交通相关空气污染与台北市老年居民慢性肾脏病的关系。
Traffic-related air pollution associated with chronic kidney disease among elderly residents in Taipei City.
机构信息
Division of Surgical Intensive Care, Department of Critical Care Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; Department of Nursing, Fooyin University, Kaohsiung, Taiwan.
Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Neurosurgery, Taipei City Hospital, Taipei, Taiwan.
出版信息
Environ Pollut. 2018 Mar;234:838-845. doi: 10.1016/j.envpol.2017.11.084. Epub 2017 Dec 21.
The associations of air pollution with chronic kidney disease (CKD) have not yet been fully studied. We enrolled 8,497 Taipei City residents older than 65 years and calculated the estimated glomerular filtration rate (eGFR) using the Taiwanese Chronic Kidney Disease Epidemiology Collaboration equation. Proteinuria was assessed via dipstick on voided urine. CKD prevalence and risk of progression were defined according to the KDIGO 2012 guidelines. Land-use regression models were used to estimate the participants' one-year exposures to PM of different sizes and traffic-related exhaust, PM absorbance, nitrogen dioxide (NO), and NO. Generalized linear regressions and logistic regressions were used to examine the associations of one-year air pollution exposures with eGFR, proteinuria, CKD prevalence and risk of progression. The results showed that the interquartile range (IQR) increments of PM absorbance (0.4 × 10/m) and NO (7.0 μg/m) were associated with a 1.07% [95% confidence interval (CI): 0.54-1.57] and 0.84% (95% CI: 0.37-1.32) lower eGFR, respectively; such relationships were magnified in subjects who had an eGFR >60 ml/min/1.73 m or who were non-diabetic. Similar associations were also observed for PM and PM. Two-pollutant models showed that PM and PM absorbance were associated with a lower eGFR. The odd ratios (ORs) of CKD prevalence and risk of progression also increased with exposures to PM absorbance and NO In summary, one-year exposures to traffic-related air pollution were associated with lower eGFR, higher CKD prevalence, and increased risk of CKD progression among the elderly population. Air pollution-related impaired renal function was stronger in non-CKD and non-diabetic subjects.
空气污染与慢性肾脏病(CKD)的关联尚未得到充分研究。我们招募了 8497 名年龄大于 65 岁的台北市居民,并使用台湾慢性肾脏病流行病学合作方程计算估算肾小球滤过率(eGFR)。通过对随机尿液进行尿试纸检测来评估蛋白尿。根据 KDIGO 2012 指南定义 CKD 的患病率和进展风险。使用土地利用回归模型来估计参与者一年中对不同大小的 PM、交通相关废气、PM 吸光度、二氧化氮(NO)和 NO 的暴露量。广义线性回归和逻辑回归用于研究一年的空气污染暴露与 eGFR、蛋白尿、CKD 患病率和进展风险的关系。结果显示,PM 吸光度(0.4×10/m)和 NO(7.0μg/m)的四分位间距(IQR)增量与 eGFR 分别降低 1.07%(95%置信区间:0.54-1.57)和 0.84%(95%置信区间:0.37-1.32);在 eGFR >60ml/min/1.73m 或非糖尿病患者中,这种关系更为显著。对于 PM 和 PM 也观察到了类似的关联。双污染物模型显示,PM 和 PM 吸光度与 eGFR 降低有关。CKD 患病率和进展风险的比值比(ORs)也随着 PM 吸光度和 NO 的暴露而增加。总之,交通相关空气污染的一年暴露与老年人中较低的 eGFR、较高的 CKD 患病率和 CKD 进展风险增加有关。与空气污染相关的肾功能损害在非 CKD 和非糖尿病患者中更为严重。