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Outline
To examine the joint association of intrinsic capacity (IC) and long-term fine particulate matter (PM2.5) exposure with incident cardiovascular disease (CVD) among older Chinese adults.
This prospective cohort study used data from the China Health and Retirement Longitudinal Study (CHARLS). We included 3 241 participants aged ≥60 years who were free of CVD at baseline in 2011 and followed them through 2020. IC was assessed across five domains: locomotion, vitality, sensory function, cognition, and psychological well-being, and categorized by the number of deficits (0, 1, 2, or ≥3). Long-term PM2.5 exposure was estimated using satellite-based data linked to participants’ residential locations. Cox proportional hazards models were used to estimate the association between IC-PM2.5 joint exposure groups and incident CVD, with hazard ratios (HRs) and 95% confidence intervals (CIs) reported. In addition, group-based trajectory modelling (GBTM) was applied to identify IC trajectories, and the association between PM2.5 exposure and CVD risk was further evaluated across different trajectory groups.
During a mean follow-up of 7.9±2.2 years, 697 participants (21.5%) developed incident CVD, with an incidence density of 27.3 per 1 000 person-years (95%CI: 25.3-29.4). Compared with the “high IC + low PM2.5 exposure” group, the adjustedHRs for incident CVD were 1.53 (95%CI: 1.20-1.96) for the “low IC + high PM2.5 exposure” group. Three IC trajectories were further identified: “low-level with transient improvement”, “moderate-level with persistent decline”, and “high-level with stable improvement”. In the “low-level with transient improvement” trajectory group, each 10 μg/m3 increase in PM2.5 exposure was associated with an increased risk of incident CVD (HR=1.20, 95%CI: 1.02-1.42), whereas no statistically significant associations were observed in the other trajectory groups.
Older adults with both lower IC levels and higher long-term PM2.5 exposure had the highest risk of incident CVD. PM2.5-related CVD risk also differed across IC trajectory groups.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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