Association of the components of ambient fine particulate matter (PM2.5) and chronic kidney disease prevalence in China
Association of the components of ambient fine particulate matter (PM2.5) and chronic kidney disease prevalence in China
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DOI：
10.1016/j.jenvman.2023.117885
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发表时间：
2023-04-20
影响因子：
8.7
通讯作者：
Li，Hongliang
中科院分区：
文献类型：
--
作者：
Zhang，Xingyuan;Tao，Jiayi;Li，Hongliang
以前的研究表明PM2.5是慢性肾脏病的潜在环境风险因素，但对其成分与慢性肾脏病之间的联系知之甚少。我们利用最新的全国人口空气污染数据进行了一项全国横断面研究(N=2,938,653)。使用广义加性模型，我们评估了长期暴露于PM2.5及其成分(即黑碳[BC]、有机物[OM]、硝酸盐[NO3−]、铵[NH4+]、硫酸盐[SO42−])与慢性肾脏病患病率之间的关系。利用高分辨率、高质量的中国地面空气污染物时空数据集对大气污染数据进行了估算。此外，我们采用了一种新的基于分位数的g计算方法来评估PM2.5组分的混合物对CKD患病率的影响。PM2.5平均浓度为78.67g/m~3±22.5g/m~3，远远超过世界卫生组织空气质量浓度(μ)。在完全调整的广义加性模型中，在10公里×10公里的空间分辨率下，过去1年PM2.5暴露的每IQR增加的OR为1.380(95%CI：1.345-1.415)，NH4+为1.094(95%CI：1.062-1.126)，BC为1.604(95%CI：1.563-1.646)，N03−为1.094(95%CI：1.060-1.130)，SO42−为1.239(95%CI：1.208-1.272)，OM为1.387(95%CI：1.354~1.421)。亚组分析表明，更年轻、更健康的女性更容易受到这种影响。在进一步探讨PM2.5组分在所有5个PM2.5组分中每四分位数增加的联合效应(OR 1.234[95%CI 1.222-1.246])中，我们发现PM2.5SO42−的贡献最大。这些发现为长期接触PM2.5及其化学成分与中国健康体检人群慢性肾脏病患病率之间的正相关关系提供了重要证据，并发现PM2.5SO42−对这种关系的贡献率最高。这项研究为降低CKD高危人群的特定空气颗粒物暴露提供了临床和公共卫生指导。
Previous research has implicated PM2.5as a potential environmental risk factor for CKD, but little is known about the associations between its components and CKD. We conducted a nationwide cross-sectional study using the updated air pollution data in the nationwide population (N = 2,938,653). Using generalized additive models, we assessed the association between long-term exposure to PM2.5and its components (i.e., black carbon [BC], organic matter [OM], nitrate [NO3−], ammonium [NH4+], sulfate [SO42−]), and CKD prevalence. The air pollution data was estimated using high-resolution and high-quality spatiotemporal datasets of ground-level air pollutants in China. Besides, we adopted a novel quantile-based g-computation approach to assess the effect of a mixture of PM2.5constituents on CKD prevalence. The average concentration of PM2.5was 78.67 ± 22.5 μg/m3, which far exceeded WHO AQG. In the fully adjusted generalized additive model, at a 10 km × 10 km spatial resolution, the ORs per IQR increase in previous 1-year average PM2.5exposures was 1.380 (95%CI: 1.345–1.415), for NH4+was 1.094 (95%CI: 1.062–1.126), for BC was 1.604 (95%CI: 1.563–1.646), for NO3−was 1.094 (95%CI: 1.060–1.130), for SO42−was 1.239 (95%CI: 1.208–1.272), and for the OM was 1.387 (95%CI: 1.354–1.421), respectively. Subgroup analysis showed females, younger, and healthier were more vulnerable to this effect. In the further exploration of the joint effect of PM2.5compositions (OR 1.234 [95%CI 1.222–1.246]) per quartile increase in all 5 PM2.5components, we found that PM2.5SO42−contributed the most. These findings provide important evidence for the positive relationship between long-term exposure to PM2.5and its chemical constituents and CKD prevalence in a Chinese health check-up population, and identified PM2.5SO42−has the highest contribution to this relationship. This study provides clinical and public health guidance for reducing specific air particle exposure for those at risk of CKD.