Reducing PM2.5 Exposure Lowers Dyslipidemia Risk: A Longitudinal Quasi-Experimental Study

Dezhong Chen; Yiyue Yin; Dongmei Yu; Ling Zhang; Weiyi Chen; Jian Xu; Ting Xiao; Hung Chak Ho; G. Neil Thomas; Yu Huang; Xiang Qian Lao

doi:10.1093/aje/kwaf192

Reducing PM_2.5 Exposure Lowers Dyslipidemia Risk: A Longitudinal Quasi-Experimental Study

Dezhong Chen
, Yiyue Yin
, Dongmei Yu
, Ling Zhang
, Weiyi Chen
, Jian Xu
, Ting Xiao
, Hung Chak Ho
, G. Neil Thomas
, Yu Huang
, Xiang Qian Lao^*

^*Corresponding author for this work

Research output: Journal Publications and Reviews › RGC 21 - Publication in refereed journal › peer-review

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Abstract

Evidence demonstrating the beneficial effects of improved air quality on lipid health is scarce. This study addresses this gap by examining whether reducing PM_2.5exposure can decrease the risk of dyslipidemia. We conducted a longitudinal quasi-experimental study using the Taiwan MJ and Hong Kong MJ cohorts from 2000 to 2018. A total of 8,808 adults with consistently high PM_2.5 exposure (≥ 25 μg/m³) were paired with 4,612 adults whose PM_2.5exposure decreased from high to low levels (< 25 μg/m³) using propensity score matching. Cox regression models with time-dependent covariates were used to analyze the associations between PM_2.5reduction and the risk of dyslipidemia, as well as individual lipid abnormalities. We found that participants with reducing PM_2.5exposure had a significantly lower risk of dyslipidemia compared to their counterparts (HR = 0.75, 95% CI: 0.68, 0.84). Non-linear concentration-response relationships were observed. Similar associations were found for elevated TC (HR = 0.61, 95% CI: 0.51, 0.74) and LDL-C (HR = 0.69, 95% CI: 0.57, 0.84), and decreased HDL-C (HR = 0.59, 95% CI: 0.47, 0.75). Reducing PM_2.5 exposure significantly lowers the risk of dyslipidemia and improves lipid profiles, providing direct evidence of the health benefits associated with air quality improvement.

© 2025 Johns Hopkins Bloomberg School of Public Health

Original language	English
Pages (from-to)	524-532
Journal	American Journal of Epidemiology
Volume	195
Issue number	2
Online published	29 Aug 2025
DOIs	https://doi.org/10.1093/aje/kwaf192
Publication status	Published - Feb 2026

Funding

This work was supported by Health and Medical Research Fund (18190131), New Research Initiatives/Infrastructure Support from Central of City University of Hong Kong (9610613), and RGC-Theme-based Research Scheme (T24-508/22-N).

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 11 Sustainable Cities and Communities

Research Keywords

Cardiovascular disease
Dyslipidemia
Quasi-experimental study
PM2.5
Risk factor

Publisher's Copyright Statement

This full text is made available under CC-BY 4.0. https://creativecommons.org/licenses/by/4.0/

RGC Funding Information

RGC-funded

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10.1093/aje/kwaf192

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Cite this

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title = "Reducing PM2.5 Exposure Lowers Dyslipidemia Risk: A Longitudinal Quasi-Experimental Study",

abstract = "Evidence demonstrating the beneficial effects of improved air quality on lipid health is scarce. This study addresses this gap by examining whether reducing PM2.5 exposure can decrease the risk of dyslipidemia. We conducted a longitudinal quasi-experimental study using the Taiwan MJ and Hong Kong MJ cohorts from 2000 to 2018. A total of 8,808 adults with consistently high PM2.5 exposure (≥ 25 μg/m3) were paired with 4,612 adults whose PM2.5 exposure decreased from high to low levels (< 25 μg/m3) using propensity score matching. Cox regression models with time-dependent covariates were used to analyze the associations between PM2.5 reduction and the risk of dyslipidemia, as well as individual lipid abnormalities. We found that participants with reducing PM2.5 exposure had a significantly lower risk of dyslipidemia compared to their counterparts (HR = 0.75, 95\% CI: 0.68, 0.84). Non-linear concentration-response relationships were observed. Similar associations were found for elevated TC (HR = 0.61, 95\% CI: 0.51, 0.74) and LDL-C (HR = 0.69, 95\% CI: 0.57, 0.84), and decreased HDL-C (HR = 0.59, 95\% CI: 0.47, 0.75). Reducing PM2.5 exposure significantly lowers the risk of dyslipidemia and improves lipid profiles, providing direct evidence of the health benefits associated with air quality improvement. {\textcopyright} 2025 Johns Hopkins Bloomberg School of Public Health",

keywords = "Cardiovascular disease, Dyslipidemia, Quasi-experimental study, PM2.5, Risk factor",

author = "Dezhong Chen and Yiyue Yin and Dongmei Yu and Ling Zhang and Weiyi Chen and Jian Xu and Ting Xiao and Ho, \{Hung Chak\} and Thomas, \{G. Neil\} and Yu Huang and Lao, \{Xiang Qian\}",

year = "2026",

month = feb,

doi = "10.1093/aje/kwaf192",

language = "English",

volume = "195",

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T2 - A Longitudinal Quasi-Experimental Study

AU - Chen, Dezhong

AU - Yin, Yiyue

AU - Yu, Dongmei

AU - Zhang, Ling

AU - Chen, Weiyi

AU - Xu, Jian

AU - Xiao, Ting

AU - Ho, Hung Chak

AU - Thomas, G. Neil

AU - Huang, Yu

AU - Lao, Xiang Qian

PY - 2026/2

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N2 - Evidence demonstrating the beneficial effects of improved air quality on lipid health is scarce. This study addresses this gap by examining whether reducing PM2.5 exposure can decrease the risk of dyslipidemia. We conducted a longitudinal quasi-experimental study using the Taiwan MJ and Hong Kong MJ cohorts from 2000 to 2018. A total of 8,808 adults with consistently high PM2.5 exposure (≥ 25 μg/m3) were paired with 4,612 adults whose PM2.5 exposure decreased from high to low levels (< 25 μg/m3) using propensity score matching. Cox regression models with time-dependent covariates were used to analyze the associations between PM2.5 reduction and the risk of dyslipidemia, as well as individual lipid abnormalities. We found that participants with reducing PM2.5 exposure had a significantly lower risk of dyslipidemia compared to their counterparts (HR = 0.75, 95% CI: 0.68, 0.84). Non-linear concentration-response relationships were observed. Similar associations were found for elevated TC (HR = 0.61, 95% CI: 0.51, 0.74) and LDL-C (HR = 0.69, 95% CI: 0.57, 0.84), and decreased HDL-C (HR = 0.59, 95% CI: 0.47, 0.75). Reducing PM2.5 exposure significantly lowers the risk of dyslipidemia and improves lipid profiles, providing direct evidence of the health benefits associated with air quality improvement. © 2025 Johns Hopkins Bloomberg School of Public Health

AB - Evidence demonstrating the beneficial effects of improved air quality on lipid health is scarce. This study addresses this gap by examining whether reducing PM2.5 exposure can decrease the risk of dyslipidemia. We conducted a longitudinal quasi-experimental study using the Taiwan MJ and Hong Kong MJ cohorts from 2000 to 2018. A total of 8,808 adults with consistently high PM2.5 exposure (≥ 25 μg/m3) were paired with 4,612 adults whose PM2.5 exposure decreased from high to low levels (< 25 μg/m3) using propensity score matching. Cox regression models with time-dependent covariates were used to analyze the associations between PM2.5 reduction and the risk of dyslipidemia, as well as individual lipid abnormalities. We found that participants with reducing PM2.5 exposure had a significantly lower risk of dyslipidemia compared to their counterparts (HR = 0.75, 95% CI: 0.68, 0.84). Non-linear concentration-response relationships were observed. Similar associations were found for elevated TC (HR = 0.61, 95% CI: 0.51, 0.74) and LDL-C (HR = 0.69, 95% CI: 0.57, 0.84), and decreased HDL-C (HR = 0.59, 95% CI: 0.47, 0.75). Reducing PM2.5 exposure significantly lowers the risk of dyslipidemia and improves lipid profiles, providing direct evidence of the health benefits associated with air quality improvement. © 2025 Johns Hopkins Bloomberg School of Public Health

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JO - American Journal of Epidemiology

JF - American Journal of Epidemiology

IS - 2

ER -

Reducing PM_2.5 Exposure Lowers Dyslipidemia Risk: A Longitudinal Quasi-Experimental Study

Abstract

Funding

UN SDGs

Research Keywords

Publisher's Copyright Statement

RGC Funding Information

Access Output

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Permanent Link

Other Files and Links

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TBRS-ExtU-Lead: Unravelling the Black Box between Air Pollution and Public Health for Transformative Air Quality Management

HMRF: Long-term Exposure to Ambient Air Pollution and Intermediate Health Outcomes: A Cohort Study with 55,000 Hong Kong Residents

Cite this

Reducing PM2.5 Exposure Lowers Dyslipidemia Risk: A Longitudinal Quasi-Experimental Study

Abstract

Funding

UN SDGs

Research Keywords

Publisher's Copyright Statement

RGC Funding Information

Access Output

Other Access Options

Permanent Link

Other Files and Links

Fingerprint

Projects

TBRS-ExtU-Lead: Unravelling the Black Box between Air Pollution and Public Health for Transformative Air Quality Management

HMRF: Long-term Exposure to Ambient Air Pollution and Intermediate Health Outcomes: A Cohort Study with 55,000 Hong Kong Residents

Cite this

Reducing PM_2.5 Exposure Lowers Dyslipidemia Risk: A Longitudinal Quasi-Experimental Study