Data Sheet 1_Association of PM2.5 exposure with 10-year atherosclerotic cardiovascular disease risk: a mediation analysis of blood and urinary biomarkers.docx

AimsTo explore the relationship of fine particulate matter (PM2.5) exposure with 10-year risk of atherosclerotic cardiovascular disease (ASCVD), explore effect modifiers, identify susceptible populations, and examine potential mediating factors.
Methods and resultsA cross-sectional study among 9,539 residents of Fujian Province, China, from May 2021 to January 2022 was administered. PM2.5 exposure was estimated using the China High Air Pollutants (CHAP) dataset with a spatial resolution of 1 km from May 2021 to January 2022. ASCVD risk was predicted utilizing the China-PAR model. We performed weighted linear mixed-effects models to assess the association of exposure to PM2.5 with 10-year risk of ASCVD. Potential effect modifiers were assessed using stratified analyses and interaction analysis. We used mediation analyses to explore the role of blood and urine indicators in this association. An elevated risk of 10-year ASCVD was found in association with PM2.5 exposure. For every 5 μg/m3 rise in PM2.5, 10-year ASCVD risk increased by 3.246 (95% CI: 2.602, 3.889). Age, smoking, alcohol consumption, and hypertension modified the association of exposure to PM2.5 with the risk of ASCVD. Glycosylated hemoglobin, fasting blood glucose, and blood uric acid partially mediated this association.
ConclusionExposure to PM2.5 is correlated with the elevated 10-year ASCVD risk, with blood glucose, and uric acid potentially acting as mediators.