大气PM2.5长期暴露与肾功能的关联研究

    Association of long-term exposure to ambient PM2.5 with renal function

    • 摘要:
      目的 评估长期暴露于大气细颗粒物(fine particulate matter, PM2.5)5种成分(黑炭、铵盐、硝酸盐、有机物、硫酸盐)对肾功能的长期效应。
      方法 基于中国健康与养老追踪调查(China Health and Retirement Longitudinal Study, CHARLS) 2011年和2015年的数据, 纳入5 696名中老年人, 使用贝叶斯核机器回归(Bayesian kernel machine regression, BKMR)方法探究黑炭、铵盐、硝酸盐、有机物和硫酸盐5种PM2.5成分对肾功能的单独效应、交互效应和联合效应。
      结果 2011—2015年慢性肾脏病发生率为5.53%。有机物、黑炭、硝酸盐和硫酸盐的后验包含概率(posterior inclusion probabilities, PIP)值均为1.000, 对估算肾小球滤过率(estimated glomerular filtration rate, eGFR)的影响较大。当其余4种变量固定在第25, 50和75百分位时, 有机物每增加1个四分位数间距(interquartile range, IQR), 估算肾小球滤过率eGFR效应值分别为-9.18(95%CI: -40.16, 21.80), -61.57(95%CI: -87.50, -35.64), 10.24(95%CI: -16.53, 37.01);黑炭每增加1个IQR, eGFR水平分别上升16.67(95%CI: -12.50, 45.84), 33.30(95%CI: 10.30, 56.30), 53.40(95%CI: 25.00, 81.80);硫酸盐每增加1个IQR, eGFR水平与其呈负相关, 效应值分别为-89.83(95%CI: -161.17, -18.47), -73.28(95%CI: -102.49, -44.47), -22.76(95%CI: -91.42, 45.90)。PM2.5组分联合效应与估计肾小球滤过率总体呈负相关。
      结论 有机物单独暴露与中老年人估计肾小球滤过率水平降低相关, PM2.5混合物与估计肾小球滤过率呈负相关关联, 对慢性肾脏病具有正联合影响。

       

      Abstract:
      Objective To evaluate the long-term effects of exposure to atmospheric fine particulate matter (PM2.5) components (black carbon, ammonium salts, nitrates, organic matter, and sulfates) on renal function.
      Methods Based on the data of the China Health and Retirement Longitudinal Study(CHARLS) from 2011 to 2015, a total of 5 696 middle-aged and elderly people were included to explore the individual, interactive, and combined effects of the five PM2.5 components above on renal function by the Bayesian kernel machine regression(BKMR) method.
      Results The incidence of chronic kidney disease during 2011 to 2015 was 5.53%. The posterior inclusion probability(PIP) values of organic matter, black carbon, nitrates, and sulfates were all 1.000, indicating great impact on the estimated glomerular filtration rate (eGFR). When the other four variables were fixed at the 25th, 50th, and 75th percentile, for each increase in organic matter by a quartile, eGFR changed by -9.18 (95% confidence interval CI: -40.16, 21.80), -61.57 (95%CI: -87.50, -35.64), and 10.24 (95%CI: -16.53, 37.01), respectively; for each increase in black carbon by a quartile, the eGFR level increased by 16.67 (95%CI: -12.50, 45.84), 33.30 (95%CI: 10.30, 56.30), and 53.40 (95%CI: 25.00, 81.80), respectively; eGFR was negatively correlated with sulfates, and for each increase in sulfates by a quartile, the changes were -89.83 (95%CI: -161.17, -18.47), -73.28 (95%CI: -102.49, -44.47), and -22.76 (95%CI: -91.42, 45.9), respectively. The combined effect of the PM2.5 components was generally negatively correlated with eGFR.
      Conclusion Organic matter exposure alone is associated with decreased eGFR levels in middle-aged and elderly people. PM2.5 mixture has a negative correlation with eGFR, with a positive combined effect on the risk of chronic kidney disease.

       

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