在中国,老年人暴露于环境中的铵与身体功能障碍有关。
Ambient ammonium exposure is associated with physical dysfunction in older adults in China.
作者信息
Shi JiaHao
机构信息
College of Public Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand.
出版信息
Sci Rep. 2025 May 31;15(1):19162. doi: 10.1038/s41598-025-04289-6.
The health effects associated with particulate matter (PM) are extensively reported; nevertheless, limited research has explored the exact contributions of its chemical constituents to physical dysfunctional aging. This study assesses the relationships between prolonged exposure to significant ambient air pollutants, especially ammonium (NH), and physical dysfunction in a nationally representative cohort of older Chinese adults. We investigated data from 14,641 participants aged 45 years or older in the 2015 wave of the China Health and Retirement Longitudinal Study (CHARLS), which was integrated with high-resolution air pollution data from the ChinaHighAirPollutants (CHAP) dataset. Physical dysfunction was evaluated by self-reported challenges in executing routine activities. After controlling for a wide range of confounders, associations among eight air contaminants (averaged from 2013 to 2015) and dysfunction risk were investigated using logistic regression models. Multicollinearity among covariates in the fully adjusted models was assessed using the generalized variance inflation factor (GVIF), with a threshold value of 5 adopted as the criterion to indicate potential collinearity. Sensitivity analyses-including exclusion of high-exposure participants, standardized z-score modeling, stratified subgroup evaluations, and multipollutant adjustments-were performed to assess the robustness of associations. Dose-response relationships were modeled using both quartile-based logistic regression and restricted cubic spline (RCS) models, revealing consistent and complementary trends. To estimate independent effects and address potential collinearity, we further constructed a multipollutant model adjusting for seven co-pollutants. In all and fully adjusted models, ambient ammonium (NH) was the only air pollutant that demonstrated a significant and independent association with physical dysfunction (OR: 1.03; 95% CI: 1.01-1.05; p < 0.05); no significant associations were found for the other pollutants. This association remained robust across multiple sensitivity analyses, including exclusion of extreme exposure (OR: 1.13; 95% CI: 1.08-1.17; p < 0.001), z-score standardization (OR: 2.17; 95% CI: 1.57-2.98; p < 0.001), and 5 stratified subgroup models. A significant dose-response relationship was identified both in quartile-based trend tests (p for trend < 0.001) and restricted cubic spline analysis (p for non-linearity < 0.001). Taken together, the monotonic trend from quartile analysis and the non-linear pattern from spline modeling suggest that even moderate exposure to NH4⁺ may contribute to physical dysfunction. Furthermore, multicollinearity diagnostics based on generalized variance inflation factors (GVIFs) indicated no evidence of problematic collinearity among covariates in the fully adjusted models (all GVIF < 5). Besides, the association remained significant and became stronger in a multipollutant model, highlighting the independent effect of NH beyond co-pollutant confounding (OR: 1.49; 95% CI: 1.26-1.76; p < 0.001). Our findings indicate that NH, a significant secondary component of PM predominantly sourced from agricultural ammonia emissions, may uniquely contribute to the deterioration of physical function. It may be important to evaluate particle chemical makeup for analyzing health concerns, as there is no association for total PM mass. Long-lasting exposure to ambient NH has been independently associated with increased odds of physical dysfunction across older adults in China. These findings underscore the necessity for specific environmental strategies focused on ammonia reduction to alleviate age-related functional deterioration and foster healthy aging.
与颗粒物(PM)相关的健康影响已有广泛报道;然而,关于其化学成分对身体机能衰退的确切作用的研究却很有限。本研究评估了在中国具有全国代表性的老年人群体中,长期暴露于重要的环境空气污染物,尤其是铵(NH)与身体机能障碍之间的关系。我们调查了中国健康与养老追踪调查(CHARLS)2015年波次中14641名年龄在45岁及以上参与者的数据,并将其与来自中国高空气污染物(CHAP)数据集的高分辨率空气污染数据相结合。身体机能障碍通过自我报告的日常活动执行困难来评估。在控制了一系列混杂因素后,使用逻辑回归模型研究了八种空气污染物(2013年至2015年的平均值)与机能障碍风险之间的关联。使用广义方差膨胀因子(GVIF)评估完全调整模型中协变量之间的多重共线性,采用5的阈值作为表明潜在共线性的标准。进行了敏感性分析,包括排除高暴露参与者、标准化z分数建模、分层亚组评估和多污染物调整,以评估关联的稳健性。使用基于四分位数的逻辑回归和受限立方样条(RCS)模型对剂量反应关系进行建模,揭示了一致且互补的趋势。为了估计独立效应并解决潜在的共线性问题,我们进一步构建了一个调整七种共污染物的多污染物模型。在所有完全调整模型中,环境铵(NH)是唯一与身体机能障碍表现出显著且独立关联的空气污染物(OR:1.03;95%CI:1.01 - 1.05;p < 0.05);其他污染物未发现显著关联。这种关联在多项敏感性分析中仍然稳健,包括排除极端暴露(OR:1.13;95%CI:1.08 - 1.17;p < 0.001)、z分数标准化(OR:2.17;95%CI:1.57 - 2.98;p < 0.001)以及5个分层亚组模型。在基于四分位数的趋势检验(趋势p < 0.001)和受限立方样条分析(非线性p < 0.001)中均确定了显著的剂量反应关系。综合来看,四分位数分析的单调趋势和样条建模的非线性模式表明,即使是适度暴露于NH4⁺也可能导致身体机能障碍。此外,基于广义方差膨胀因子(GVIF)的多重共线性诊断表明,在完全调整模型中协变量之间没有证据表明存在有问题的共线性(所有GVIF < 5)。此外,在多污染物模型中该关联仍然显著且更强,突出了NH超出共污染物混杂的独立效应(OR:1.49;95%CI:1.26 - 1.76;p < 0.001)。我们的研究结果表明,NH作为PM的一种重要二次成分,主要源自农业氨排放,可能独特地导致身体机能的恶化。在分析健康问题时评估颗粒物的化学组成可能很重要,因为总PM质量与之没有关联。在中国老年人中,长期暴露于环境NH与身体机能障碍几率增加独立相关。这些发现强调了有必要制定专门针对减少氨排放的环境策略,以缓解与年龄相关的功能衰退并促进健康老龄化。