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Fine particulate matter and incidence of metabolic syndrome in non-CVD patients: A nationwide population-based cohort study
Authors:Seulbi Lee  Hyesook Park  Soontae Kim  Eun-Kyung Lee  Jiyoung Lee  Young Sun Hong  Eunhee Ha
Affiliation:1. Department of Medical Science, College of Medicine, Ewha Womans University, Seoul, Republic of Korea;2. Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea;3. Ewha Medical Research Institute, College of Medicine, Ewha Womans University, Seoul, Republic of Korea;4. Department of Environmental and Safety Engineering, Ajou University, Suwon, Republic of Korea;5. Department of Statistics, Ewha Womans University, Seoul, Republic of Korea;6. Department of Occupational and Environment Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea;7. Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea;8. Research Institute for Human Health Information, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
Abstract:

Background

It has been reported that particulate matter (PM) is associated with cardiovascular diseases (CVD) while metabolic syndrome is also an important risk factor for CVD. However, few studies have investigated the epidemiological association between PM and metabolic syndrome.

Objective

To investigate the association between one-year exposure to PM with an aerodynamic diameter <2.5?μm (PM2.5) and the risk of metabolic syndrome in Korean adults without CVD.

Methods

Exposure to PM2.5 was assessed using a Community Multiscale Air Quality (CMAQ) model. Metabolic syndrome was defined by National Cholesterol Education Program Adult Treatment Panel III. Andersen and Gill model with time-varying covariates, considering recurrent events, was used to investigate the association between one-year average PM2.5 and the risk of incident metabolic syndrome in 119,998 adults from the national health screening cohort provided by Korea National Health Insurance from 2009 to 2013.

Results

Higher risk of metabolic syndrome, waist-based obesity, hypertension, hypertriglyceridemia, low HDL cholesterol, and hyperglycemia were significantly associated with a 10-μg/m3 increase in PM2.5 [adjusted hazard ratio (HR): 1.070, 1.510, 1.499, 1.468, 1.627 and 1.380, respectively]. In addition, the risk of metabolic syndrome associated with PM2.5 exposure was significant in the consistently obese group (obese at baseline and endpoint).

Conclusion

Exposure to one-year average PM2.5 is associated with an increased risk of metabolic syndrome and its components in adults without CVD. These associations are particularly prominent in the consistently obese group (obese at baseline and endpoint). Our findings indicate that PM2.5 affects the onset of MS and its components which may lead to increase the risk of CVD.
Keywords:Air pollution  Fine particulate matter  Metabolic syndrome  Body mass index  Recurrent events  Andersen-Gill model  Particulate matters whose diameters are equal to or less than 2.5?  CVD  Cardiovascular disease  BMI  Body mass index  HDL-C  High-density lipoprotein cholesterol  HR  Hazard ratio  CI  Confidence interval  SD  Standard deviation
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