Liu Xiaoxia, Zhao Xiuli, Ye Lu, Hu Chengfeng, Xie Zhihao, Ma Jianan, Wang Xia, Liang Wei
Zhenjiang Center for Disease Control and Prevention, 9# South Huangshan Road, Zhenjiang 212002, China.
School of Public Health, Faculty of Medicine, Yangzhou University, 136# Jiangyang Middle Road, Yangzhou 225000, China.
Toxics. 2025 Aug 8;13(8):669. doi: 10.3390/toxics13080669.
Ambient air pollutants (APs) are associated with increased chronic kidney disease (CKD) risk in general populations, but their renal impact on HIV/AIDS patients remains understudied. This dynamic cohort included 7981 HIV/AIDS patients without baseline kidney disease from Wuhan and Zhenjiang, followed every 6 months with fasting blood tests to assess the triglyceride-glucose (TyG) index and estimated glomerular filtration rate (eGFR). Monthly average exposures to six APs were estimated from geocoded residential addresses. Modified Poisson regression models were used to assess associations between cumulative AP exposure and CKD incidence, with mediation analysis conducted to explore the potential role of the TyG index. Weighted quantile sum regression was applied to evaluate the joint effects of six APs. During the follow-up period, 168 new cases of CKD were identified. Each interquartile range increase in PM, PM, and SO corresponded to a 16.5%, 18.9%, and 9.7% higher CKD risk, respectively, with the TyG index mediating 10.21%, 9.16%, and 5.14% of these associations. PM demonstrated the highest attribution weight (44.4%) for CKD risk elevation in mixed-exposure models. Chronic ambient AP exposure, particularly PM, synergistically elevates CKD risk in HIV/AIDS patients with glucolipid dysregulation potentially being involved, necessitating targeted air quality policies to mitigate AP impacts on this vulnerable population.
环境空气污染物（APs）与普通人群慢性肾脏病（CKD）风险增加相关，但它们对艾滋病毒/艾滋病患者的肾脏影响仍未得到充分研究。这个动态队列包括来自武汉和镇江的7981名无基线肾脏疾病的艾滋病毒/艾滋病患者，每6个月进行一次空腹血液检查，以评估甘油三酯-葡萄糖（TyG）指数和估计肾小球滤过率（eGFR）。根据地理编码的居住地址估算每月平均接触六种空气污染物的情况。采用修正泊松回归模型评估累积空气污染物暴露与慢性肾脏病发病率之间的关联，并进行中介分析以探讨TyG指数的潜在作用。应用加权分位数和回归来评估六种空气污染物的联合效应。在随访期间，确定了168例新发慢性肾脏病病例。PM、PM和SO的每一个四分位数间距增加分别对应慢性肾脏病风险升高16.5%、18.9%和9.7%，其中TyG指数介导了这些关联的10.21%、9.16%和5.14%。在混合暴露模型中，PM对慢性肾脏病风险升高的归因权重最高（44.4%）。长期暴露于环境空气污染物，尤其是PM，会协同增加艾滋病毒/艾滋病患者的慢性肾脏病风险，可能涉及糖脂代谢紊乱，因此需要有针对性的空气质量政策来减轻空气污染物对这一脆弱人群的影响。
