Liu Minghui, Gao Meng, Zhu Zewu, Hu Jiao, Wu Jian, Chen Hequn, Kuang Xiaogen, Chen Jinbo
Department of Urology, Xiangya Hospital, Central South University, Changsha, China.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
J Expo Sci Environ Epidemiol. 2024 Oct 22. doi: 10.1038/s41370-024-00728-0.
The epidemiological evidence regarding the correlation between air pollution, residential greenspace, and the risk of kidney stone disease (KSD) is limited, with no large-scale prospective studies conducted on this relationship.
We conducted a large-scale prospective study from the UK Biobank to explore the correlation between air pollution, residential greenspace, and the risk of KSD.
This study included 419,835 UK Biobank participants who did not have KSD at baseline. An air pollution score was derived through the summation of concentrations for five air pollutants, including particulate matter (PM) with aerodynamic diameter ≤2.5 μm (PM), ranging from 2.5 to 10 μm (PM), ≤10 μm (PM), nitrogen dioxide (NO), and nitrogen oxides (NO). Various covariates were adjusted for in Cox proportional hazard regression to evaluate the risk of KSD associated with air pollution score, single air pollutant, and residential greenspace.
During a follow-up period of 12.7 years, 4503 cases of KSD were diagnosed. Significant associations were found between KSD risk and air pollution score (HR: 1.08, 95% CI: 1.03-1.13), PM (1.06, 1.02-1.11), PM (1.04, 1.01-1.07), NO (1.09, 1.02-1.16), NO (1.08, 1.02-1.11), greenspace buffered at 300 m (0.95, 0.91-0.99), and greenspace buffered at 1000 m (0.92, 0.86-0.98) increase per interquartile range (IQR). PM and NO reductions may be a key mechanism for the protective impact of residential greenspace on KSD (P < 0.05).
Prolonged exposure to air pollution was correlated with a higher risk of KSD, while residential greenspace exhibits an inverse association with KSD risk, partially mediated by the reduction in air pollutants concentrations. These findings emphasize the significance of mitigating air pollution and maintaining substantial greenspace exposure as preventive measures against KSD.
关于空气污染、住宅绿地与肾结石疾病（KSD）风险之间相关性的流行病学证据有限，尚未针对这种关系开展大规模前瞻性研究。
我们利用英国生物银行开展了一项大规模前瞻性研究，以探究空气污染、住宅绿地与KSD风险之间的相关性。
本研究纳入了419835名在基线时无KSD的英国生物银行参与者。通过对包括空气动力学直径≤2.5μm的颗粒物（PM）、2.5至10μm的颗粒物（PM）、≤10μm的颗粒物（PM）、二氧化氮（NO）和氮氧化物（NO）在内的五种空气污染物浓度进行求和得出空气污染评分。在Cox比例风险回归中对各种协变量进行了调整，以评估与空气污染评分、单一空气污染物和住宅绿地相关的KSD风险。
在12.7年的随访期内，共诊断出4503例KSD病例。发现KSD风险与空气污染评分（风险比：1.08，95%置信区间：1.03 - 1.13）、PM（1.06，1.02 - 1.11）、PM（1.04，1.01 - 1.07）、NO（1.09，1.02 - 1.16）、NO（1.08，1.02 - 1.11）、300米缓冲绿地（0.95，0.91 - 0.99）以及1000米缓冲绿地（0.92，0.86 - 0.98）每增加一个四分位数间距（IQR）存在显著关联。PM和NO的减少可能是住宅绿地对KSD产生保护作用的关键机制（P < 0.05）。
长期暴露于空气污染与较高的KSD风险相关，而住宅绿地与KSD风险呈负相关，部分由空气污染物浓度的降低介导。这些发现强调了减轻空气污染和保持大量绿地接触作为预防KSD的预防措施的重要性。
