{
  "abstract": "Although current research supports associations between residential environment and inflammation and/or adiposity, evidence remains limited and partly contradictory for combined exposures, especially in vulnerable populations. To address this issue, this cross-sectional study, taking place in 2023 and 2024, investigated the associations between residential factors and adiposity and proinflammatory markers in 90 obese adults with metabolic syndrome from Bulgaria. All underwent clinical, anthropometric, and laboratory examinations, and completed a questionnaire. We measured their serum proinflammatory cytokines [interleukin-6 (IL-6), tumour necrosis factor alpha (TNF-α)], C-reactive protein (CRP), and adipokines (visfatin, leptin, adiponectin). Adiposity-related markers included body mass index (BMI), waist-to-hip ratio (WHR), body fat, and visceral fat percentage. Residential air pollution (NO₂, PM2.5, PM₁₀), road traffic noise (Lden), domestic burning of solid fuel, total greenness, tree cover, and time spent in nature were linked to these data. There was suggestive evidence that every 10 μg/m³ increase in NO₂ levels was associated with higher concentrations of TNF-α (36.27 %; 95 % CI: -5.66 %, 96.83 %), IL-6 (41.63 %; 95 % CI: 8.16 %, 85.46 %), CRP (37.80 %; 95 % CI: 5.89 %, 79.32 %), leptin (25.61 %; 95 % CI: -8.73 %, 72.88 %), and lower adiponectin-leptin ratio (-33.83 %; 95 % CI: -56.59 %, 0.85 %). Additionally, NO₂ was associated with higher BMI (6.37 %; 95 % CI: -0.82 %, 14.08 %) and visceral fat (7.52 %; 95 % CI: 1.30 %, 14.12 %). For every 2 h/week spent in nature, TNF-α concentration was lower (-20.49 %; 95 % CI: -37.56 %, 1.23 %), and adiponectin was higher (10.30 %; 95 % CI: 1.36 %, 20.03 %). Other observed associations were largely null, inconsistent, or occasionally showed an unexpected protective direction. These findings can serve as a general roadmap, and only larger longitudinal studies may provide a better insight into the environmental determinants of metabolic inflammation, which could in turn support the development of alternative preventive strategies.",
  "abstract_shown": true,
  "affiliations": [
    "Medical University of Plovdiv, Strategic Research and Innovation Program for the Development of MU - Plovdiv, Health and Quality of Life in a Green and Sustainable Environment Research Group, Plovdiv, Bulgaria.",
    "Medical University of Plovdiv, Research Institute at Medical University of Plovdiv, Environmental Health Division, Plovdiv, Bulgaria.",
    "Medical University of Plovdiv, First Department of Internal Diseases, Plovdiv, Bulgaria.",
    "St George University Hospital, Clinic of Cardiology Plovdiv, Bulgaria.",
    "Medical University of Plovdiv Faculty of Public Health, Department of Social Medicine and Public Health, Plovdiv, Bulgaria.",
    "Medical University of Plovdiv Faculty of Medicine, Plovdiv, Bulgaria.",
    "University of Architecture, Civil Engineering, and Geodesy, Faculty of Architecture, Department of Urban Planning, Sofia, Bulgaria.",
    "Utrecht University, Faculty of Geosciences, Department of Human Geography and Spatial Planning, Utrecht, The Netherlands.",
    "Medical University of Plovdiv, Faculty of Medicine, Department of Clinical Laboratory, Plovdiv, Bulgaria."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Angel M Dzhambov",
      "orcid": "0000-0003-2540-5111"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Spas Kitov"
    },
    {
      "affs": [
        0,
        1,
        4
      ],
      "name": "Kostadin R Kostadinov"
    },
    {
      "affs": [
        5
      ],
      "name": "Maria-Florance Kitova"
    },
    {
      "affs": [
        0,
        1,
        6
      ],
      "name": "Angel Burov"
    },
    {
      "affs": [
        0,
        1,
        7
      ],
      "name": "Marco Helbich"
    },
    {
      "affs": [
        1,
        8
      ],
      "name": "Tanya Deneva"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Lyudmila Kitova"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9h3xqybcb6pph.bib",
  "cited_by": 0,
  "doi": "10.2478/aiht-2026-77-4124",
  "fulltext_url": "https://europepmc.org/articles/PMC13613160",
  "id": "9h3xqybcb6pph",
  "issns": [
    "0004-1254",
    "1848-6312"
  ],
  "landing_url": "https://europepmc.org/article/MED/42859413",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2713|Adipokines, Inflammation, and Metabolic Diseases"
    ]
  ],
  "openalex": "W7213449978",
  "pdf_url": "https://europepmc.org/articles/PMC13613160?pdf=render",
  "pmcid": "PMC13613160",
  "pmid": "42859413",
  "published": "2026-09-25",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/9h3xqybcb6pph.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:16Z",
      "native_id": "MED:42859413",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42859413"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Adipokines, Inflammation, and Metabolic Diseases",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Residential exposures associated with adiposity and proinflammatory markers in obese adults with metabolic syndrome: a cross-sectional study.",
  "title_text": "Residential exposures associated with adiposity and proinflammatory markers in obese adults with metabolic syndrome: a cross-sectional study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:16Z",
  "url": "https://research.draconitic.com/paper/9h3xqybcb6pph",
  "venue": "Arhiv za higijenu rada i toksikologiju",
  "versions": []
}