Air pollution, meteorological factors, and cardiac remodelling in children: a multi-omics cohort study

BACKGROUND AND AIMS: Exposure to air pollution and several meteorological factors was associated with increased cardiovascular diseases in adults. However, little is known about their effects on cardiovascular structure and function as well as the underlying biomolecular mechanisms in children. METHODS: A total of 2029 children were enrolled at baseline in the Southwest Health Children Cohort from three provinces (Chongqing, Guizhou, and Sichuan provinces) in China from 2021 to 2025. Exposure to particulate matter smaller than 2.5 µm (PM2.5), temperature (TE), extreme temperature events (ETEs), and relative humidity (RH) were estimated from machine-learning approaches according to residential addresses, and cardiovascular parameters were obtained from high-quality echocardiography images both at baseline and each visit. RESULTS: The results indicated that ambient PM2.5, TE, ETEs, and RH exposure levels were significantly associated with cardiovascular structure and function remodelling from pregnancy to full exposure windows including thickening in carotid intima and decreased ejection fraction. Moreover, the associations were more pronounced in children from low-income families or with elevated blood pressure. In addition, PM2.5 synergistically interacted with ETEs to promote abnormal cardiovascular remodelling in children. Lipidomes including hexosylceramide, phosphoenolpyruvate, and triacylglyceride, and one protein myosin light chain 3 were identified to be important biomarkers linking environmental hazards with abnormal cardiovascular remodelling in children. CONCLUSIONS: This study provided new evidence of air pollution and meteorological factors in children's cardiovascular health, suggesting that environmental improvement strategies are urgently needed to promote cardiovascular health in vulnerable children and adolescents.