The influences of ambient fine particulate matter constituents on plasma hormones, circulating TMAO levels and blood pressure: A panel study in China

Considerable investigations have been carried out to address the relationship between ambient fine particulate matter (PM_2.5) and blood pressure (BP) in patients with hypertension. However, few studies have explored the influence of PM_2.5 and its constituents on Trimethylamine N-oxide (TMAO), an established risk factor for hypertension and cardiovascular disease (CVD), particularly in severely air-polluted areas. To explore the potential impact of PM_2.5 constituents on BP, plasma hormones, and TMAO, a panel study was conducted to investigate changes in BP, plasma hormones, and TMAO in response to ambient air pollution exposure in stage 1 hypertensive young adults. Linear mixed effect models were used to estimate the cumulative effects of fine particulate matters (PM_2.5) and its constituents on BP, plasma hormones and TMAO. We found that one interquartile range (IQR) (35 μg/m³) increase in 0–1 day moving-average PM_2.5 concentrations was statistically significantly associated with elevated systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) with estimated values of 0.13 (95% confidence interval (CI): 0.03 to 0.23) mmHg, 0.18 (95% CI: 0.08 to 0.28) mmHg, and 0.17 (95% CI: 0.09 to 0.26) mmHg, respectively. Hormone disturbance in the renin-angiotensin-aldosterone system was also associated with PM_2.5 exposure. Elevated TMAO levels with an IQR increase for 0–4, 0–5, 0–6 moving-average concentrations of PM_2.5 were found, and the increased values ranged from 26.28 (95% CI: 2.92 to 49.64) to 60.78 (31.95–89.61) ng/ml. More importantly, the PM_2.5-bound metal constituents, such as manganese (Mn), titanium (Ti), and selenium (Se) showed robust associations with elevated BP and plasma TMAO levels. This study demonstrates associations between PM_2.5 metal constituents and increased BP, changes in plasma hormones and TMAO, in stage 1 hypertensive young adults. Source control, aiming to reduce the emission of PM_2.5-bound metals should be implemented to reduce the risk of hypertension and CVD.