title: Is air quality index associated with cardiometabolic risk factors in adolescents? The CASPIAN-III Study.
abstract: OBJECTIVE
  This study aims to evaluate the association of air quality index (AQI) with cardiometabolic risk factors in a nationally representative sample of healthy adolescents.
  
  
  METHODS
  This nationwide survey was conducted among a stratified multi-stage probability sample of students, aged 10-18 years, from 27 provinces of Iran. Those students with history of any acute or chronic diseases, any medication use, as well as active or passive smoking were not included to the current study. Dietary and physical activity habits were documented by valid questionnaires. Physical examination and blood sampling were conducted under standard protocols. AQI data were obtained from air pollution monitoring sites from the entire country by considering air pollutants concentration, which includes all provincial counties containing different clusters.
  
  
  RESULTS
  The study participants consisted of 1413 students (48.8% boys) with a mean (SD) age of 14.81±2.48 years. The mean AQI level was 285.37±30.11 at national levels. After adjustment for confounding factors including age, sex, and anthropometric measures, as well as for dietary and physical activity habits, multiple linear regressions based on correlation of coefficients of the AQI with cardiometabolic risk factors showed significant positive correlations of AQI with systolic blood pressure, fasting blood glucose, total cholesterol, LDL-cholesterol, and triglycerides, as well as significant negative correlations with HDL-cholesterol. After adjustment for abovementioned confounding factors, binary logistic regressions analyses showed that AQI increased the risk of abnormal levels of some risk factors as elevated levels of systolic blood pressure, total cholesterol, and triglycerides.
  
  
  CONCLUSIONS
  The associations of low air quality with some cardiometabolic factors in the current survey, although not strong, might be considered as an evidence of the adverse cardiometabolic consequences of exposure to air pollutants in the pediatric age group, and predisposing them to earlier development of non-communicable diseases.
authors.affiliation: Environment Engineering Department, Environment Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Parinaz
authors.initials: P
authors.lastname: Poursafa
authors.affiliation: Biostatistics and Epidemiology Department, Faculty of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran; Pediatrics Department, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Marjan
authors.initials: M
authors.lastname: Mansourian
authors.affiliation: Pediatrics Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Mohammad-Esmaeil
authors.initials: ME
authors.lastname: Motlagh
authors.affiliation: Pediatrics Department, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Gelayol
authors.initials: G
authors.lastname: Ardalan
authors.affiliation: Pediatrics Department, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: kelishadi@med.mui.ac.ir.
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
mesh_terms: D000293:Adolescent; D000393:Air Pollutants / Q000633:toxicity*; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology*; D002648:Child; D002784:Cholesterol / Q000097:blood; D005260:Female; D006801:Humans; D007492:Iran; D008297:Male; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D000393:Air Pollutants; D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol
keywords: Adolescents; Air pollutants; Cardiovascular risk factors; Prevention; Public health