Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, School of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Department of Traditional Chinese Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Environ Pollut. 2020 Nov;266(Pt 2):115129. doi: 10.1016/j.envpol.2020.115129. Epub 2020 Jul 10.
There is a lack of evidence regarding the association of short-term exposure to fine particulate matter (PM) with renal function in children and its underlying mechanism. We included 105 children aged 4-13 years from a panel study conducted in Wuhan, China with up to 3 repeated visits across 3 seasons from October 9, 2017 to June 1, 2018. We measured personal real-time PM exposure concentration continuously for 72 h preceding each round of health examinations that included serum creatinine and cytokines. Linear mixed-effects models were performed to estimate the effects of PM on estimated glomerular filtration rate (eGFR) over various lag times, and a mediation analysis was applied for the role of cytokines in association between PM and eGFR. Results showed that personal exposure to PM was dose-responsive related to decreased eGFR within lag 2 days. The effect was the strongest at lag 0 day with estimation of -1.69% [95% confidence interval (CI): -2.27%, -1.10%] in eGFR by a 10-μg/m increase in PM, and reached peak at lag 3 h, then declined over time. Such inverse relationships were more evident among children aged 4-6 years, or boys or those who lived proximity to major roadways <300 m. Notably, eGFR still held on to decrease even when PM was below Class II Chinese ambient air quality standard at lag 0 day. Moreover, the effect of PM on eGFR was significantly reduced in children with high and medium levels of serum chemokine ligand 27 (CCL27), but not in those with low CCL27. Furthermore, CCL27 was positively relevant to PM, and mediated proportion of CCL27 ranged from 3.75% to 6.61% in relations between PM and decreased eGFR over various lag times. In summary, short-term PM exposure might be dose-responsive associated with reduced eGFR whereby a mechanism partly involving CCL27 among healthy children.
目前，关于短期暴露于细颗粒物（PM）与儿童肾功能之间的关联及其潜在机制，相关证据还很缺乏。我们纳入了 2017 年 10 月 9 日至 2018 年 6 月 1 日期间在中国武汉进行的一项队列研究中的 105 名 4-13 岁儿童，这些儿童在 3 个季节中接受了多达 3 次重复健康检查，检查包括血清肌酐和细胞因子。我们采用线性混合效应模型来估计 PM 对不同滞后时间内估算肾小球滤过率（eGFR）的影响，并应用中介分析来探讨细胞因子在 PM 与 eGFR 之间关联中的作用。结果显示，个人 PM 暴露与 eGFR 降低呈剂量反应关系，滞后 2 天内的影响最为显著。在滞后 0 天，PM 每增加 10μg/m，eGFR 估计降低-1.69%（95%置信区间：-2.27%，-1.10%），效果最强，在滞后 3 小时达到峰值，随后随时间下降。在 4-6 岁儿童、男孩或居住在距离主要道路<300 米的儿童中，这种负相关关系更为明显。值得注意的是，即使在滞后 0 天 PM 低于中国环境空气质量二级标准时，eGFR 仍持续下降。此外，在血清趋化因子配体 27（CCL27）水平较高和中等的儿童中，PM 对 eGFR 的影响明显降低，但在 CCL27 水平较低的儿童中则不然。此外，CCL27 与 PM 呈正相关，并且在不同滞后时间内 PM 与 eGFR 降低之间的关系中，CCL27 的中介比例为 3.75%至 6.61%。总之，短期 PM 暴露可能与健康儿童的 eGFR 降低呈剂量反应关系，其机制部分涉及 CCL27。
