Adverse effects of air pollutant exposure on blood lipid levels in adults: A systematic review and meta-analysis

• Published in: Cardiology plus 2020-07, Vol.5 (3), p.118-129
• Main Authors: Zhang, Xin-Yu, Huang, Si-Han, Gong, Hai-Yan, Wang, Xin-Yan, Huang, Ke-Yong, Lu, Xiang-Feng, Liu, Fang-Chao
• Format: Article
• Language: English
• Subjects: air pollutants; lipids; meta-analysis; Air pollution; Blood lipids; Development and progression; Health aspects; Hypercholesterolemia; Risk factors
• ISSN: 2470-7511; 2470-752X; 2470-752X
• DOI: 10.4103/cp.cp_18_20

Background: Air pollution is a crucial public health issue, but evidence on its association with blood lipids is still limited and inconsistent. Objectives: To systematically review and explore associations between major air pollutants (PM2.5, PM10, SO2, NO2, and O3) and blood lipid levels in long-, middle-, and short-term exposure durations. Data Source: Databases of PubMed, Embase, and Web of Science were searched for eligible articles published until August 16, 2019. Study Eligibility Criteria: English articles were explored for associations between air pollutants and blood lipids among adults using quantitative measures. Methods: Random-effect models were used to synthesize the association, and I2 value was used to evaluate the degree of heterogeneity. Results: Of the 15 studies that met the inclusion criteria, 11, 7, and 4 records were used to evaluate long-, middle-, and short-term effects. Generally, air pollutants had adverse influence on blood lipid levels, and results were robust across sensitivity analyses. For example, PM2.5 was significantly associated with increased total cholesterol and low-density lipoprotein-cholesterol levels, with a percentage change of 4.53 (0.12, 8.93) and 5.36 (0.37, 10.35) per 10 μg/m3 increment, respectively, in long-term exposure. However, associations with NO2, SO2, and O3 were still insufficient. Moreover, prospective evidence was considerably inadequate. Limitation: We only pooled the association of air pollution with major blood lipids. We were unable to clarify the health effects of chemical components or susceptible population because of limited studies. Conclusions: Ambient air pollutants have detrimental effects on blood lipid levels. Further prospective evidence is highly warranted to demonstrate these associations.