Long-term exposure to ambient air pollution and cardiometabolic multimorbidity in Chinese adults over 45 years

Oct 24, 2025Scientific reports

Long-term air pollution exposure linked to multiple heart and metabolism diseases in Chinese adults over 45

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Abstract

Each interquartile range increase in (PM10) exposure is associated with a 1.01 times increased risk of (CMM) among participants aged 45 and older.

Chronic exposure to PM10 showed a consistent positive association with the prevalence of CMM.
The analysis included 9,830 participants aged 45 years and older from the China Health and Retirement Longitudinal Study.
Other pollutants, such as PM2.5 and sulfur dioxide, exhibited weaker or inconsistent associations with CMM.
Sensitivity analyses confirmed the robust link between PM10 exposure and increased CMM risk under various conditions.
The findings suggest a significant connection between long-term ambient particulate matter exposure and CMM in an aging population.

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The rising prevalence of (CMM), characterized by the coexistence of two or more cardiometabolic disorders, poses a significant public health challenge in aging populations. While ambient air pollution is a recognized environmental risk factor, its long-term impact on CMM remains underexplored, particularly in China. Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS, 2015 wave), we analyzed 9,830 participants aged ≥ 45 years. CMM was defined as the concurrent presence of two or more conditions: diabetes/hyperglycemia, cardiovascular diseases (myocardial infarction, angina pectoris, coronary artery disease, or heart failure, or stroke. Annual pollutant exposures were estimated using a machine learning-based spatiotemporal model (space-time extremely randomized trees) based on residential addresses. Generalized linear models adjusted for sociodemographic, lifestyle, and meteorological covariates were employed to assess odds ratios (ORs) per interquartile range (IQR) increase in pollutants. Chronic exposure to (PM) 10 demonstrated a consistent positive association with CMM prevalence across models. In fully adjusted analyses, each IQR increase in PM10 was associated with elevated CMM risk (OR = 1.01, 95% CI: 1.00-1.02, P = 0.039). Sensitivity analyses, including alternative exposure windows and adjustments for regional variations, reinforced PM10's robust association with CMM. Other pollutants (PM2.5, and sulfur dioxide) showed weaker or inconsistent associations. Long-term exposure to ambient particulate matter, particularly PM10, is significantly linked to increased CMM prevalence in China's aging population. The findings of this study provide epidemiological evidence, laying the foundation for future cohort studies and mechanistic investigations.

Key numbers

1.01

Increased Risk per

Odds ratio for each interquartile range increase in exposure.

13.1%

Prevalence

Percentage of participants aged 45 and older diagnosed with .

9,830

Study Cohort Size

Total number of participants aged 45 and older included in the analysis.

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Long-term exposure to ambient air pollution and cardiometabolic multimorbidity in Chinese adults over 45 years

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