Long-term effects of PM2.5 constituents on metabolic syndrome and mediation effects of serum uric acid

Exposure to particulate matter with aerodynamic diameter ≤2.5 μm (PM2.5) was associated with the risk for metabolic syndrome (MetS) in the general population, but the contributions of individual PM2.5 constituents to this association and the potential pathway between PM2.5 constituents and MetS risk are not well elaborated. This study aimed to investigate associations between PM2.5 constituents and MetS in general populations, relative importance of PM2.5 constituents to and mediation effects of serum uric acid (SUA) on those associations. The 48,148 participants from a provincially representative cohort established in southwest China were included. The 3-year average concentrations of PM2.5 and its constituents (nitrate [NO3−], sulfate [SO42−], ammonium [NH4+], organic matter [OM], and black carbon [BC]) were estimated using a series of machine-learning models. Multivariate logistic regression and weighted quantile sum regression were used to estimate effects of independent PM2.5 constituents on MetS and their contributions to the joint effect. Mediation analysis examined the potential mediation effects of SUA on the associations between PM2.5 constituents and MetS. Each interquartile range (IQR) increase in the concentration of PM2.5 constituents was all positively associated with the increased MetS odds, including SO42− (OR = 1.15 [1.11, 1.19]]), NO3− (OR = 1.12 [1.08, 1.16]), NH4+ (OR = 1.13 [1.09, 1.17]), OM (OR = 1.09 [1.06, 1.13]), and BC (OR = 1.09 [1.06, 1.13]). Their joint associations on MetS were mainly attributed to SO42− (weight=46.1%) and NH4+ (44.0%). The associations of PM2.5 constituents with abnormal MetS components were mainly attributed to NH4+ for elevated BP (51.6%) and reduced HDL-C (97.0%), SO42− for elevated FG (68.9%), NO3- for elevated TG (51.0%), and OM for elevated WC (63.0%). Percentages mediated by SUA for the associations of PM2.5, SO42−, NO3−, and BC with MetS were 13.6%, 13.1%, 10.6%, and 11.1%, respectively. Long-term exposure to PM2.5 constituents, mainly NH4+ and SO42−, was positively associated with MetS odds, partially mediated by SUA.