Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Environ Int. 2019 Oct;131:105018. doi: 10.1016/j.envint.2019.105018. Epub 2019 Jul 20.
Whole-body and thoracic ionizing radiation exposure are both associated with the development of renal dysfunction. However, whether low-level environmental radiation from air pollution affects renal function remains unknown.
We investigated the association of particle radioactivity (PR) with renal function defined by the estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD) in the Normative Aging Study.
This longitudinal analysis included 2491 medical visits from 809 white males enrolled between 1999 and 2013. The eGFR was calculated using the CKD-EPI and MDRD equations, and CKD cases were identified as those with an eGFR <60 mL/min/1.73 m. Gross β activity measured by five monitors of the U.S. Environmental Protection Agency's RadNet monitoring network was utilized to represent PR.
Ambient PR levels from 1 to 28 days prior to clinical visit demonstrated robust negative associations with both forms of eGFR, but not with the increased odds of CKD. An interquartile range higher 28-day average ambient PR level was significantly associated with 0.83-mL/min/1.73 m lower eGFR estimated by the CKD-EPI equation (95% confidence interval: -1.46, -0.20, p-value = 0.01). Controlling for PM or black carbon in the model slightly attenuated the PR effects on eGFR. However, in individuals with the highest levels (3rd tertile) of C-reactive protein (CRP) or fibrinogen, we observed robust associations of PR with eGFR and CKD, suggesting that systemic inflammation may modify the PR-eGFR and PR-CKD relationships.
Our study reveals adverse health effects of short-term low-level ambient PR on the renal function, providing evidence to guide further study of the interplay between PR, inflammation, and renal health.
全身和胸部电离辐射暴露均与肾功能障碍的发展有关。然而,空气污染造成的低水平环境辐射是否会影响肾功能尚不清楚。
我们在《规范老化研究》中调查了粒子放射性(PR)与肾小球滤过率(eGFR)和慢性肾脏病(CKD)定义的肾功能之间的关系。
这项纵向分析包括 1999 年至 2013 年间招募的 809 名白人男性的 2491 次就诊。使用 CKD-EPI 和 MDRD 方程计算 eGFR,将 eGFR<60mL/min/1.73m 的患者确定为 CKD 病例。利用美国环境保护署 RadNet 监测网络的五个监测器测量的总β活性来代表 PR。
临床就诊前 1 至 28 天的环境 PR 水平与两种形式的 eGFR 均呈显著负相关,但与 CKD 的发生几率增加无关。较高的 28 天平均环境 PR 水平与使用 CKD-EPI 方程估计的 eGFR 降低 0.83mL/min/1.73m 显著相关(95%置信区间:-1.46,-0.20,p 值=0.01)。在模型中控制 PM 或黑碳后,PR 对 eGFR 的影响略有减弱。然而,在 C-反应蛋白(CRP)或纤维蛋白原水平最高(第三 tertile)的个体中,我们观察到 PR 与 eGFR 和 CKD 之间存在显著关联,这表明全身炎症可能会改变 PR-eGFR 和 PR-CKD 之间的关系。
我们的研究揭示了短期低水平环境 PR 对肾功能的不良健康影响,为进一步研究 PR、炎症和肾脏健康之间的相互作用提供了证据。