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Abstract：
BACKGROUND: Several studies reported that exposure to higher levels of fine particulate matter (PM2.5) was associated with deteriorated lipid profiles in children and adolescents. However, whether a sodium-rich diet could modify the associations remains unknown. We aimed to examine the associations of long-term exposure to PM2.5 with blood lipids in children and adolescents, and further examine the effect modification by dietary and urinary sodium levels based on a multi-community population in China.
METHODS: The 3711 study participants were from a cross-sectional study, which interviewed children and adolescents aged 6 to 17 years across Sichuan Province, China between 2015 and 2017. Blood lipid outcomes including blood total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) were assessed. Information on daily dietary sodium consumption was estimated with a semi-quantitative food frequency questionnaire (FFQ), and urinary sodium was used as an internal exposure biomarker. A linear regression model was applied to estimate the associations of prior 2-years\' average exposure to ambient PM2.5 with blood lipids. The effect modification by dietary and urinary sodium was examined by stratified analyses.
RESULTS: The participants from rural areas had higher levels of daily sodium consumptions. The results of multivariable regression analysis indicated that per 10 μg/m3 incremental change in PM2.5 was associated with a 1.56% (95% confidence interval 0.90%-2.23%) and a 2.26% (1.15%-3.38%) higher blood TC and LDL-C levels, respectively. Among the study participants with higher levels of dietary sodium or urinary sodium, exposure to higher levels of PM2.5 was significantly associated with deteriorated lipid profiles. For example, each 10 μg/m3 incremental change in exposure to PM2.5 was correlated with a 2.83 (-4.65 to -0.97) lower percentage decrease in blood HDL-C levels among the participants who were from the highest quartile of urinary sodium levels. While, these associations changed to be nonsignificant in the participants who were from the lowest quartile of dietary sodium levels.
CONCLUSIONS: Exposure to higher levels of PM2.5 was associated with deteriorated blood lipid levels in children and adolescents. It is noteworthy that these associations might be ameliorated through the adoption of a low-sodium dietary regimen.
METHODS: The 3711 study participants were from a cross-sectional study, which interviewed children and adolescents aged 6 to 17 years across Sichuan Province, China between 2015 and 2017. Blood lipid outcomes including blood total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) were assessed. Information on daily dietary sodium consumption was estimated with a semi-quantitative food frequency questionnaire (FFQ), and urinary sodium was used as an internal exposure biomarker. A linear regression model was applied to estimate the associations of prior 2-years\' average exposure to ambient PM2.5 with blood lipids. The effect modification by dietary and urinary sodium was examined by stratified analyses.
RESULTS: The participants from rural areas had higher levels of daily sodium consumptions. The results of multivariable regression analysis indicated that per 10 μg/m3 incremental change in PM2.5 was associated with a 1.56% (95% confidence interval 0.90%-2.23%) and a 2.26% (1.15%-3.38%) higher blood TC and LDL-C levels, respectively. Among the study participants with higher levels of dietary sodium or urinary sodium, exposure to higher levels of PM2.5 was significantly associated with deteriorated lipid profiles. For example, each 10 μg/m3 incremental change in exposure to PM2.5 was correlated with a 2.83 (-4.65 to -0.97) lower percentage decrease in blood HDL-C levels among the participants who were from the highest quartile of urinary sodium levels. While, these associations changed to be nonsignificant in the participants who were from the lowest quartile of dietary sodium levels.
CONCLUSIONS: Exposure to higher levels of PM2.5 was associated with deteriorated blood lipid levels in children and adolescents. It is noteworthy that these associations might be ameliorated through the adoption of a low-sodium dietary regimen.
摘要：
背景：多项研究报道，暴露于较高水平的细颗粒物（PM2.5）与儿童和青少年的血脂状况恶化有关。然而,富含钠的饮食是否能改变这种联系仍不得而知.我们旨在研究儿童和青少年长期暴露于PM2.5与血脂之间的关系，并进一步研究了基于中国多社区人群的饮食和尿钠水平的影响。
方法：3711名研究参与者来自一项横断面研究，采访了四川省6至17岁的儿童和青少年，2015年至2017年的中国。血脂结果包括血液总胆固醇（TC），高密度脂蛋白胆固醇（HDL-C），低密度脂蛋白胆固醇（LDL-C），和甘油三酯（TG）进行评估。使用半定量食物频率问卷（FFQ）估计每日膳食钠消耗的信息，尿钠被用作内部暴露生物标志物。线性回归模型用于估计前2年平均暴露于环境PM2.5与血脂的关联。通过分层分析检查了饮食和尿钠的作用修饰。
结果：来自农村地区的参与者每日钠摄入量较高。多元回归分析结果表明，PM2.5每增加10μg/m3，与血液TC和LDL-C水平升高1.56%(95%置信区间0.90%-2.23%)和2.26%(1.15%-3.38%)相关。分别。在膳食钠或尿钠水平较高的研究参与者中，暴露于较高水平的PM2.5与血脂状况恶化显著相关.例如,在来自尿钠水平最高四分位数的参与者中,PM2.5暴露量每增加10μg/m3,与血液HDL-C水平降低2.83(-4.65~-0.97)的百分比相关.同时,在膳食钠水平最低四分位数的参与者中,这些相关性变为不显著.
结论：暴露于较高水平的PM2.5与儿童和青少年的血脂水平恶化有关。值得注意的是，通过采用低钠饮食方案可以改善这些关联。
方法：3711名研究参与者来自一项横断面研究，采访了四川省6至17岁的儿童和青少年，2015年至2017年的中国。血脂结果包括血液总胆固醇（TC），高密度脂蛋白胆固醇（HDL-C），低密度脂蛋白胆固醇（LDL-C），和甘油三酯（TG）进行评估。使用半定量食物频率问卷（FFQ）估计每日膳食钠消耗的信息，尿钠被用作内部暴露生物标志物。线性回归模型用于估计前2年平均暴露于环境PM2.5与血脂的关联。通过分层分析检查了饮食和尿钠的作用修饰。
结果：来自农村地区的参与者每日钠摄入量较高。多元回归分析结果表明，PM2.5每增加10μg/m3，与血液TC和LDL-C水平升高1.56%(95%置信区间0.90%-2.23%)和2.26%(1.15%-3.38%)相关。分别。在膳食钠或尿钠水平较高的研究参与者中，暴露于较高水平的PM2.5与血脂状况恶化显著相关.例如,在来自尿钠水平最高四分位数的参与者中,PM2.5暴露量每增加10μg/m3,与血液HDL-C水平降低2.83(-4.65~-0.97)的百分比相关.同时,在膳食钠水平最低四分位数的参与者中,这些相关性变为不显著.
结论：暴露于较高水平的PM2.5与儿童和青少年的血脂水平恶化有关。值得注意的是，通过采用低钠饮食方案可以改善这些关联。
