Associations of short-, mid-, and long-term particulate matter exposure with elevated LDL-C levels in Korean adults: analysis of KNHANES 2016-2022.

Abstract

Purpose Evidence linking particulate matter (PM) to low-density lipoprotein cholesterol (LDL-C) remains inconsistent. We examined associations of short- (1-7 days), mid- (1-6 months), and long-term (1-5 years) PM₁₀ and PM_2.5 exposures with elevated LDL-C (≥ 160 mg/dL or medication use) in Korean adults.Methods In this cross-sectional analysis of 14,867 Korean adults from the 2016-2022 the Korea National Health and Nutrition Examination Survey (KNHANES), a nationally representative survey. We used complex samples logistic regression, to estimate odds ratios (ORs) per interquartile range increase in PM, adjusting for sociodemographic, behavioral, occupational, and clinical covariates. Results Both PM₁₀ and PM_2.5 were positively associated with elevated LDL-C across most windows. In fully adjusted models, PM₁₀ ORs ranged from 1.143 to 1.236. For PM_2.5, ORs ranged from 1.097 to 1.181. Associations remained robust after adjusting for lifestyle, adiposity, and chronic conditions. Conclusion Short-, mid-, and long-term PM exposures were consistently associated with elevated LDL-C levels. These findings suggest PM is associated with alterations in lipid metabolism through acute and chronic pathways, highlighting air pollution as an environmental factor associated with dyslipidemia and cardiometabolic risk.