细颗粒物暴露与肾功能的关系：来自韩国国家健康和营养检查调查的结果。

Association between exposure to fine particulate matter and kidney function: Results from the Korea National Health and Nutrition Examination Survey.

机构信息

Department of Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.

Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Incheon, Republic of Korea.

出版信息

Environ Res. 2022 Sep;212(Pt A):113080. doi: 10.1016/j.envres.2022.113080. Epub 2022 Mar 18.

DOI:10.1016/j.envres.2022.113080

PMID:35314162

Abstract

BACKGROUND

The incidence and prevalence of chronic kidney disease (CKD) are increasing worldwide. Recent studies have shown that air pollution is associated with poorer kidney function. We evaluated the association of long-term exposure to air pollutants with kidney function, and with risk of CKD using data from the seventh Korean National Health and Nutrition Examination Survey (KNHANES).

METHODS

KNHANES data from 2016 through 2018 and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation were used to calculate estimated glomerular filtration rates (eGFRs) and define the CKD patients with eGFRs <60 mL/min/1.73 m. After applying the sampling weights based on the complex survey design, we conducted multivariate linear regression and logistic regression analyses to examine the association of air pollutant exposure with kidney function and CKD risk, after adjusting for covariates, including gender, body mass index, education level, household income, smoking status, alcohol consumption, comorbidities, and serum triglyceride.

RESULTS

A total of 15,983 adults aged ≥20 years were included in the analysis. Long-term exposure to PM, PM, NO, and CO was associated with decreases in eGFR levels (PM: -4.67, 95% confidence interval (CI): -6.16, -3.18; PM: -2.19, 95% CI: -2.84, -1.54; NO: -1.56, 95% CI: -2.16, -0.97; CO: -1.34, 95% CI: -1.96, -0.71). Long-term exposure to PM (odds ratio (OR): 1.97, 95% CI: 1.14, 3.42) and PM (OR: 1.45, 95% CI: 1.10, 1.91) was associated with an increased the risk of CKD.

CONCLUSIONS

Annual exposure to PM, PM, NO, and CO was significantly associated with decreased eGFR. Long-term exposure to PM and PM was associated with an increased risk of CKD.

摘要

背景

慢性肾脏病（CKD）的发病率和患病率在全球范围内呈上升趋势。最近的研究表明，空气污染与肾脏功能较差有关。我们利用 2016 年至 2018 年韩国第七次全国健康和营养调查（KNHANES）的数据，评估了长期暴露于空气污染物与肾功能以及 CKD 风险之间的关系。

方法

使用 KNHANES 数据和慢性肾脏病流行病学合作研究（CKD-EPI）方程计算估算肾小球滤过率（eGFR），并根据 eGFR<60 mL/min/1.73 m 定义 CKD 患者。在基于复杂调查设计应用抽样权重后，我们进行了多元线性回归和逻辑回归分析，以检查空气污染物暴露与肾功能和 CKD 风险之间的关系，调整了性别、体重指数、教育水平、家庭收入、吸烟状况、饮酒状况、合并症和血清甘油三酯等混杂因素。

结果

共纳入 15983 名年龄≥20 岁的成年人进行分析。长期暴露于 PM、PM、NO 和 CO 与 eGFR 水平降低相关（PM：-4.67，95%置信区间[CI]：-6.16，-3.18；PM：-2.19，95%CI：-2.84，-1.54；NO：-1.56，95%CI：-2.16，-0.97；CO：-1.34，95%CI：-1.96，-0.71）。长期暴露于 PM（比值比[OR]：1.97，95%CI：1.14，3.42）和 PM（OR：1.45，95%CI：1.10，1.91）与 CKD 风险增加相关。