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<p>There is less evidence on the association between long-term PM<sub>2.5</sub>, O<sub>3</sub>, greenness exposure and cardiometabolic multimorbidity (CMM), and the aim of this study was to investigate the combined effects of PM<sub>2.5</sub>, O<sub>3</sub> and greenness exposure on the risk of developing CMM.Our findings demonstrated that a 10&#xa0;µg/m³ rise in PM<sub>2.5</sub> concentration led to a 23.8% increased CMM risk (HR = 1.238, 95%CI: 1.202,1.275). A 0.1 increase in NDVI reduced CMM risk by 18.9% (HR = 0.811, 95% CI: 0.779,0.845). A 10&#xa0;µg/m³ O<sub>3</sub> concentration increase surprisingly lowered CMM risk by 30.8% (HR = 0.692, 95% CI: 0.649,0.738). Positive interactions were seen between high PM<sub>2.5</sub>+low O<sub>3</sub> and low O<sub>3</sub> + low NDVI, while high PM<sub>2.5</sub>+low NDVI had negative interactions regarding CMM. PM<sub>2.5</sub> mediated the link between NDVI and CMM, heart disease, and stroke.This study emphasizes that long-term high PM<sub>2.5</sub> exposure ups CMM risk in Chinese middle-aged and older adults, yet NDVI exposure reduces it, with PM<sub>2.5</sub> as a mediator. The O<sub>3</sub>-CMM relationship remains unclear.</p>

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Association of PM2.5, O3 and greenness exposure with risk of cardiometabolic multimorbidity: a prospective cohort study

  • 期刊论文

  • 发表日期：

    2026年1月6日

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  • Ning Gao,
  • Dan Sheng,
  • Shaoyan Tang,
  • Minzhen Wang,
  • Shan Zheng

摘要

There is less evidence on the association between long-term PM2.5, O3, greenness exposure and cardiometabolic multimorbidity (CMM), and the aim of this study was to investigate the combined effects of PM2.5, O3 and greenness exposure on the risk of developing CMM.Our findings demonstrated that a 10 µg/m³ rise in PM2.5 concentration led to a 23.8% increased CMM risk (HR = 1.238, 95%CI: 1.202,1.275). A 0.1 increase in NDVI reduced CMM risk by 18.9% (HR = 0.811, 95% CI: 0.779,0.845). A 10 µg/m³ O3 concentration increase surprisingly lowered CMM risk by 30.8% (HR = 0.692, 95% CI: 0.649,0.738). Positive interactions were seen between high PM2.5+low O3 and low O3 + low NDVI, while high PM2.5+low NDVI had negative interactions regarding CMM. PM2.5 mediated the link between NDVI and CMM, heart disease, and stroke.This study emphasizes that long-term high PM2.5 exposure ups CMM risk in Chinese middle-aged and older adults, yet NDVI exposure reduces it, with PM2.5 as a mediator. The O3-CMM relationship remains unclear.