Ethnic disparities in the association between ambient air pollution and risk for cardiometabolic abnormalities in China

Shujuan Yang; Xian Liang; Qingyu Dou; Yang La; Jiaojiao Cai; Jun Yang; Ciren Laba; Qiaolan Liu; Bing Guo; Wanqi Yu; Qinjian Wang; Gongbo Chen; Feng Hong; Peng Jia; Xing Zhao; China Multi-Ethnic Cohort (CMEC) collaborative group

doi:10.1016/j.scitotenv.2022.155940

Ethnic disparities in the association between ambient air pollution and risk for cardiometabolic abnormalities in China

Sci Total Environ. 2022 Sep 10;838(Pt 1):155940. doi: 10.1016/j.scitotenv.2022.155940. Epub 2022 May 14.

Authors

Shujuan Yang¹, Xian Liang², Qingyu Dou³, Yang La⁴, Jiaojiao Cai⁵, Jun Yang⁶, Ciren Laba⁷, Qiaolan Liu⁸, Bing Guo⁸, Wanqi Yu⁸, Qinjian Wang⁸, Gongbo Chen⁹, Feng Hong¹⁰, Peng Jia¹¹, Xing Zhao¹²; China Multi-Ethnic Cohort (CMEC) collaborative group

Affiliations

¹ West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China.
² Chengdu Center for Disease Control and Prevention, Chengdu, China.
³ National Clinical Research Center of Geriatrics, Geriatric Medicine Center, West China Hospital, Sichuan University, Chengdu, China; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China.
⁴ Tibet University, Lhasa, China.
⁵ Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China.
⁶ Yunnan Center for Disease Control and Prevention, Kunming, China.
⁷ Tibet Center for Disease Control and Prevention, Lhasa, China.
⁸ West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
⁹ Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China.
¹⁰ School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China. Electronic address: fhong@gmc.edu.cn.
¹¹ International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China; School of Resource and Environmental Sciences, Wuhan University, Wuhan, China. Electronic address: jiapengff@hotmail.com.
¹² West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China. Electronic address: xingzhao@scu.edu.cn.

PMID: 35580681
DOI: 10.1016/j.scitotenv.2022.155940

Abstract

Background: Long-term exposure to ambient air pollution has been associated with cardiometabolic abnormalities (CAs), which, however, may be stronger in vulnerable populations, such as minorities. The variation of the association between ambient air pollution and CAs between the majority (Han) and minority populations in China have been poorly studied.

Objectives: We aimed to estimate and compare the Hans' and minorities' risks for CAs associated with long-term exposure to ambient air pollution in Southwest China.

Methods: A cross-sectional study was conducted on the basis of the China Multi-Ethnic Cohort. CAs were defined by the presence of at least three pre-defined metabolic dysfunctions (central obesity, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure, and elevated fasting glucose). The concentrations of ambient air pollutants, including particulate matters (PM₁, PM_2.5, and PM₁₀) and nitrogen dioxide (NO₂), were generated from random forest models on the basis of multi-source data. One- and two-pollutant regression models were fit to assess associations between air pollutant exposure and CA risks. Sensitivity analyses were performed to examine the robustness of the associations.

Results: The final sample included 51,037 Hans and 28,702 minority participants. The prevalence of CAs was 25.0%, slightly higher in the minorities (25.5%) than the Hans (24.4%). The higher risks for CAs in the overall population were associated with each 10 μg/m³ increase in the exposure to PM₁ (OR = 1.07 [1.05-1.09]), PM_2.5 (OR = 1.11 [1.06-1.17]), PM₁₀ (OR = 1.04 [1.03-1.06]), and NO₂ (OR = 1.04 [1.03-1.07]). Compared to the Hans, the higher risks for CAs were observed in the minorities for PM₁ (OR = 1.35 [1.18-1.53]), PM_2.5 (OR = 1.61 [1.34-1.93]), and PM₁₀ (OR = 1.15 [1.07-1.23]). The associations of metabolic dysfunctions (CA components) with ambient air pollution also varied between the Han and minority populations.

Conclusions: The associations between exposure to ambient air pollution and CA risks were stronger in the minorities than Hans. Our findings provide a better understanding of ethnic disparities in CA risks when being exposed to ambient air pollution in China, which also have important implications for other low- and middle-income countries where less health resources (e.g., cohort populations) are available to conduct such studies.

Keywords: Air pollution; Cardiometabolic abnormalities; Ethnic disparity; LMIC; Minority.

MeSH terms

Air Pollutants* / analysis
Air Pollution* / analysis
Cardiovascular Diseases* / epidemiology
China / epidemiology
Cross-Sectional Studies
Environmental Exposure / analysis
Humans
Nitrogen Dioxide / analysis
Particulate Matter / analysis

Substances

Air Pollutants
Particulate Matter
Nitrogen Dioxide