Associations of long-term particulate matter exposure with cardiometabolic diseases: A systematic review and meta-analysis

This review aimed to establish a holistic perspective of long-term PM exposure and cardiometabolic diseases, identify long-term PM-related cardiovascular and metabolic risk factors, and provide practical significance to preventative measures. A combination of computer and manual retrieval was used to search for keywords in PubMed (2903 records), Embase (2791 records), Web of Science (5488 records) and Cochrane Library (163 records). Finally, a total of 82 articles were considered in this meta-analysis. Stata 13.0 was accustomed to inspecting the studies' heterogeneity and calculating the combined effect value (RR) by selecting the matching models. The subgroup analysis, sensitivity analysis and publication bias tests were also performed. Meta-analysis figured an association between PM and cardiometabolic diseases. PM2.5 (per 10 μg/m3 increase) boosted the risk of hypertension (RR = 1.14, 95 % CI: 1.09–1.19), coronary heart disease (CHD) (RR = 1.21, 95 % CI: 1.08–1.35), diabetes (RR = 1.16, 95 % CI: 1.11–1.21) and stroke (including ischemic stroke and hemorrhagic stroke). PM10 (per 10 μg/m3 increase) elevated the incidence of hypertension (RR = 1.11, 95 % CI: 1.07–1.16) and diabetes (RR = 1.26, 95 % CI: 1.08–1.47). PM1 (per 10 μg/m3 increase) exposure increased the risk of total dyslipidemia, yielding the RR of 1.10 (95 % CI: 1.01–1.18). Furthermore, the elderly, overweight and higher background pollutant level were potentially susceptible to related diseases. There was a virtual connection between long-term exposure to PM and cardiometabolic diseases. PM2.5 or PM10 (per 10 μg/m3) increased the risk of hypertension, CHD, diabetes, stroke and dyslipidemia, causing cardiovascular "multimorbidity" in high-risk populations.