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腹部肥胖对空气污染与肾功能关联的影响。

Effects of abdominal obesity on the association between air pollution and kidney function.

机构信息

Department of Family Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center & Seoul National University Health Service Center, Seoul, South Korea.

Department of Family Medicine, Seoul National University College of Medicine, Seoul, South Korea.

出版信息

Int J Obes (Lond). 2020 Jul;44(7):1568-1576. doi: 10.1038/s41366-020-0540-8. Epub 2020 Jan 28.

Abstract

OBJECTIVES

This study aimed to evaluate the associations between ambient air pollutants, obesity, and kidney function.

SUBJECTS/METHODS: We enrolled 3345 people who had undergone health checkups at Seoul National University Hospital. We recorded the annual average concentrations of ambient air pollutants, including particulate matter with an aerodynamic diameter of ≤10 μm (PM), nitrogen dioxide (NO), sulfur dioxide (SO), and carbon monoxide (CO), in each subject's residential area. Various obesity traits, such as body mass index, waist circumference, and visceral and subcutaneous adipose tissue areas, were measured by quantified computerized tomography (CT), and kidney function was assessed in relation to estimated glomerular filtration rate as an indicator of kidney function.

RESULTS

High PM, NO, SO, and CO concentrations were significantly associated with decreased kidney function (β = -2.39 and standard error = 0.32, -1.00 and 0.31, -1.23 and 0.28, and -1.32 and 0.29, respectively), and with the prevalence of chronic kidney disease (CKD). The association between air pollutant concentrations and decreased kidney function, including CKD, was stronger among those with high abdominal adiposity, as defined by CT measurement. For example, the association between increased concentrations of air pollutants and the prevalence of CKD was stronger in the group with greater visceral adiposity than in the group with less visceral adiposity (aORs = 1.29 vs 1.16 for PM, 1.42 vs 1.21 for SO, and 1.27 vs 1.11 for CO).

CONCLUSIONS

Long-term exposure to higher concentrations of air pollutants was unfavorably associated with kidney function and CKD prevalence, especially in people with abdominal obesity. This may indicate a high susceptibility to air pollutants in obese people.

摘要

目的

本研究旨在评估环境空气污染物、肥胖与肾功能之间的关联。

方法

我们纳入了在首尔国立大学医院接受健康检查的 3345 人。我们记录了每位受试者居住地区内的环境空气污染物(包括空气动力学直径≤10μm 的颗粒物(PM)、二氧化氮(NO)、二氧化硫(SO)和一氧化碳(CO))的年平均浓度。通过定量计算机断层扫描(CT)测量了各种肥胖特征,如体重指数、腰围和内脏及皮下脂肪组织面积,并评估了肾功能与肾小球滤过率(作为肾功能的指标)的关系。

结果

高浓度的 PM、NO、SO 和 CO 与肾功能下降(β=−2.39 和标准误=0.32、−1.00 和 0.31、−1.23 和 0.28、−1.32 和 0.29)和慢性肾脏病(CKD)的患病率显著相关。与 CT 测量的腹部肥胖程度较高的人群相比,空气污染物浓度与肾功能下降(包括 CKD)之间的关联更强。例如,与空气污染物浓度增加相关的 CKD 患病率在内脏脂肪较多的组中高于内脏脂肪较少的组(PM 的比值比(OR)=1.29 对 1.16、SO 的 OR=1.42 对 1.21、CO 的 OR=1.27 对 1.11)。

结论

长期暴露于较高浓度的空气污染物与肾功能和 CKD 的患病率呈不利相关,尤其是在有腹部肥胖的人群中。这可能表明肥胖人群对空气污染物的敏感性较高。

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