianghui Li¹, Yao Yao², Wuxiang Xie³, Bin Wang¹, Tianjia Guan⁴, Yiqun Han⁵, Huiyu Wang¹, Tong Zhu⁶, Tao Xue⁷

Affiliations

¹ Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
² Center for Healthy Aging and Development Studies, Raissun Institute for Advanced Studies, National School of Development, Peking University, Beijing, China.
³ Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China.
⁴ School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁵ Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, London, UK.
⁶ BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Center for Environment and Health, Peking University, Beijing China.
⁷ Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. Electronic address: xuetaogk_9032@126.com.

PMID: 33676285
DOI: 10.1016/j.envint.2021.106454

Abstract

Background: Although epidemiological studies on the effect of chronic fine particulate matter (PM_2.5) exposure on lipid disorders have been conducted, it is unclear if improved air quality is associated with beneficial changes in the blood lipid profile. In China, clean air actions introduced in 2013 have rapidly reduced the concentration of ambient PM_2.5.

Methods: We conducted a change-by-change study, based on two waves (2011 and 2015) of a national survey of the same 5111 Chinese adults before and after implementation of the clean air actions. Long-term PM_2.5 exposure was assessed using a state-of-the-art estimator at the city level. Based on the within-individual differences between the two waves, we associated PM_2.5 changes with the variations of four lipid biomarkers-triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C)-using a mixed-effects regression model. The robustness and homogeneity of the association were tested via sensitivity analyses.

Results: For each 10 μg/m³ reduction in PM_2.5, LDL-C, and TC decreased by 2.71 (95% confidence interval [CI] 0.10-5.32) and 4.16 (95% CI 1.24-7.08)mg/dL, respectively. There was no significant association with HDL-C or TG. The results were robust among models adjusted for different covariates. PM_2.5 was a significant risk factor for dyslipidemia with an adjusted relative risk of 1.21 (95% CI 1.09-1.34). The association between PM_2.5 and LDL-C was stronger in the elderly or adults who did not take medications.

Conclusions: The results suggest that PM_2.5 exert a cardiotoxic effect by increasing the risk of lipid disorders. Improvement of air quality could prevent dyslipidemia by reducing LDL-C and TC levels. Clean air policies should be implemented as public health measures in countries with aging societies, especially developing ones with a high air pollution burden.

Keywords: Air quality policy; Cardiovascular diseases; Lipids; PM(2.5); Quasi-experiment.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Air Pollutants* / adverse effects
Air Pollutants* / analysis
Air Pollution* / adverse effects
Air Pollution* / analysis
China
Cities
Environmental Exposure / analysis
Humans
Lipids
Particulate Matter / analysis

Substances

Air Pollutants
Lipids
Particulate Matter