Front Public Health. 2026 Oct 6;14:1950282. doi: 10.3389/fpubh.2026.1950282. eCollection 2026.
ABSTRACT
BACKGROUND: Dyslipidemia is an important modifiable risk factor for cardiovascular disease, and growing evidence suggests that long-term ambient air pollution exposure may adversely affect lipid metabolism. However, longitudinal evidence from heavily industrialized regions with complex multipollutant exposure remains limited.
METHODS: We conducted a repeated-measures study of 9,040 adults with 19,113 lipid measurements from a health-screening program in Shanxi Province, China, between October 2019 and September 2023. Three-year average exposures to PM, PM, O, SO, NO, and CO were estimated using the high-resolution ChinaHighAirPollutants (CHAP) dataset based on geocoded residential addresses. Linear mixed-effects models and generalized linear mixed-effects models were used to evaluate associations with lipid profiles and dyslipidemia, respectively. Restricted cubic spline, stratified, sensitivity, and quantile g-computation-style mixed-effects analyses were further conducted.
RESULTS: Higher long-term exposure to PM, PM, O, NO, and SO was associated with higher triglyceride (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) levels and lower high-density lipoprotein cholesterol (HDL-C) levels, whereas CO showed weaker associations. Among pollutants, PM showed relatively pronounced associations; each 10 μg/m3 increase was associated with 1.85, 1.70, and 1.81% increases in TG, TC, and LDL-C, respectively, and a 1.55% decrease in HDL-C. Similar patterns were observed for dyslipidemia. Stratified analyses suggested potential effect modification by sex, age, and BMI for selected pollutant-lipid associations, with the most robust interaction signals observed for age-stratified HDL-C associations after false discovery rate (FDR) correction. The associations remained consistent in sensitivity analyses. Restricted cubic spline analyses suggested nonlinear exposure-response relationships between PM and lipid parameters, while the quantile g-computation-style mixed-effects analysis indicated that multipollutant exposure was associated with adverse lipid profiles, with PM and O showing relatively large weights in the overall mixed-exposure association.
CONCLUSION: Long-term ambient air pollution exposure was associated with adverse lipid profiles and may be related to higher odds of dyslipidemia among adults in a heavily industrialized region of northern China. These findings suggest that ambient air pollution may be an important environmental factor associated with lipid metabolism and highlight the need to consider long-term multipollutant exposure in cardiometabolic health research and prevention strategies.
PMID:42903168 | PMC:PMC13680454 | DOI:10.3389/fpubh.2026.1950282