Air quality and obesity at older ages in China: The role of duration, severity and pollutants

English version

Autoři: Nan Zhang ^aff001; Lei Wang ^aff003; Min Zhang ^aff005; James Nazroo ^aff002
Působiště autorů: Social Statistics, Cathie Marsh Institute for Social Research (CMI), School of Social Sciences, The University of Manchester, Manchester, United Kingdom ^aff001; Manchester Institute for Collaborative Research on Ageing (MICRA), School of Social Sciences, The University of Manchester, Manchester, United Kingdom ^aff002; Key Laboratory of Watershed Geographic Sciences, Nanjing Institute of Geography and Limnology, Chinese Academy of Sciences, Nanjing, China ^aff003; Manchester Urban Institute, Urban Planning, School of Environment, Education and Development, The University of Manchester, United Kingdom ^aff004; Faculty of Education, University of Cambridge, Cambridge, United Kingdom ^aff005; Sociology, School of Social Sciences, The University of Manchester, Manchester, United Kingdom ^aff006
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0226279

Souhrn

Background

Population ageing and air pollution have emerged as two of the most pressing challenges in China. However, little evidence has explored the impact of air pollution on obesity among older adults in China.

Methods

The China Health and Retirement Longitudinal Study—a nationally representative sample of middle-aged and older Chinese was linked to the air pollution data at the city level. Multilevel logistic models were fitted on obesity status among older people in relation to different air quality measures such as chronic exposures to severities of air pollution and pollutants.

Results

Air pollution was positively associated with increased risks of general obesity and abdominal obesity among older adults (N = 4,364) especially for those with disability. The marginal effects of average air quality index (AQI) on obesity suggest that one standard deviation increase in AQI is associated with increased risks of central obesity by 2.8% (95%CI 1.7% 3.9%) and abdominal obesity by 6.2% (95%CI 4.4% 8.0%). The risk of chronic exposures to light (and moderate), heavy and severe pollution on obesity elevated in a graded fashion in line with the level of pollution. Durations of exposure to PM2.5 and PM10 were significantly associated with increased risk of obesity among older people in China.

Conclusions

Chronic exposures to severe air pollution and certain pollutants such as PM2.5 and PM10 raise the risk of obesity among older people in China and the relationships were stronger for those with disability. Future policies that target these factors might provide a promising way of enhancing the physical health of older people.

Klíčová slova:

Physical activity – Obesity – Economic analysis – Elderly – China – Air pollution – Pollutants – Air quality

Zdroje

1. WHO. Air pollution: World Health Organisation; 2018 [cited 2018 October 29]. Available from: https://www.who.int/airpollution/en/.

2. WHO. WHO Global Ambient Air Quality Database (update 2018): World Health Organisation; 2018 [cited 2018 October 29]. Available from: http://www.who.int/airpollution/data/cities/en/.

3. Greenstone M, Hanna R. Environmental Regulations, Air and Water Pollution, and Infant Mortality in India. American Economic Review. 2014;104(10):3038–72.

4. Rohde RA, Muller RA. Air Pollution in China: Mapping of Concentrations and Sources. PLoS One. 2015;10(8):e0135749. doi: 10.1371/journal.pone.0135749 26291610

5. Greenpace. 绿色和平发布2017年中国365个城市PM2.5浓度排名:“大气十条”目标完成,全国臭氧污染及非京津冀地区空气治理需加强 2018 [cited 2018 November 5]. Available from: http://www.greenpeace.org.cn/air-pollution-2017-city-ranking/.

6. United States Environmental Protection Agency. Criteria Air Pollutants 2018 [cited 2018 November 4]. Available from: https://www.epa.gov/criteria-air-pollutants.

7. Ministry of Ecology and Environment of the People's Republic of China. Ambient Air Quality Standards "环境空气质量标准" Ministry of Ecology and Environment of the People's Republic of China, 2012. Report No.: GB 3095–2012.

8. WHO. Mortality and burden of disease from ambient air pollution: World Health Organisation; 2016 [cited 2018 October 29]. Available from: http://www.who.int/gho/phe/outdoor_air_pollution/burden/en/.

9. Mazidi M, Speakman JR. Ambient particulate air pollution (PM2.5) is associated with the ratio of type 2 diabetes to obesity. Sci Rep. 2017;7(1):9144. doi: 10.1038/s41598-017-08287-1 28831041

10. Mazidi M, Speakman JR. Impact of Obesity and Ozone on the Association Between Particulate Air Pollution and Cardiovascular Disease and Stroke Mortality Among US Adults. J Am Heart Assoc. 2018;7(11). doi: 10.1161/JAHA.117.008006 29848499

11. Lin H, Guo Y, Zheng Y, Di Q, Liu T, Xiao J, et al. Long-Term Effects of Ambient PM2.5 on Hypertension and Blood Pressure and Attributable Risk Among Older Chinese Adults. Hypertension. 2017;69(5):806–12. doi: 10.1161/HYPERTENSIONAHA.116.08839 28348017

12. Qin XD, Qian Z, Vaughn MG, Trevathan E, Emo B, Paul G, et al. Gender-specific differences of interaction between obesity and air pollution on stroke and cardiovascular diseases in Chinese adults from a high pollution range area: A large population based cross sectional study. Sci Total Environ. 2015;529:243–8. doi: 10.1016/j.scitotenv.2015.05.041 26022408

13. Weichenthal S, Hoppin JA, Reeves F. Obesity and the cardiovascular health effects of fine particulate air pollution. Obesity. 2014;22(7):1580–9. doi: 10.1002/oby.20748 24639433

14. Yang BY, Qian ZM, Li S, Chen G, Bloom MS, Elliott M, et al. Ambient air pollution in relation to diabetes and glucose-homoeostasis markers in China: a cross-sectional study with findings from the 33 Communities Chinese Health Study. Lancet Planet Health. 2018;2(2):e64–e73. doi: 10.1016/S2542-5196(18)30001-9 29615239

15. Wang Y, Eliot MN, Kuchel GA, Schwartz J, Coull BA, Mittleman MA, et al. Long-term exposure to ambient air pollution and serum leptin in older adults: results from the MOBILIZE Boston study. J Occup Environ Med. 2014;56(9):e73–7. doi: 10.1097/JOM.0000000000000253 25192230

16. Dubowsky SD, Suh H, Schwartz J, Coull BA, Gold DR. Diabetes, obesity, and hypertension may enhance associations between air pollution and markers of systemic inflammation. Environ Health Perspect. 2006;114(7):992–8. doi: 10.1289/ehp.8469 16835049

17. Zeka A, Sullivan JR, Vokonas PS, Sparrow D, Schwartz J. Inflammatory markers and particulate air pollution: characterizing the pathway to disease. Int J Epidemiol. 2006;35(5):1347–54. doi: 10.1093/ije/dyl132 16844771

18. WHO. Ambient (outdoor) air quality and health 2018 [cited 2018 November 4]. Available from: http://www.who.int/en/news-room/fact-sheets/detail/ambient-(outdoor)-air-quality-and-health.

19. Clark C, Smuk M, Cummins S, Eldridge S, Fahy A, Lewis D, et al. An Olympic Legacy? Did the Urban Regeneration Associated With the London 2012 Olympic Games Influence Adolescent Mental Health? American Journal of Epidemiology. 2018;187(3):474–83. doi: 10.1093/aje/kwx205 28595334

20. Wei Y, Zhang JJ, Li Z, Gow A, Chung KF, Hu M, et al. Chronic exposure to air pollution particles increases the risk of obesity and metabolic syndrome: findings from a natural experiment in Beijing. FASEB J. 2016;30(6):2115–22. doi: 10.1096/fj.201500142 26891735

21. Gray CL, Messer LC, Rappazzo KM, Jagai JS, Grabich SC, Lobdell DT. The association between physical inactivity and obesity is modified by five domains of environmental quality in U.S. adults: A cross-sectional study. PLoS One. 2018;13(8):e0203301. doi: 10.1371/journal.pone.0203301 30161196

22. Yu H, An R, Andrade F. Ambient Fine Particulate Matter Air Pollution and Physical Activity: A Longitudinal Study of University Retirees in Beijing, China. Am J Health Behav. 2017;41(4):401–10. doi: 10.5993/AJHB.41.4.4 28601099

23. Jiao K, Xu M, Liu M. Health status and air pollution related socioeconomic concerns in urban China. International Journal for Equity in Health. 2018;17(1):18. doi: 10.1186/s12939-018-0719-y 29402280

24. Liu S, Yan Z, Liu Y, Yin Q, Kuang L. Association between air pollution and chronic diseases among the elderly in China. Nat Hazards. 2017;89:79–91.

25. Fisher RJ, Katz JE. Social‐desirability bias and the validity of self‐reported values. Psychology & Marketing. 2000;17(2):105–20.

26. Zhang J, McLaughlin SJ, Li LW. Cumulative exposure to air pollution and subsequent mortality among older adults in China. Journal of Public Health. 2018. doi: 10.1093/pubmed/fdy154 30184234

27. Dannefer D. Cumulative advantage/disadvantage and the life course: Cross-fertilizing age and social science theory. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences. 2003;58(6):S327–S37. doi: 10.1093/geronb/58.6.s327 14614120

28. Zhou B. Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults—study on optimal cut-off points of body mass index and waist circumference in Chinese adults. Biomedical and environmental sciences: BES. 2002;15(1):83–96. 12046553

29. WHO. Obesity: preventing and managing the global epidemic. Geneva: WHO, 1997.

30. Thomas GN, McGhee SM, Schooling M, Ho SY, Lam KS, Janus ED, et al. Impact of sex-specific body composition on cardiovascular risk factors: the Hong Kong Cardiovascular Risk Factor Study. Metabolism. 2006;55(5):563–9. doi: 10.1016/j.metabol.2005.08.004 16631430

31. Schneider HJ, Friedrich N, Klotsche J, Pieper L, Nauck M, John U, et al. The predictive value of different measures of obesity for incident cardiovascular events and mortality. J Clin Endocrinol Metab. 2010;95(4):1777–85. doi: 10.1210/jc.2009-1584 20130075

32. Reis JP, Allen N, Gunderson EP, Lee JM, Lewis CE, Loria CM, et al. Excess body mass index- and waist circumference-years and incident cardiovascular disease: the CARDIA study. Obesity. 2015;23(4):879–85. doi: 10.1002/oby.21023 25755157

33. Fan H, Li X, Zheng L, Chen X, Wu H, Ding X, et al. Abdominal obesity is strongly associated with Cardiovascular Disease and its Risk Factors in Elderly and very Elderly Community-dwelling Chinese. Scientific Reports. 2016;6:21521. doi: 10.1038/srep21521 26882876

34. Michalakis K, Goulis DG, Vazaiou A, Mintziori G, Polymeris A, Abrahamian-Michalakis A. Obesity in the ageing man. Metabolism. 2013;62(10):1341–9. doi: 10.1016/j.metabol.2013.05.019 23831443

35. Zamboni M, Mazzali G, Zoico E, Harris TB, Meigs JB, Di Francesco V, et al. Health consequences of obesity in the elderly: a review of four unresolved questions. Int J Obes. 2005;29(9):1011–29. doi: 10.1038/sj.ijo.0803005 15925957

36. Ministry of Ecology and Environment of the People's Republic of China. Technical Regulation on Ambient Air Quality Index (on trial) "环境空气质量指数(AQI) 技术规定(试行)”. Ministry of Ecology and Environment of the People's Republic of China, 2012 2018-10-29. Report No.: Contract No.: HJ 633–2012.

37. Meyer BD, Sullivan JX. Measuring the well-being of the poor using income and consumption. J Hum Resour. 2003;38:1180–220.

38. World Bank. World Development Report 2000/2001: Attacking Poverty. New York: The World Bank, 2001.

39. Zhang Z, Treiman DJ. Social origins, hukou conversion, and the wellbeing of urban residents in contemporary China. Social Science Research. 2013;42(1):71–89. doi: 10.1016/j.ssresearch.2012.08.004 23146599

40. Chan KW, Buckingham W. Is China abolishing the hukou system? The China Quarterly. 2008;195(1):582–605.

41. China City Statistical Yearbook (2016): China Statistics Press; 2016.

42. Duncan C, Jones K, Moon G. Context, composition and heterogeneity: using multilevel models in health research. Social Science & Medicine. 1998;46(1):97–117.

43. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51(6):1173–82. doi: 10.1037//0022-3514.51.6.1173 3806354

44. Song MN X. C, J.X K, Wang HM. Prevalence and influencing factors of overweight obesity among middle-aged and elderly people in China. Chin J Dis Control Prev. 2018;22(8):804–8.

45. Zou MH. Is NAD (P) H oxidase a missing link for air pollution-enhanced obesity? Arteriosclerosis, Thrombosis, and Vascular Biology. 2010;30(12):2323–4. doi: 10.1161/ATVBAHA.110.216648 21084700

46. Dong GH, Qian Z, Liu MM, Wang D, Ren WH, Flick LH, et al. Ambient air pollution and the prevalence of obesity in Chinese children: The seven northeastern cities study. Obesity. 2014;22(3):795–800.

47. Moran A, Gu D, Zhao D, Coxson P, Wang YC, Chen C-S, et al. Future cardiovascular disease in China: Markov model and risk factor scenario projections from the coronary heart disease policy model–China. Circulation: Cardiovascular Quality and Outcomes. 2010;3(3):243–52. doi: 10.1161/CIRCOUTCOMES.109.910711 20442213

48. Wang J, Ning X, Yang L, Lu H, Tu J, Jin W, et al. Trends of hypertension prevalence, awareness, treatment and control in rural areas of northern China during 1991–2011. Journal of Human Hypertension. 2014;28(1):25. doi: 10.1038/jhh.2013.44 23739160

49. Yu Z, Nissinen A, Vartiainen E, Song G, Guo Z, Tian H. Changes in cardiovascular risk factors in different socioeconomic groups: seven year trends in a Chinese urban population. Journal of Epidemiology & Community Health. 2000;54(9):692–6.

50. Gordon-Larsen P, Wang H, Popkin BM. Overweight dynamics in Chinese children and adults. Obesity Reviews. 2014;15(S1):37–48.

51. Chatterji S, Kowal P, Mathers C, Naidoo N, Verdes E, Smith JP, et al. The health of aging populations in China and India. Health Affairs. 2008;27(4):1052–63. doi: 10.1377/hlthaff.27.4.1052 18607041

52. Hu J, Ying Q, Wang Y, Zhang H. Characterizing multi-pollutant air pollution in China: Comparison of three air quality indices. Environ Int. 2015;84:17–25. doi: 10.1016/j.envint.2015.06.014 26197060

53. Aleksandrova K, Mozaffarian D, Pischon T. Addressing the Perfect Storm: Biomarkers in Obesity and Pathophysiology of Cardiometabolic Risk. Clin Chem. 2018;64(1):142–53. doi: 10.1373/clinchem.2017.275172 29138271