Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, 100034, China; Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, 100034, China; Advanced Institute of Information Technology, Peking University, Hangzhou, 311215, China.
Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China.
Chemosphere. 2022 Nov;306:135603. doi: 10.1016/j.chemosphere.2022.135603. Epub 2022 Jul 5.
The health hazards of ambient ozone (O) pollution are receiving increasing attention worldwide. However, the evidence on the association between O and risks of chronic kidney disease (CKD) remains insufficient and inconsistent, particularly in developing countries where there is an absence of macroscopic investigations at a large population scale. Based on data from a representative nationwide cross-sectional CKD survey in 13 Chinese provinces and a high resolution O air pollution inversion dataset, generalized linear models were used to evaluate the associations of O concentration with prevalence of CKD. The results of this study suggested that long-term O exposure was positively associated with the risk of CKD. A 10 μg/m increment in O concentration was associated with an increased odds of CKD prevalence [OR = 1.11 (95% CI: 1.03, 1.21)] among all the 47,086 participants. Stronger associations were found in urban regions, younger adults <65 years, and people with higher socio-economic status (income and education level). A 10 μg/m increment in O concentration was associated with a higher increased odds of CKD prevalence in urban regions [OR = 1.31 (95% CI: 1.16, 1.47)] compared to rural regions [OR = 0.95 (95% CI: 0.84, 1.08), P for subgroup difference<0.001]. A stronger association of O concentration with CKD prevalence was found among younger people aged <65 years [OR = 1.21 (95% CI: 1.10, 1.33)] compared to those aged ≥65 years [OR = 0.92 (95% CI: 0.79, 1.07), P for subgroup difference = 0.003]. Our study demonstrated that long-term O exposure may increase risk of CKD in the general Chinese population, and the findings stressed the importance of persistent efforts in air pollution prevention and control.
环境臭氧 (O) 污染对健康的危害正受到全球越来越多的关注。然而，关于 O 与慢性肾脏病 (CKD) 风险之间关联的证据仍然不足且不一致，特别是在发展中国家，这些国家缺乏大规模人群层面的宏观调查。本研究基于中国 13 个省份具有代表性的全国性横断面 CKD 调查数据和高分辨率 O 空气污染反演数据集，采用广义线性模型评估 O 浓度与 CKD 患病率之间的关联。研究结果表明，长期 O 暴露与 CKD 风险呈正相关。在所有 47086 名参与者中，O 浓度每增加 10μg/m，CKD 患病率的比值比 [OR=1.11（95%CI：1.03，1.21）] 增加。在城市地区、年龄<65 岁的年轻人和社会经济地位较高（收入和教育水平较高）的人群中，相关性更强。与农村地区相比，O 浓度每增加 10μg/m，城市地区 CKD 患病率的比值比 [OR=1.31（95%CI：1.16，1.47）] 更高，而农村地区的比值比 [OR=0.95（95%CI：0.84，1.08），P 亚组差异<0.001]。与年龄≥65 岁的人群相比，年龄<65 岁的人群中 O 浓度与 CKD 患病率的相关性更强 [OR=1.21（95%CI：1.10，1.33）]，而年龄≥65 岁的人群的比值比 [OR=0.92（95%CI：0.79，1.07），P 亚组差异=0.003]。本研究表明，长期 O 暴露可能会增加中国一般人群患 CKD 的风险，研究结果强调了持续努力进行空气污染防控的重要性。
