Air pollution exposure and vascular endothelial function: a systematic review and meta-analysis

Li, Jinyue; Liu, Fangchao; Liang, Fengchao; Yang, Yuxin; Lu, Xiangfeng; Gu, Dongfeng

doi:10.1007/s11356-023-25156-9

Air pollution exposure and vascular endothelial function: a systematic review and meta-analysis

Review Article
Published: 27 January 2023

Volume 30, pages 28525–28549, (2023)
Cite this article

Environmental Science and Pollution Research Aims and scope Submit manuscript

Jinyue Li¹,
Fangchao Liu¹,
Fengchao Liang^1,2,
Yuxin Yang¹,
Xiangfeng Lu¹ &
…
Dongfeng Gu^1,2,3

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Abstract

Vascular endothelial dysfunction is an early stage to cardiovascular diseases (CVDs), but whether air pollution exposure has an effect on it remains unknown. We conducted a systematic review and meta-analysis to summarize epidemiological evidence between air pollution and endothelial dysfunction. We searched the database of PubMed, EMBASE, the Cochrane Library, and Web of Science up to November 10, 2022. Fixed and random effect models were used to pool the effect change or percent change (% change) and 95% confidence interval (95% CI) of vascular function associated with particulate matter (PM) and gaseous pollutants. I² statistics, funnel plot, and Egger’s test were used to evaluate heterogeneity and publication bias. There were 34 articles included in systematic review, and 25 studies included in meta-analysis. For each 10 µg/m³ increment in short-term PM_2.5 exposure, augmentation index (AIx) and pulse wave velocity (PWV) increased by 2.73% (95% CI: 1.89%, 3.57%) and 0.56% (95% CI: 0.22%, 0.89%), and flow-mediated dilation (FMD) decreased by 0.17% (95% CI: − 0.33%, − 0.00%). For each 10 µg/m³ increment in long-term PM_2.5 exposure, FMD decreased by 0.99% (95% CI: − 1.41%, − 0.57%). The associations between remaining pollutants and outcomes were not statistically significant. The effect of short-term PM_2.5 exposure on FMD change was stronger in population with younger age, lower female proportion, higher mean body mass index and higher PM_2.5 exposure. Cardiac or vasoactive medication might attenuate this effect. Our study provides evidence that PM_2.5 exposure had adverse impact on vascular endothelial function, indicating the importance of air quality improvement for early CVD prevention.

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Data availability

All data generated or analyzed during this study are included in this published article.

Abbreviations

DALY:: Disability-adjusted life year
CVD:: Cardiovascular disease
PM:: Particulate matter
PM_2.5 :: Particulate matters of aerodynamic diameter ≤ 2.5 μm
PM₁₀ :: Particulate matters of aerodynamic diameter ≤ 10 μm
NO₂ :: Nitrogen dioxide
O₃ :: Ozone
SO₂ :: Sulfur dioxide
FMD:: Flow-mediated dilation
RHI:: Reactive hyperemia index
NO:: Nitric oxide
CO:: Carbon monoxide
PWV:: Pulse wave velocity
AIx:: Augmentation index
PRISMA:: Preferred Reporting Items for Systematic reviews and Meta-Analysis;
95% CI:: 95% Confidence interval
BMI:: Body mass index
NOx:: Nitrogen oxides
NOS:: Newcastle–Ottawa Scale
AHRQ:: Agency for Healthcare Research and Quality
GRADE:: Grading of Recommendations Assessment, Development and Evaluation
ROS:: Reactive oxygen species
ICAM-1:: Intercellular cell adhesion molecule-1
vWF:: Von Willebrand factor
VEGF:: Vascular endothelial growth factors
8-OHdG:: 8-Hydroxy-2-deoxyguanosine
SOD:: Superoxide dismutase
GPx:: Glutathione peroxidase
eNOS:: Endothelial nitric oxide synthase
TLR:: Toll-like receptor

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Acknowledgements

The authors acknowledge Junfeng Jim Zhang, Drew B Day, and Jianbang Xiang from Duke University, and Aruni Bhatnagar and Daniel W Riggs, from the University of Louisville for their kind help to our data requirement.

Funding

This work was supported by the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (Nos. 2021-I2M-1–010, 2017-I2M-1–004), the National Key R&D Program of China (Nos. 2017YFC0211703, 2018YFE0115300), and National Natural Science Foundation of China (Nos. 91643208, 82073658).

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Authors and Affiliations

Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10037, China
Jinyue Li, Fangchao Liu, Fengchao Liang, Yuxin Yang, Xiangfeng Lu & Dongfeng Gu
School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, 518055, China
Fengchao Liang & Dongfeng Gu
School of Medicine, Southern University of Science and Technology, Shenzhen, 518055, China
Dongfeng Gu

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Jinyue Li
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Fangchao Liu
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Fengchao Liang
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Yuxin Yang
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Xiangfeng Lu
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Dongfeng Gu
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Contributions

J.Li. conducted the conception of the meta-analysis, literature review, prepared the datasets, interpreted the results, and drafted and finalized the manuscript; F.Liu. contributed to the conception of the meta-analysis, literature review, dataset preparation, results interpretation, and assisted in drafting the manuscript; F.Liang. contributed to the interpreted the findings, and assisted in drafting the manuscript; Y.Yang. contributed to the literature review and prepared the datasets; X.Lu contributed to the drafting the manuscript and supervision; D.Gu contributed to the drafting the manuscript and supervision. All authors have read and approved the manuscript.

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Correspondence to Dongfeng Gu.

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Li, J., Liu, F., Liang, F. et al. Air pollution exposure and vascular endothelial function: a systematic review and meta-analysis. Environ Sci Pollut Res 30, 28525–28549 (2023). https://doi.org/10.1007/s11356-023-25156-9

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Received: 18 September 2022
Accepted: 02 January 2023
Published: 27 January 2023
Issue Date: March 2023
DOI: https://doi.org/10.1007/s11356-023-25156-9

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Air pollution exposure and vascular endothelial function: a systematic review and meta-analysis