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大气PM2.5长期暴露与肾功能的关联研究

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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.
Association of long-term exposure to ambient PM2.5 with renal function
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 includ-ed 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 im-pact on the estimated glomerular filtration rate(eGFR).When the other four variables were fixed at the 25th,50th,and 75th percen-tile,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 chan-ges 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.

Bayesian kernel machine regressionfine particulate matter(PM2.5)chronic kidney diseaseestimated glomerular filtration rate

欧阳逸馨、谢文涵、李元、苏宇腾、薛咏茜、李舒婷、胡美玲、刘相佟

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首都医科大学公共卫生学院,北京 100069

临床流行病学北京市重点实验室

贝叶斯核机器回归 细颗粒物 慢性肾脏病 估计肾小球滤过率

国家自然科学基金

82003559

2024

环境卫生学杂志
中国疾病预防控制中心

环境卫生学杂志

CSTPCD
影响因子:0.735
ISSN:2095-1906
年,卷(期):2024.14(1)
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