大气细颗粒物长期暴露及身体活动与中国成人中心性肥胖的关联研究

Association of long-term exposure to atmospheric fine particulate matter and physical activity with central obesity in Chinese adults

目的基于中国动脉粥样硬化性心血管疾病风险预测(China-PAR)研究队列人群,综合评估大气细颗粒物(particulate matter,PM_(2.5))长期暴露及身体活动与腰围、中心性肥胖的关联。方法选择China-PAR队列中参加2007—2008年(104697人)或2012—2015年(80235人)调查的个体,采用不完全重复测量设计,利用卫星遥感反演的1×1 km高分辨率的PM_(2.5)浓度数据,应用广义估计方程评估PM_(2.5)长期暴露与腰围及中心性肥胖患病风险的关联,以及理想身体活动在其中的修饰效应。此外,还进行了亚组分析和敏感性分析。结果PM_(2.5)浓度每增加10μg/m^(3),腰围增加1.10(95%CI:1.05~1.15)cm,中心性肥胖患病风险增加19%(OR=1.19,95%CI:1.17~1.20)。分类变量结果也显示PM_(2.5)暴露浓度与腰围、中心性肥胖风险显著关联。PM_(2.5)暴露与身体活动对腰围、中心性肥胖的影响存在显著交互作用。亚组分析和敏感性分析证实结果较稳健。结论PM_(2.5)长期暴露可以显著增加腰围及中心性肥胖患病风险,理想身体活动和PM_(2.5)暴露存在显著的交互作用。采取积极措施控制PM_(2.5)污染与增强身体活动对降低中心性肥胖疾病负担均有重要意义。

Objective Based on the Prediction for Atherosclerotic Cardiovascular Disease Risk in China(China-PAR),this study aimed to comprehensively evaluate the association between long-term PM_(2.5)exposure,physical activity,waist circumference,and central obesity.Methods Individuals who participated in the China-PAR study in 2007-2008(n=104697)or 2012-2015(n=80235)were involved in this study.The generalized estimating equation(GEE)method was employed to assess the associations between satellite-based PM_(2.5)estimated at 1×1 km spatial resolution and waist circumference as well as central obesity with unbalanced repeat measurement design.We also evaluated the modification effect of ideal physical activity on these associations.Moreover,sensitivity analyses and subgroup analyses were also conducted.Results Each increment of 10μg/m^(3)in PM_(2.5)concentration was associated with an increase of 1.10(95%CI:1.05-1.15)cm in waist circumference and 19%in the prevalence of central obesity(OR=1.19,95%CI:1.17-1.20).The results of categorical variables also suggest that PM_(2.5)exposure was significantly associated with waist circumference and the prevalence of central obesity.There were positive interactions between PM_(2.5)exposure and physical activity on waist circumference and central obesity.Subgroup analyses and sensitivity analyses confirmed the robustness of the results.Conclusions Long-term exposure to PM_(2.5)significantly increases waist circumference and the prevalence of central obesity,with a significant interaction between ideal physical activity and PM_(2.5)exposure.Active interventions for improving air quality and enhancing physical activity are of great importance in reducing the burden of central obesity-relateddiseases.