Long-term Exposure to Ambient Air Pollution (Including PM 1) and Metabolic Syndrome: The 33 Communities Chinese Health Study (33CCHS)

Environ Res. 2018 Jul;164:204-211. doi: 10.1016/j.envres.2018.02.029. Epub 2018 Mar 20.


Little evidence exists about the effects of long-term exposure to ambient air pollution on metabolic syndrome (MetS). This study aimed to determine the association between long-term ambient air pollution and MetS in China. A total of 15,477 adults who participated in the 33 Communities Chinese Health Study (33CCHS) in 2009 were evaluated. MetS was defined based on the recommendation by the Joint Interim Societies. Exposure to air pollutants was assessed using data from monitoring stations and a spatial statistical model (including particles with diameters ≤ 1.0 µm (PM1), ≤ 2.5 µm (PM2.5), and ≤ 10 µm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3)). Two-level logistic regression analyses were utilized to assess the associations between air pollutants and MetS. The prevalence of MetS was 30.37%. The adjusted odds ratio of MetS per 10 µg/m3 increase in PM1, PM2.5, PM10, SO2, NO2, and O3 were 1.12 (95% CI = 1.00-1.24), 1.09 (95% CI = 1.00-1.18), 1.13 (95% CI = 1.08-1.19), 1.10 (95% CI = 1.02-1.18), 1.33 (95% CI = 1.12-1.57), and 1.10 (95% CI = 1.01-1.18), respectively. Stratified analyses indicated that the above associations were stronger in participants with the demographic variables of males, < 50 years of age, and higher income, as well as with the behavioral characteristics of smoking, drinking, and consuming sugar-sweetened soft drinks frequently. This study indicates that long-term exposure to ambient air pollutants may increase the risk of MetS, especially among males, the young to middle aged, those of low income, and those with unhealthy lifestyles.

Keywords: Cardiometabolic risk factors; Chinese adults; Cross-sectional study; Gaseous pollutant; Particulate matter.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Air Pollutants* / toxicity
  • Air Pollution* / adverse effects
  • China
  • Environmental Exposure*
  • Humans
  • Male
  • Metabolic Syndrome* / epidemiology
  • Middle Aged
  • Nitrogen Dioxide
  • Particulate Matter


  • Air Pollutants
  • Particulate Matter
  • Nitrogen Dioxide