Abstract
Several studies showed that indoor air pollution may pose significant risks to public health, causing illnesses such as pulmonary and cardiovascular disorders. It is known very little of the association between air pollution and sarcopenia in older Chinese adults. We conducted a cohort study to examine the detrimental health effects of indoor solid fuel use for heating and cooking on sarcopenia and further explore the mediating role of depression and C-reaction protein (CRP). The sample of the study consists of 2088 participants from the CHARLS 2011-2015. Sarcopenia status was assessed according to the AWGS 2019 criteria. Participants were asked specific questions about the source of their primary heating and cooking fuels, which served as the basis for defining solid fuel use. Multivariate logistic regressions were constructed to explore the relationship between indoor solid fuel use and sarcopenia or possible sarcopenia. Serial mediation analyses were applied to explore the potential mediating role of depression and CRP in the relationship. Among all participants, 224 and 61 had possible sarcopenia or sarcopenia. Compared to individuals who used clean fuel for heating and cooking, participants who utilized indoor solid fuel for heating exhibited a higher risk of possible sarcopenia or sarcopenia, with OR (and 95% CI) of 1.48 (1.04, 2.11) and 8.42 (2.01, 35.32). The risk of possible sarcopenia demonstrates a gradual increase in correlation with the duration of solid fuel usage for heating (P for trend <0.01). Approximately 16.27% of the relationship between indoor solid fuel use and possible sarcopenia is mediated by depression. Our stratified analysis indicates that participants residing in a city/town are associated with higher odds of possible sarcopenia. Additionally, our sensitivity analysis demonstrates that our estimates are generally robust and consistent. Indoor heating using solid fuels is associated with a higher risk of sarcopenia, while prolonged exposure to household air pollution is found to be positively correlated with this increased risk. Furthermore, depression plays a mediating role in this relationship.
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Data availability
Publicly available datasets were analyzed in this study. This data can be found at China Health and Retirement Longitudinal Survey (2020). Available online at https://charls.charlsdata.com/pages/data/111/zh-cn.html.
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Acknowledgements
We appreciate the very kind support from all colleagues of National Institute of Health Data Science at Peking University and coordinators at the data sites for their support.
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ZZ: conception and design of the study. MW and LH: acquisition and interpretation of data, drafting the article. HP and JY: formal analysis and methodology. XZ: draw figures and tables. All authors contributed to and have approved the final manuscript.
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CHARLS obtained its initial approval from the Institutional Review Board of Peking University in 2008 (IRB00001052-11,015), and the methods used in this study complied with the applicable norms and guidelines of CHARLS. All participants provided written informed consent before voluntarily joining CHARLS.
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Wang, M., Hu, L., Peng, H. et al. The longitudinal association between indoor air pollution and sarcopenia in China: the mediating role of depression. Environ Sci Pollut Res 30, 115506–115516 (2023). https://doi.org/10.1007/s11356-023-30379-x
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DOI: https://doi.org/10.1007/s11356-023-30379-x