The Impact of PM2.5 on the Growth Curves of Children's Obesity Indexes: A Prospective Cohort Study

Long-term exposure to outdoor air pollution correlated with overweight/obesity in children and adolescents: A cross-sectional real-world study

Air pollution has emerged as an essential risk factor for overweight and obesity. However, the combined effects of multiple air pollutants on overweight/obesity development in children and adolescents are not fully understood. In this study, a total of 189,448 children and adolescents in China were included. Logistics, weighted quantile sum, quantile g-computation, and bayesian kernel machine regression models were used to systematically assess the association between long-term outdoor air pollution exposure and overweight/obesity, and identified the major contributors. Our results revealed a significantly positive association of PM2.5, PM10, CO, and NO2 concentrations with overweight/obesity risk. Multi-pollutant models consistently demonstrated a positive association between the air pollutant mixture and the risk of overweight/obesity (OR: 1.825; 95 % CI: 1.036, 2.614). PM2.5 and PM10 were identified as the most significant contributors. Furthermore, we found significantly positive overall effects and interactions of these pollutants on an additive risk of overweight/obesity. The effects of air pollutants on overweight/obesity were pronounced in boys, rural residents, smokers, and primary school students. Our findings demonstrated that long-term exposure to air pollutants, particularly PM2.5 and PM10 was positively linked with an increased risk of overweight/obesity in children and adolescents. The cross-sectional design and potential confounders limited the ability to establish causality. Prospective cohort studies and specific mechanism investigations are needed to provide more precise and robust evaluations in the future. Coordinated policies to reduce air pollutants and mitigate their combined effects are essential for addressing this public health issue.

Air pollution and hypertension in rural versus urban children: Lipidomic insights into PM2.5 impacts

Fine particulate matter and its impact on blood pressure (BP) in children remain a concern, with the role of lipid metabolism as a potential mediator not fully elucidated. We conducted a cohort study of 2239 urban subjects and 2194 rural subjects at baseline in China from 2014 to 2024 and a nested case-control study with lipidomics analyses. Analysis results showed that higher fine particulate matter smaller than 2.5 μm (PM2.5) exposure associated with high density lipoprotein cholesterol (HDL-C), non-HDL-C, and higher systolic blood pressure (SBP), partially mediated by HDL-C/non-HDL-C changes. Mediation analysis indicated a significant mediating effect of HDL-C on the PM2.5-DBP and PM2.5-MAP (DBP, diastolic blood pressure; MAP, mean arterial pressure) association in urban subjects, while no mediation effect was found in rural subjects. For non-HDL-C, significant mediating effects were observed in both urban and rural subjects. Further analyses revealed distinct urban-rural lipidomic patterns, with specific phosphatidylethanolamine (PEs) mediating PM2.5-related hypertension in rural subjects, while lactosylceramides (LacCer) played this role in urban youth. These patterns extended to other BP indices as well. In the urban area, PG(44:11), LacCer(d45:1), were identified as playing significant mediating roles in the association between PM2.5 exposure and hypertension while for rural subjects, PEs including PE(16:0/16:0) and PE(18:0/18:2) showed significant mediating effects. Our findings underscore the impact of PM2.5 exposure on lipid profiles and BP risk in children, suggesting area-specific mechanisms and the potential for lipidomic-based interventions to mitigate environmental health risks.

Association of early life co-exposure to ambient PM2.5 and O3 with the offspring's growth within two years of age: A birth cohort study

BACKGROUND

Previous studies indicated that early life exposure to particulate matter of 2.5 μm or less (PM2.5) could impair children's growth. However, the adverse effects of maternal ozone (O3) and its interplay with PM2.5 on offspring's growth are unclear.

OBJECT

We aimed to investigate the independent and combined association of early-life exposure to PM2.5 and O3 with offspring growth in early childhood.

METHODS

This study included 632 Chinese mother-child pairs. Residential PM2.5 and O3 exposure concentrations in pregnancy and postanal 2 years were estimated by an established spatiotemporal model. During each exposure period, we also calculated the exceedance rate, the accumulative proportion of over-standard days (Exceedance standard: PM2.5>35 μg/m3, O3 > 100 μg/m3). We repeatedly measured the offspring's weight and length from birth to 2 years old and calculated the age-standardized Z-score of weight for height (WFL), body mass index (BMI), and overweight risk (BMI Z-score >85th percentile).

RESULTS

The adjusted generalized estimating equations showed that the concentration (an IQR increase) and exceedance rate (per 10% increase) of PM2.5 in prenatal (especially the second trimesters) and postnatal periods were associated with increased WFL, BMI Z-score, and overweight risk (βs/ORs ranging from 0.10 to 0.41/1.23 to 1.62, P < 0.05) in children within age 2 years. Although early-life exposure to O3 was not associated with growth outcomes, it showed multiplicative and additive interactions with PM2.5 on offspring growth, particularly in the 2nd trimester and early life 1000 days. The associations with WFL and BMI Z-score were greatest in the higher exceedance rates group of PM2.5 and O3 (βs ranging from 0.21 to 0.37, Pforinteraction<0.01).

CONCLUSION

This study demonstrated that early-life PM2.5 exposure, especially exceedance rate, was associated with increased offspring growth within 2 years of age. Furthermore, we discovered that O3 may strengthen the adverse effect of PM2.5 exposure on children's growth.

Long-term exposure to fine particulate matter components with obesity in children and adolescents in China: The age-sex disparities and key effect modifiers

Long-term fine particulate matter (PM2.5) exposure was associated with childhood obesity. However, the key PM2.5 components and whether PM2.5 effect may vary by obesity type, growth stage, sex, and individual/family characteristics have yet been examined. In this study, we investigated 213,907 Chinese children and adolescents aged 3-18 years in 2017-2019. Three-year average concentrations of PM2.5 and five major components were assigned to each participant's address. Multivariable mixed-effects model and weighted quantile sum regression were used to estimate the effect sizes of each component. Stratified analyses were performed by age and sex groups, with the interactive effects of a series of individual/family features evaluated. The odds ratio of childhood obesity was 1.28 (95 %CI: 1.15-1.43) for per interquartile range increase in PM2.5, with organic matter identified as the key contributor. General central obesity and mixed obesity were more sensitive to PM2.5 exposure than peripheral obesity. As children aged, the effect size of PM2.5 attenuated for general central obesity, remained unchanged for mixed obesity and increased for peripheral obesity. Females, children with obese parents, and those with lower levels of physical activity were more vulnerable than others. Other adverse effect modifiers for certain children included family with one child, low family income, and less sleep duration. Our findings emphasize that the influence of exposure to PM2.5 and its components on risk of obesity in children and adolescents should be considered comprehensively in developing adequate obesity prevention strategies.

Association Between Serum Essential Metal Elements and Blood Pressure in Children: A Cohort Study

A limited number of cohort studies have explored the impact of serum essential metal elements on blood pressure (BP) or glycolipids and their regulatory mechanism in children. This study aimed to investigate the relationship between serum metal concentrations of iron (Fe), zinc (Zn), calcium (Ca), copper (Cu), and magnesium (Mg) and BP in children, and explore the potential mediating effects of glycolipid profiles. This cohort study included 1993 children (3566 BP measurements) aged 6-14 years in Chongqing, China. Serum essential metals, BP, lipid profiles, and glucose and insulin levels were measured. The relationship between serum metal levels and BP was analyzed using generalized linear and regression models, and a mediation analysis was performed to examine the potential mediating role of glycolipids. After adjusting for confounders, positive associations were found between serum Fe and Zn levels and BP parameters (all P < 0.05). A "U" style relationship between Cu and BP was found. Stronger associations were found in children aged ≤ 10 years, with sex-specific differences for Fe, Zn, and Cu. The relationship between elevated BP and serum Mg and Ca was not found. Our study found that triglycerides showed a significant relationship with Fe and Zn levels (P < 0.005). Moreover, triglycerides, partially mediate the effects of Zn on elevated BP. Serum Fe, Zn, and Cu concentrations were associated with BP in children, and age and sex differences were observed. Triglycerides may play a mediating role. These findings highlight the importance of maintaining an optimal serum essential metal status for cardiovascular health in children and suggest potential early prevention strategies.

Association Between Exposure to Particulate Matter Air Pollution with Risk of Obesity Among Children and Adolescents in Northern and Central Taiwan

INTRODUCTION

The present study investigated the relationship between air pollution, specifically PM2.5 and PM10, and childhood and adolescent obesity in northern and central Taiwan. Previous research has shown a positive correlation between air pollution and pediatric obesity, but no study has been conducted in Taiwan. We used data from the K-12 Education Administration, Ministry of Education, and the Taiwan Air Quality Monitoring Network to analyze the association between PM2.5 and PM10 exposures and obesity rates among elementary and junior high school students.

METHODS

Data on students' height and weight were combined with air pollution data obtained from monitoring stations to assess exposure. A multivariable model estimated the relative risk and 95% confidence intervals of obesity linked to PM2.5 and PM10 exposures. Cities were categorized into quartiles (Q1-Q4) based on pollutant accumulation to compare the obesity rates.

RESULTS

Students living in areas with higher PM2.5 and PM10 exposures (Q4) had a significantly higher risk of obesity than those living in areas with lower exposures (Q1). The effect was more pronounced in girls and older students, with PM2.5 exhibiting a stronger relationship than PM10.

CONCLUSIONS

PM2.5 and PM10 exposures are significantly associated with an increased obesity risk in children and adolescents, particularly in girls and older students. Further research is needed to explore the underlying mechanisms and to control for socioeconomic and demographic factors.

Association Between Long Term Exposure to PM2.5 and Its Components on Severe Obesity in Chinese Children and Adolescents: A National Study in China

BACKGROUND

The aim of this study was to explore the association between long-term exposure to particulate matter with an aerodynamic diameter <2.5 μm (PM2.5) and its components and severe obesity in children and adolescents.

METHODS

Data for children and adolescents aged 9-18 in this cross-sectional study were obtained from the 2019 Chinese National Survey on Students' Constitution and Health (CNSSCH). Data for PM2.5 and its components were obtained from the Tracking Air Pollution in China (TAP) dataset and matched with information on these children. Logistic regression models were used to assess the risk of severe obesity associated with long-term exposure to PM2.5 and its components.

RESULTS

A total of 160,205 children were included in the analysis. Long-term exposure to PM2.5 may increase the odds of severe childhood obesity, with this effect being more pronounced in girls. Among boys, the component with the most significant impact on severe obesity was organic matter (OM). The impact of PM2.5 and its components on severe obesity was greater in children from low economic and low parental education level households. Children with unhealthy lifestyle habits have higher odds of severe obesity due to long-term exposure to PM2.5 and its components.

CONCLUSIONS

The findings of this research support the development of strategies aimed at addressing severe obesity in children, suggesting that adopting healthy lifestyle practices could mitigate the odds of severe obesity due to PM2.5 and its components. There is a need for an increased focus on children in economically underdeveloped areas and those with unhealthy lifestyle habits, particularly those in rural areas and those who do not engage in adequate physical activity or get enough sleep.

Circulating Interleukin-6 Mediates PM2.5-Induced Ovarian Injury by Suppressing the PPARγ Pathway

Exposure to airborne fine particulate matter (PM2.5) is strongly associated with poor fertility and ovarian damage. However, the mechanism underlying this remains largely unclear. Here, we found that PM2.5 markedly impaired murine ovarian reserve, decreased hormone levels, and aggravated ovarian inflammation. Circulating interleukin-6 (IL-6) was elevated in PM2.5-exposed mice and was further confirmed to mediate this damage by IL-6 recombinant protein intervention. PM2.5 exposure led to increased alveolar macrophage infiltration in the lungs. However, alveolar macrophage clearance with clodronate liposomes could not fully reverse the elevated IL-6 levels and ovarian injury, suggesting that alveolar macrophages were probably not the only source of circulating IL-6. Further experiments indicated that IL-6 mainly targeted ovarian theca-interstitial cells and impaired testosterone synthesis via suppressing the peroxisome proliferator-activated receptor γ (PPARγ) pathway. In addition, apoptosis of granulosa cells and restriction of follicular growth were observed in co-cultures with IL-6-treated theca-interstitial cells, which could be further reversed by the PPARγ agonist. Moreover, IL-6-neutralizing antibodies ameliorated PM2.5-induced ovarian damage. Notably, increased levels of circulating IL-6 were observed in premature ovarian aging patients and were inversely associated with their ovarian function. In summary, our findings offer a mechanistic explanation for PM2.5-induced ovarian dysfunction and verify IL-6 as a biomarker and potential therapeutic target.

The impact of folic acid/VB12 deficiency on essential hypertension in children and adolescents: from a nested case-control and a cohort study

To explore the relationship between serum folic acid (FA) or Vitamin B12 (VB12) and elevated BP in children and adolescents. Both a nested case control and a cohort study were designed to explore the relationship between serum folic acid (FA) or Vitamin B12 (VB12) and elevated blood pressure (BP). All the included participants were from primary school. A total of 326 subjects (116:210) in nested case control were from an established cohort. And 270 participants without hypertension at baseline and followed in 2019 in cohort. FA and VB12 levels were lower in the elevated BP group than in the control group, and homocysteine level was higher than that in the control group. In the elevated BP group, overweight/obese children had lower FA than overweight/obese children in the normal BP group. FA was positively correlated with high-density lipoprotein (HDL) and Apo lipoprotein A (APOA), but negatively correlated with triglyceride (TG). FA was significantly correlated with elevated BP in children and adolescents (β = -0.353, P = 0.032), after adjusting VB12, and homocysteine (HCY), and the interaction effect of FA*HCY was significant. Both systolic and diastolic BP levels were statistically lower in the FA high exposure group than in the FA low exposure group in the cohort study. This study found that FA and vitamin B12 deficiency in childhood was correlated with elevated BP levels, which may affect BP by regulating lipid levels, and confirmed the importance of maintaining high levels of FA and vitamin B12 in childhood either by diet or supplementation.

Prenatal exposure to PM2.5 and its composition on child growth trajectories in the first two years: A prospective birth cohort study

The findings on the relationship between prenatal exposure to particulate matter with aerodynamic diameter ≤2.5 μm (PM2.5) and its constituent and children's growth trajectories are inconsistent. This association's sensitive exposure time window and possible gender differences remain unclear. Our aim was to determine the association between prenatal exposure to PM2.5 and its component and children's growth trajectories by the age of two. From 2015 to 2021, 6407 mother-infant pairs were enrolled in the study. The PM2.5 include sulfate (SO42-), nitrate (NO3-), ammonium (NH4+), organic matter (OM), and black carbon (BC), from the ChinaHighAirPollutants (CHAP) datasets. Children were followed at birth, 1, 3, 6, 9, 12, 18, and 24 months. Population-based and individual-based methods were used to simulate child growth trajectories: slow growth, normal growth, and rapid growth. The distributed lags modeling was used to identify sensitive time windows for the effects of prenatal exposure to PM2.5 and its components on child growth. Sex-stratified analyses estimated sex differences. Median concentrations [interquartile ranges (IQRs)] were 57.46(17.3), 10.59(3.8), 14.26(4.4), 8.69(2.8), 13.05(3.4), and 2.53(0.7) μg/m3 for PM2.5, SO42-, NO3-, NH4+, OM, and BC, respectively. Compared with the normal growth trajectory group, exposure to PM2.5 was significantly associated with a higher risk of rapid growth trajectory in boys (ORs with 95% CI for the entire, first trimester, and second trimester of pregnancy, respectively: 1.016[1.006,1.025], 1.007[1.002,1.011], 1.007[1.002,1.011]). Exposure to PM2.5 was significantly associated with a higher risk of slow growth trajectory in girls (ORs with 95% CI for the entire, second trimester, and third trimester of pregnancy, respectively: 1.010 [1.001,1.018], 1.006 [1.001,1.011], 1.007 [1.002,1.012]). Prenatal PM2.5 and its composition exposure was positively associated with BMI peak in boys (βs with 95% CI for PM2.5, SO42-, NO3-, NH4+, OM, BC: 0.004[0.000,0.007], 0.025[0.006,0.044], 0.012[0.002,0.023], 0.022[0.004,0.039], 0.016[0.001,0.031], 0.082[0.005,0.159]), and not statistically significant in girls. We observed a more pronounced BC effect in our cohort. Prenatal exposure to PM2.5 and its component, especially at 10-22 weeks of gestation, is associated with a higher risk of rapid growth in boys and a risk of slow growth in girls.

Effect modifications of parents' age at childbirth on association between ambient particulate matter and children obesity

BACKGROUND

There is limited evidence regarding the modifying effects of parents' age at childbirth on the relationship between air pollution and obesity in plateau areas. This study aimed to explore the association between particulate matter (PM) and child obesity, specifically investigating whether parents' age at childbirth could modify this relationship in the Tibetan plateau, China.

METHODS

Satellite-based random forest models were used to estimate the concentrations of PM2.5 (particulate matter with aerodynamic diameters ≤ 2.5 μm), PMc (particulate matter with aerodynamic diameters between 2.5 μm and 10 μm), and PM10 (particulate matter with aerodynamic diameters ≤ 10 μm). Linear and logistic regression models were employed to assess associations between PM exposure and obesity indicators, and effect estimates of PM across different particle sizes were compared.

RESULTS

The study comprised 2,015 children under five years old. Postnatal exposure to PM was positively associated with overweight and obesity (OWO), waist-to-hip ratio (WHR) and body mass index (BMI). Among these pollutants, PM10 exhibited the strongest association with BMI and OWO, whereas PMc showed the strongest association with WHR. An interquartile range (IQR) increase in PM2.5 (5.67 µg/m3), PMc (5.25 µg/m3), and PM10 (11.06 µg/m3) was positively associated with OWO (odd ratio [OR] for PM2.5 = 1.52, 95% confidence interval [CI] for PM2.5 = 1.24 to 1.85; OR for PMc = 1.50, 95% CI for PMc = 1.19 to 1.88; OR for PM10 = 1.56, 95% CI for PM10 = 1.25 to 1.96), respectively. Stratified analysis by parents' age at childbirth indicated that the effects of PM on obesity indicators were more pronounced in the advanced age group.

CONCLUSIONS

Long-term exposure to PM was positively associated with OWO, WHR, and BMI. Our findings also underscore the importance of examining the effects of ambient PM exposure on OWO, particularly in parents of advanced age at childbirth.

Examining the Link between Air Quality (PM, SO2, NO2, PAHs) and Childhood Obesity: A Systematic Review

Background/Objectives: Childhood obesity has emerged as a global health concern with profound implications for long-term health outcomes. In recent years, there has been increasing interest in the potential role of environmental factors in the development of childhood obesity. This comprehensive review aims to elucidate the intricate relationship between various components of air pollution and childhood obesity. Methods: We systematically analyze the existing literature from the past 5 years to explore the mechanistic pathways linking air pollution, including particulate matter (PM), nitrogen oxides (NOx), sulfur dioxide (SO2), and polycyclic aromatic hydrocarbons (PAHs), to childhood obesity. This systematic review examines 33 epidemiological studies on the link between air pollution and childhood obesity, published from 1 January 2018, to 31 January 2024. Results: Studies from counties with low overall air pollution noticed only low to no impact of the exposure to childhood obesity, unlike studies from countries with higher levels of pollution, suggesting that the mitigation of air pollutants can reduce the chance of it being a negative factor for the development of obesity. This relationship was noticed for PM2.5, PM1, PM10, NOx, and SO2 but not for PAHs, which showed a negative effect on children's health across 10 out of 11 studies. Conclusions: This review underscores the need for interdisciplinary approaches to address both environmental and socio-economic determinants of childhood obesity. Efforts aimed at reducing air pollution levels and promoting healthy lifestyle behaviors are essential for safeguarding the health and well-being of children worldwide.

A causal relationship between particulate matter 2.5 and obesity and its related indicators: a Mendelian randomization study of European ancestry

BACKGROUND

In recent years, the prevalence of obesity has continued to increase as a global health concern. Numerous epidemiological studies have confirmed the long-term effects of exposure to ambient air pollutant particulate matter 2.5 (PM2.5) on obesity, but their relationship remains ambiguous.

METHODS

Utilizing large-scale publicly available genome-wide association studies (GWAS), we conducted univariate and multivariate Mendelian randomization (MR) analyses to assess the causal effect of PM2.5 exposure on obesity and its related indicators. The primary outcome given for both univariate MR (UVMR) and multivariate MR (MVMR) is the estimation utilizing the inverse variance weighted (IVW) method. The weighted median, MR-Egger, and maximum likelihood techniques were employed for UVMR, while the MVMR-Lasso method was applied for MVMR in the supplementary analyses. In addition, we conducted a series of thorough sensitivity studies to determine the accuracy of our MR findings.

RESULTS

The UVMR analysis demonstrated a significant association between PM2.5 exposure and an increased risk of obesity, as indicated by the IVW model (odds ratio [OR]: 6.427; 95% confidence interval [CI]: 1.881-21.968; P FDR = 0.005). Additionally, PM2.5 concentrations were positively associated with fat distribution metrics, including visceral adipose tissue (VAT) (OR: 1.861; 95% CI: 1.244-2.776; P FDR = 0.004), particularly pancreatic fat (OR: 3.499; 95% CI: 2.092-5.855; PFDR =1.28E-05), and abdominal subcutaneous adipose tissue (ASAT) volume (OR: 1.773; 95% CI: 1.106-2.841; P FDR = 0.019). Furthermore, PM2.5 exposure correlated positively with markers of glucose and lipid metabolism, specifically triglycerides (TG) (OR: 19.959; 95% CI: 1.269-3.022; P FDR = 0.004) and glycated hemoglobin (HbA1c) (OR: 2.462; 95% CI: 1.34-4.649; P FDR = 0.007). Finally, a significant negative association was observed between PM2.5 concentrations and levels of the novel obesity-related biomarker fibroblast growth factor 21 (FGF-21) (OR: 0.148; 95% CI: 0.025-0.89; P FDR = 0.037). After adjusting for confounding factors, including external smoke exposure, physical activity, educational attainment (EA), participation in sports clubs or gym leisure activities, and Townsend deprivation index at recruitment (TDI), the MVMR analysis revealed that PM2.5 levels maintained significant associations with pancreatic fat, HbA1c, and FGF-21.

CONCLUSION

Our MR study demonstrates conclusively that higher PM2.5 concentrations are associated with an increased risk of obesity-related indicators such as pancreatic fat content, HbA1c, and FGF-21. The potential mechanisms require additional investigation.

Differentiated impacts of short-term exposure to fine particulate constituents on infectious diseases in 507 cities of Chinese children and adolescents: A nationwide time-stratified case-crossover study from 2008 to 2021

This study assesses the association of short-term exposure to PM2.5 (particles ≤2.5 μm) on infectious diseases among Chinese children and adolescents. Analyzing data from 507 cities (2008-2021) on 42 diseases, it focuses on PM2.5 components (black carbon (BC), ammonium (NH4+), inorganic nitrate (NO3-), organic matter (OM), and sulfate (SO42-)). PM2.5 constituents significantly associated with incidence. Sulfate showed the most substantial effect, increasing all-cause infectious disease risk by 2.72 % per interquartile range (IQR) increase. It was followed by BC (2.04 % increase), OM (1.70 %), NO3- (1.67 %), and NH4+ (0.79 %). Specifically, sulfate and BC had pronounced impacts on respiratory diseases, with sulfate linked to a 10.73 % increase in seasonal influenza risk and NO3- to a 16.39 % rise in tuberculosis. Exposure to PM2.5 also marginally increased risks for gastrointestinal, enterovirus, and vectorborne diseases like dengue (7.46 % increase with SO42-). Sexually transmitted and bloodborne diseases saw an approximate 6.26 % increase in incidence, with specific constituents linked to diseases like hepatitis C and syphilis. The study concludes that managing PM2.5 levels could substantially reduce infectious disease incidence, particularly in China's middle-northern regions. It highlights the necessity of stringent air quality standards and targeted disease prevention, aligning PM2.5 management with international guidelines for public health protection.

Clustering by chemicals: A novel examination of chemical pollutants and social vulnerability in children and adolescents

BACKGROUND

Inhaled air pollutants are environmental determinants of health with negative impacts on human health. Air pollution has been linked to the incidence and progression of disease, with its effects unequally distributed across the population. Children compared to adults are a highly vulnerable group and suffer disproportionately from systemic environmental inequities exacerbated by social determinants.

OBJECTIVE

To explore air pollution cluster patterns among 6- to 19-year-olds from the 2015-2016 National Health and Nutrition Examination Survey (NHANES) and examine chemical cluster associations with social vulnerability.

METHODS

NHANES data was extracted for 697 children and adolescents. Social vulnerability characteristics from questionnaires were assembled to construct a modified social vulnerability index (SVI). Thirty-four air pollutant exposure chemicals were measured in urine and available from the laboratory sub-sample A data. K-means clustering classified the sample into three groups: low, medium, and high chemical exposure groups. Logistic regression was used to examine associations between high chemical group membership and SVI after adjusting for age, biological sex, and BMI. Complex survey analysis was conducted using SAS v9.4 to reflect population effects.

RESULTS

Air pollution clusters revealed significant differences in mean concentrations between groups for 31 analytes with minimal distinction in mixture profiles. SVI scores differed significantly between the three groups (P = .002), and with each point increase in their SVI, the odds of a child being assigned to the highest-chemical exposure group increased by 11.55% (95% CI: 1.02-1.31), after adjustment.

CONCLUSION

Unsupervised clustering of environmental sub-sample specimens from NHANES provides an innovative, multi-pollutant model that can be used to explore exposure patterns in this population. Utilizing the modified SVI allows for the identification of children that may be highly susceptible to air pollution. It is imperative to interpret the research findings in light of historical structural and discriminatory inequalities to develop beneficial and sustainable solutions.

Association of air pollution exposure with overweight or obesity in children and adolescents: A systematic review and meta-analysis

Childhood overweight and obesity is a global problem. 38 million children under five years old were reported as being overweight/obese in 2019. However, current evidence regarding the effects of air pollution on children weight status remains scarce and inconsistent. This study aimed to determine the association between air pollutants and the weight status of children and adolescents. Four databases were searched up to August 9, 2023. Adjusted merged odds ratios (ORs), regression coefficients (β), and their 95 % confidence intervals (95 % CIs) were calculated and pooled. A total of 27 studies were included. The results showed that air pollutants had adverse effects on the body weight of children and adolescents. Exposure to PM1, PM2.5, PMcoarse, and PM10 were associated with increased risk of overweight/obesity, with pooled ORs (95 % CI) of 1.23 (1.09, 1.40), 1.18 (1.10, 1.28), 1.04 (1.03, 1.05) and 1.11 (1.06, 1.17) per 10 μg/m3 increment, respectively. Individuals with higher exposure levels to NOX, O3, SO2 and CO (per 10 μg/m3 increment) were associated with 12 %, 6 %, 28 % and 1 % increased odds of being overweight/obese, respectively. With respect to the level of body mass index, the pooled β (95 % CIs) for each 10 μg/m3 increase in PM1, PM2.5, PM10, and NOX exposure were 0.15 (0.12, 0.18), 0.11 (0.06, 0.16), 0.07 (0.03, 0.10), and 0.03 (0.01, 0.04), respectively. PM1 has relatively strong adverse effects on body weight status. The subgroup analysis revealed a significantly increase in the risk of overweight/obesity when the concentrations of PM2.5, PM10, and NO2 exceeded 35 μg/m3, 50 μg/m3, and 40 μg/m3, respectively. Exposure to PM2.5, PM10 and NOX increased the risk of overweight/obesity, especially in Asia. This study provides evidence of the association between air pollution and being overweight/obese in children and adolescents.

Where a child lives matters: neighborhood deprivation and pediatric obesity

PURPOSE OF REVIEW

This article outlines what is currently known regarding the relationship between neighborhood deprivation and pediatric obesity. It discusses the intersectionality between neighborhood deprivation, race, ethnicity, and pediatric obesity. We conclude by proposing several potential solutions to disparities in pediatric obesity related to neighborhood deprivation.

RECENT FINDINGS

Neighborhood deprivation, independent of individual socioeconomic status, is a risk factor for pediatric obesity. The obesogenic characteristics of high deprivation neighborhoods (e.g., lack of safe spaces to be active, easy access to fast food) and the psychological aspects of residing within high deprivation neighborhoods may also contribute to this risk. Intervention strategies and policies designed to address neighborhood related risk for pediatric obesity are needed.

SUMMARY

Pediatric obesity is a growing problem of complex etiology. Neighborhood risk factors should be considered when assessing risk burden and when designing intervention strategies.

Air Pollution, Built Environment, and Early Cardiovascular Disease

As the world's population becomes increasingly urbanized, there is growing concern about the impact of urban environments on cardiovascular health. Urban residents are exposed to a variety of adverse environmental exposures throughout their lives, including air pollution, built environment, and lack of green space, which may contribute to the development of early cardiovascular disease and related risk factors. While epidemiological studies have examined the role of a few environmental factors with early cardiovascular disease, the relationship with the broader environment remains poorly defined. In this article, we provide a brief overview of studies that have examined the impact of the environment including the built physical environment, discuss current challenges in the field, and suggest potential directions for future research. Additionally, we highlight the clinical implications of these findings and propose multilevel interventions to promote cardiovascular health among children and young adults.

The policy implemented by the government and the protection effect of PM2.5 decreasing on blood pressure in adolescents: From a quasi-experimental study

BACKGROUND

High particulate matter with an aerodynamic diameter of 2.5 μm or less (PM2.5) exposure levels posed a great risk to human health, but the protection effects of environmental protection on cardiovascular disease have not been systematically evaluated. This study aims to illustrate the effect of the decreased concentration of PM2.5 on blood pressure level in adolescents after enacting the protection measures of environment from a cohort study.

METHODS

A quasi-experimental study including 2415 children from the Chongqing Children's Health Cohort, aged 7.32 ± 0.60 years with normal blood pressure at baseline, with 53.94% males, were analysed. Both the generalised linear regression model (GLM) and Poisson regression model were used to calculate the impact of the declining exposure level of PM2.5 on blood pressure and the incidence of prehypertension and hypertension.

RESULTS

The annual mean PM2.5 concentration in 2014 and in 2019 were 65.01 ± 6.46 µgmes per cubic metre (μg / m3), 42.08 ± 2.04 μg / m3 respectively, and the decreased PM2.5 concentration between 2014 and 2019 was 22.92 ± 4.51 μg / m3. The effect of decreased PM2.5 concentration by 1μg / m3 on systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and the difference of blood pressure (BP) indexes between 2014 and 2019 were all significant (P < 0.001). The absolute differences of SBP (-3.598 mmHg; 95% confidence interval (CI) = -4.47,-2.72 mm Hg), DBP (-2.052 mmHg; 95% CI = -2.80,-1.31 mm Hg) and MAP (-2.568 mmHg; 95% CI = -3.27,-1.87 mm Hg) in the group with a decreased level of ≥25.56 μg / m3 were more significant than those in a decreased concentration of PM2.5 for <25.56 μg / m3 (P < 0.001). And the incidence of prehypertension and hypertension for three occasions blood pressure diagnose was 2.21% (95% CI = 1.37%-3.05%, P = 0.001) in children with PM2.5 decreased level ≤25.56 μg / m3 (50%), which was significant higher than its' counterparts 0.89% (95% CI = 0.37%-1.42%, P = 0.001).

CONCLUSIONS

Our study found the etiological relationship between the declining PM2.5 concentration and the BP values and the incidence of prehypertension and hypertension in children and adolescents, suggesting continuous environmental protection measures in China have achieved remarkable health benefits.

Multi-omics reveals hypertrophy of adipose tissue and lipid metabolism disorder via mitochondria in young mice under real-ambient exposure to air pollution

Air pollution has become one of the most serious health risks as a result of industrialization, especially in developing countries. More attention has been drawn to the relationship between obesity/overweight and fine particulate matter (PM2.5). Especially for susceptible populations, the impact of air pollution on children and adolescents has attracted more public attentions. However, the detailed underlying mechanism influencing obesity or overweight under PM2.5 exposure is still unknown. Therefore, young mice were exposed to PM2.5 using the real-ambient exposure system that we previously established in Shijiazhuang city. Compared with the traditionally concentrated air particle (CAP) system, our real-ambient exposure system provides similar PM2.5 concentrations and characteristics as outdoor ambient air and minimizes the influence of external interfering factors. After 8 weeks of exposure to PM2.5, the weight of gonadal white adipose tissue (gWAT) and subcutaneous white adipose tissue (sWAT) was considerably increased, accompanied by a significantly enlarged size of adipocytes in sWAT. Importantly, multiomics analysis indicated altered metabolites involved in the lipid metabolism pathway, and transcriptomic analysis revealed notably changed signaling pathways related to fatty acid metabolism. Moreover, the mtDNA copy number, mitochondrial activity and fatty acid oxidation (FAO) were increased in the liver under PM2.5 exposure. Taken together, our research investigated the hypotrophy of adipose tissue in young mice, supported an imbalance in lipid metabolism based on multiomics analysis, and revealed disordered mitochondrial function under PM2.5 exposure. Our study provided new insight into the hazardous effects of air pollution, and extended our understanding on the underlying mechanism.

What is the role of particulate matter 2.5 (PM2.5) on excess weight? A cross-sectional study in young Spanish people aged 2─14 years

PURPOSE

To assess the relationship between particulate matter 2.5 (PM2.5) levels and the prevalence of excess weight in a representative sample of Spanish young people aged 2─14 years.

METHODS

This was an ecological cross-sectional study using data from the 2017 wave of the Encuesta Nacional de Salud Española (ENSE), a nationally representative survey of the Spanish young and adult population. The final sample included 4378 young Spanish people (51.0% boys). The weight (kg) and height (cm) of the study participants were proxy-reported by parents or guardians. Excess weight was determined according to the age- and sex-criteria of the International Obesity Task Force. The PM2.5 level was calculated as the annual monitoring data indicator for 2017 among the different regions in Spain. Logistic regression models were performed to estimate the relationships between PM2.5 and weight.

RESULTS

Compared to young people located in regions with low levels of PM2.5, those reporting greater odds for excess weight were found in regions with medium PM2.5 (OR = 1.23; 95% CI, 1.02-1.49) and high PM2.5 (OR = 1.35; 95% CI, 1.11-1.64) after adjusting for several sociodemographic, lifestyle and environmental covariates.

CONCLUSIONS

The prevalence of excess weight in young people was positively associated with PM2.5 levels in Spain. This finding supports the hypothesis that air pollution exposure can result in excess weight in the young population, which, in turn, might lead to the development of metabolic disorders. From a socioecological perspective, a practical need to take environmental factors into consideration is important to address unhealthy weight in Spanish young people.

Relationship between quality of life and adolescent glycolipid metabolism disorder: A cohort study

BACKGROUND

The prevalence of glucolipid metabolic disorders (GLMDs) in children and adolescents has a recognized association with cardiovascular diseases and type 2 diabetes mellitus in adulthood. Therefore, it is important to enhance our under-standing of the risk factors for GLMD in childhood and adolescence.

AIM

To explore the relationship between quality of life (QoL) and adolescent GLMD.

METHODS

This study included 1956 samples in 2019 from a cohort study established in 2014. The QoL scale and glycolipid indexes were collected during follow-up; other covariates of perinatal factors, physical measures, and socioeconomic indicators were collected and adjusted. A generalized linear regression model and logistic regression model were used to analyse the correlation between QoL and GLMD.

RESULTS

Higher scores of QoL activity opportunity, learning ability and attitude, attitude towards doing homework, and living convenience domains correlated negatively with insulin and homeostasis model assessment insulin resistance (IR) levels. Psychosocial factors, QoL satisfaction factors, and total QoL scores had significant protective effects on insulin and IR levels. Activity opportunity, learning ability and attitude, attitude towards doing homework domains of QoL, psychosocial factor, and total score of QoL correlated positively with high density lipoprotein. In addition, the attitude towards doing homework domain was a protective factor for dyslipidaemia, IR > 3, and increased fasting blood glucose; four factors, QoL and total QoL score correlated significantly negatively with IR > 3. In subgroup analyses of sex, more domains of QoL correlated with insulin and triglyceride levels, dyslipidaemia, and IR > 3 in females. Poor QoL was associated with an increased prevalence of GLMD, and the effect was more pronounced in males than in females. Measures to improve the QoL of adolescents are essential to reduce rates of GLMD.

CONCLUSION

Our study revealed that QoL scores mainly correlate negatively with the prevalence of GLMD in adolescents of the healthy population. The independent relationship between QoL and GLMD can be illustrated by adjusting for multiple covariates that may be associated with glycaemic index. In addition, among females, more QoL domains are associated with glycaemic index.