Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Epidemiology and Department of Earth, Environmental, and Planetary Sciences, Brown University, Providence, RI, United States.
Sci Total Environ. 2024 Jan 10;907:168119. doi: 10.1016/j.scitotenv.2023.168119. Epub 2023 Oct 25.
Limited research has examined associations between exposure to ambient temperature, air pollution, and kidney function or injury during the preadolescent period. We examined associations between exposure to ambient temperature and particulate matter with aerodynamic diameter ≤ 2.5 μm (PM) with preadolescent estimated glomerular filtration rate (eGFR) and urinary kidney injury biomarkers.
Participants included 437 children without cardiovascular or kidney disease enrolled in the Programming Research in Obesity, Growth, Environment and Social Stressors birth cohort study in Mexico City. eGFR and urinary kidney injury biomarkers were assessed at 8-12 years. Validated satellite-based spatio-temporal models were used to estimate mean daily temperature and PM levels at each participant's residence 7- and 30-days prior to the date of visit. Linear regression and distributed lag nonlinear models (DLNM) were used to examine associations between daily mean temperature and PM exposure and kidney outcomes, adjusted for covariates.
In single linear regressions, higher seven-day average PM was associated with higher urinary alpha-1-microglobulin and eGFR. In DLNM analyses, higher temperature exposure in the seven days prior to date of visit was associated with a decrease in urinary cystatin C of -0.56 ng/mL (95 % confidence interval (CI): -1.08, -0.04) and in osteopontin of -0.08 ng/mL (95 % CI: -0.15, -0.001). PM exposure over the seven days prior to date of visit was associated with an increase in eGFR of 1.77 mL/min/1.73m (95 % CI: 0.55, 2.99) and urinary cystatin C of 0.19 ng/mL (95 % CI: 0.03, 0.35).
Recent exposure to ambient temperature and PM were associated with increased and decreased urinary kidney injury biomarkers that may reflect subclinical glomerular or tubular injury in children. Further research is required to assess environmental exposures and worsening subclinical kidney injury across development.
有限的研究探讨了儿童期前暴露于环境温度、空气污染与肾功能或损伤之间的关系。我们研究了儿童期前估计肾小球滤过率(eGFR)和尿肾损伤生物标志物与环境温度和空气动力学直径≤2.5μm 颗粒物(PM)暴露之间的关系。
参与者包括来自墨西哥城肥胖、生长、环境和社会应激因素编程研究的 437 名无心血管或肾脏疾病的儿童。在 8-12 岁时评估 eGFR 和尿肾损伤生物标志物。使用经过验证的基于卫星的时空模型,根据每位参与者在就诊日期前 7 天和 30 天的居住地,估算每日平均温度和 PM 水平。线性回归和分布滞后非线性模型(DLNM)用于研究每日平均温度和 PM 暴露与肾脏结局之间的关系,并调整了协变量。
在单一线性回归中,7 天平均 PM 水平升高与尿α-1 微球蛋白和 eGFR 升高有关。在 DLNM 分析中,就诊日期前 7 天的温度升高与尿胱抑素 C 降低 0.56ng/mL(95%置信区间:-1.08,-0.04)和骨桥蛋白降低 0.08ng/mL(95%置信区间:-0.15,-0.001)有关。就诊日期前 7 天的 PM 暴露与 eGFR 升高 1.77mL/min/1.73m(95%置信区间:0.55,2.99)和尿胱抑素 C 升高 0.19ng/mL(95%置信区间:0.03,0.35)有关。
最近暴露于环境温度和 PM 与尿肾损伤生物标志物的升高和降低有关,这可能反映了儿童的亚临床肾小球或肾小管损伤。需要进一步研究环境暴露与发育过程中亚临床肾脏损伤的恶化之间的关系。