Does underweight amplify the relationship between short-term particulate matter exposure and blood pressure in children
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RESEARCH ARTICLE
Does underweight amplify the relationship between short-term particulate matter exposure and blood pressure in children and adolescents: a large cross-sectional study in a metropolis of China Jia Hu 1
&
Han Fu 2 & Hui Shen 1 & Chen-gang Teng 1 & Wei Yang 3 & Hai-bing Yang 1 & Fang Liu 1
Received: 21 March 2020 / Accepted: 20 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Overweight/obesity modified the effects of ambient particulate matter (PM) exposure on blood pressure (BP). This study aims to assess whether interaction of underweight and short-term PM exposure on BP exists in Chinese children. A cross-sectional analysis including 144,513 children aged 6 to 17 years in 2016 Health Promotion Program for Children and Adolescents of Suzhou, China, was performed. Daily concentrations of inhalable PM (PM10) and fine PM (PM2.5) were extracted from air monitoring stations close to students’ schools. We applied generalized linear mixed-effects models to estimate the interactions. Estimated changes (95% confidence intervals (CIs)) of systolic BP (SBP), diastolic BP (DBP), and odds ratios (ORs) (95% CIs) for prevalence of HBP were calculated. Significant interactions between PM and underweight on BP and prevalence of high BP (HBP) were observed. For example, at lag 6, the ORs (95% CIs) for HBP by each 10 μg/m3 changes of PM2.5 were 1.066 (1.039, 1.093) and 1.036 (1.028, 1.043) among underweight and normal weight subjects, respectively; these values for PM10 were 1.048 (1.031, 1.065) and 1.025 (1.021, 1.030). At lag 5, the increases of SBP for PM2.5 were 0.32 (95% CI 0.22, 0.43) mmHg and 0.23 (95% CI 0.29, 0.26) mmHg, while changes of DBP were 0.27 (95% CI 0.18, 0.35) mmHg and 0.19 (95% CI 0.16, 0.21) mmHg among underweight and normal weight subjects, respectively. Stratified analyses demonstrated that these interactions were only obtained in males. Effects of short-term PM exposure on BP and prevalence of HBP are enhanced in underweight children and adolescents. Keywords Adolescent . Blood pressure . Child . Interaction . Particulate matter
Introduction Hypertension is a well-recognized global public health issue that contributes to the burden of cardiovascular disease, Responsible Editor: Lotfi Aleya * Jia Hu [email protected] * Fang Liu [email protected] 1
Suzhou Center for Disease Prevention and Control, 72 Sanxiang Road, Suzhou 215004, Jiangsu, China
2
Xi’an Center for Disease Control and Prevention, Xi’an 710054, Shaanxi, China
3
School of Community Health Sciences, University of Nevada, Reno, NV 89154, USA
premature mortality, and disability (Mills et al. 2016). Childhood hypertension has attracted a wide attention as a result of its rising prevalence among children and adolescents over the past decades, especially in China (Song et al. 2019; Wang et al. 2019). China Health and Nutrition Survey has showed that hypertension prevalence increased from 6.9 to 10.7% during 1991–2011 in children and adolescents (Yan et al. 2016). Importantly, previous path
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