Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China.
Front Public Health. 2023 Aug 21;11:1239378. doi: 10.3389/fpubh.2023.1239378. eCollection 2023.
Recent studies suggest air pollution as an underlying factor to kidney disease. However, there is still limited knowledge about the short-term correlation between glomerulonephritis (GN) and air pollution. Thus, we aim to fill this research gap by investigating the short-term correlation between GN clinical visits and air pollution exposure.
Between 2015 and 2019, daily GN visit data from two grade A tertiary hospitals in Hefei City were collected, along with corresponding air pollution and meteorological data. A generalized linear model integrated with a distributed lag nonlinear model was employed to analyze the relationship between GN visits and air pollutants. Moreover, we incorporated a dual pollutant model to account for the combined effects of multiple pollutants. Furthermore, subgroup analyses were performed to identify vulnerable populations based on gender, age, and season.
The association between 23,475 GN visits and air pollutants was assessed, and significant positive associations were found between CO and NO exposure and GN visit risk. The single-day lagged effect model for CO showed increased risks for GN visits from lag0 (RR: 1.129, 95% CI: 1.031-1.236) to lag2 (RR: 1.034, 95% CI: 1.011-1.022), with the highest risk at lag0. In contrast, NO displayed a more persistent impact (lag1-lag4) on GN visit risk, peaking at lag2 (RR: 1.017, 95% CI: 1.011-1.022). Within the dual-pollutant model, the significance persisted for both CO and NO after adjusting for each other. Subgroup analyses showed that the cumulative harm of CO was greater in the cold-season and older adult groups. Meanwhile, the female group was more vulnerable to the harmful effects of cumulative exposure to NO.
Our study indicated that CO and NO exposure can raise the risk of GN visits, and female and older adult populations exhibited greater susceptibility.
最近的研究表明，空气污染是导致肾脏疾病的一个潜在因素。然而，关于肾小球肾炎（GN）与空气污染之间的短期相关性，我们的了解仍然有限。因此，我们旨在通过研究 GN 临床就诊与空气污染暴露之间的短期相关性来填补这一研究空白。
在 2015 年至 2019 年期间，我们收集了合肥市两家甲级三级医院的每日 GN 就诊数据，以及相应的空气污染和气象数据。采用广义线性模型结合分布式滞后非线性模型来分析 GN 就诊与空气污染物之间的关系。此外，我们还纳入了双污染物模型来考虑多种污染物的综合影响。此外，还进行了亚组分析，根据性别、年龄和季节来确定易受影响的人群。
我们评估了 23475 次 GN 就诊与空气污染物之间的关联，发现 CO 和 NO 暴露与 GN 就诊风险之间存在显著的正相关关系。CO 的单日滞后效应模型显示，从滞后 0 天（RR：1.129，95%CI：1.031-1.236）到滞后 2 天（RR：1.034，95%CI：1.011-1.022），GN 就诊风险增加，滞后 0 天的风险最高。相比之下，NO 对 GN 就诊风险的影响更为持久（滞后 1 天至滞后 4 天），在滞后 2 天达到峰值（RR：1.017，95%CI：1.011-1.022）。在双污染物模型中，在相互调整后，CO 和 NO 的显著性仍然存在。亚组分析表明，CO 的累积危害在寒冷季节和老年人群中更大。同时，女性群体对累积暴露于 NO 的有害影响更为敏感。
我们的研究表明，CO 和 NO 暴露会增加 GN 就诊的风险，女性和老年人群体的易感性更高。
