Abstract
To date, research on the relationship between long-term exposure to PM2.5 constituents and the risk of bipolar disorder (BD) remains underexplored. This study investigated this association using data from 495,139 participants in the UK Biobank. Daily average concentrations of PM2.5 constituents from 2006 to 2020 were estimated using the European Monitoring and Evaluation Program model applied to the UK (EMEP4UK). Time-weighted Cox proportional hazards models were employed to quantify the risk of BD associated with long-term exposure to PM2.5 and its constituents, while the Quantile g-computation model was used to identify the mixture effects and the key contributing constituent. Furthermore, polygenic risk scores for BD were used to explore gene-environment interactions and joint effects. Over a median follow-up period of 11.90 years, 1,040 newly diagnosed BD cases were detected. PM2.5 and its constituents were associated with BD risk. After adjustment, the hazard ratios for BD risk per interquartile range increase in each constituent, along with their 95% confidence intervals were as follows: 1.58 (1.47, 1.69) for PM2.5, 1.38 (1.28, 1.48) for elemental carbon (EC), 1.10 (1.02, 1.18) for organic matter (OM), 1.44 (1.41, 1.48) for ammonium (NH4+), 1.27 (1.18, 1.36) for nitrate (NO3-), and 1.26 (1.25, 1.28) for sulfate (SO42-). EC emerged as the primary risk contributor. We also observed both interactive and joint effects of PM2.5 constituents and genetic susceptibility on BD incidence. These findings underscore the importance of reducing specific PM2.5 constituents and considering genetic predisposition in public health strategies.</p>