School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China.
Department of Urology, Huanggang Central Hospital of Yangtze University, Huanggang, China; Huanggang Institute of Translation Medicine, Huanggang, China.
J Environ Manage. 2023 Aug 1;339:117885. doi: 10.1016/j.jenvman.2023.117885. Epub 2023 Apr 20.
Previous research has implicated PM as a potential environmental risk factor for CKD, but little is known about the associations between its components and CKD. We conducted a nationwide cross-sectional study using the updated air pollution data in the nationwide population (N = 2,938,653). Using generalized additive models, we assessed the association between long-term exposure to PM and its components (i.e., black carbon [BC], organic matter [OM], nitrate [NO], ammonium [NH], sulfate [SO]), and CKD prevalence. The air pollution data was estimated using high-resolution and high-quality spatiotemporal datasets of ground-level air pollutants in China. Besides, we adopted a novel quantile-based g-computation approach to assess the effect of a mixture of PM constituents on CKD prevalence. The average concentration of PM was 78.67 ± 22.5 μg/m, which far exceeded WHO AQG. In the fully adjusted generalized additive model, at a 10 km × 10 km spatial resolution, the ORs per IQR increase in previous 1-year average PM exposures was 1.380 (95%CI: 1.345-1.415), for NH was 1.094 (95%CI: 1.062-1.126), for BC was 1.604 (95%CI: 1.563-1.646), for NO was 1.094 (95%CI: 1.060-1.130), for SO was 1.239 (95%CI: 1.208-1.272), and for the OM was 1.387 (95%CI: 1.354-1.421), respectively. Subgroup analysis showed females, younger, and healthier were more vulnerable to this effect. In the further exploration of the joint effect of PM compositions (OR 1.234 [95%CI 1.222-1.246]) per quartile increase in all 5 PM components, we found that PMSO contributed the most. These findings provide important evidence for the positive relationship between long-term exposure to PM and its chemical constituents and CKD prevalence in a Chinese health check-up population, and identified PMSO has the highest contribution to this relationship. This study provides clinical and public health guidance for reducing specific air particle exposure for those at risk of CKD.
先前的研究表明，PM 是 CKD 的一个潜在环境风险因素，但人们对其成分与 CKD 之间的关联知之甚少。我们使用全国范围内的人口更新后的空气污染数据（N=2938653）进行了一项全国性的横断面研究。使用广义加性模型，我们评估了长期暴露于 PM 及其成分（即黑碳[BC]、有机物[OM]、硝酸盐[NO]、铵[NH]、硫酸盐[SO]）与 CKD 患病率之间的关联。空气污染数据是使用中国地面空气污染物的高分辨率和高质量时空数据集来估算的。此外，我们采用了一种新的基于分位数的 g 计算方法来评估 PM 成分混合物对 CKD 患病率的影响。PM 的平均浓度为 78.67±22.5μg/m，远高于世卫组织 AQG。在完全调整的广义加性模型中，在前一年平均 PM 暴露每增加一个 IQR，OR 值分别为 1.380（95%CI：1.345-1.415）、NH 为 1.094（95%CI：1.062-1.126）、BC 为 1.604（95%CI：1.563-1.646）、NO 为 1.094（95%CI：1.060-1.130）、SO 为 1.239（95%CI：1.208-1.272）、OM 为 1.387（95%CI：1.354-1.421）。亚组分析表明，女性、年轻和健康状况较好的人更容易受到这种影响。在进一步探索 PM 成分（每四分位增加 1.234[95%CI 1.222-1.246]）联合效应时，我们发现 PMSO 贡献最大。这些发现为长期暴露于 PM 及其化学成分与中国健康检查人群中 CKD 患病率之间的正相关关系提供了重要证据，并确定 PMSO 对此关系的贡献最大。本研究为降低 CKD 高危人群特定空气颗粒暴露提供了临床和公共卫生指导。
