代谢综合征组分异常人群PM2.5长期暴露与慢性肾脏疾病的关联
Association between exposure to PM2.5 and chronic kidney disease in a population with metabolic syndrome
赵泽濛 1刘露露 2田雪 1罗丽丽 1罗会 1康晓平 3王肖南 1刘相佟 1郭秀花 1罗艳侠1
作者信息
- 1. 首都医科大学公共卫生学院,首都医科大学临床流行病学北京市重点实验室,北京 100069
- 2. 首都医科大学公共卫生学院,首都医科大学临床流行病学北京市重点实验室,北京 100069;首都医科大学附属北京中医医院疾控处,北京 100010
- 3. 北京小汤山医院,北京 102211
- 折叠
摘要
目的 探究细颗粒物(fine particulate matter,PM2.5)长期暴露与代谢综合征(metabolism syndrome,MS)组分异常人群慢性肾脏疾病(chronic kidney disease,CKD)患病风险的关联.方法 基于北京市某医院健康体检数据,采用回顾性队列研究方法收集2013-2019年体检数据.问卷调查获取人口学特征和生活习惯信息,测量血压、身高、体重和腰围,检测甘油三酯(triglyceride,TG)、空腹血糖和高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)等.同时根据研究对象的地址提取经纬度进行污染物暴露数据的估计.利用Logistic回归模型分析PM2.5长期暴露对MS组分异常人群CKD患病风险的估计效应.建立双污染物和多污染物模型,检验上述结果稳定性.基于年龄、是否患有MS、MS单组分异常情况及MS双组分异常情况进行相应的亚组分析.结果 研究共纳入1540名基线期MS组分异常人员,研究期间患CKD者206人,PM2.5两年年均浓度[中位数(四分位间距)]为57.57(17.61)μg/m3.PM2.5长期暴露与MS组分异常人群CKD患病风险增加的关联有统计学意义,PM2.5暴露每增加10 μg/m3,CKD的患病风险增加2.26倍(OR=3.26,95％CI 2.72～3.90).双污染物和多污染物模型结果提示,在控制同期其它空气污染物的混杂后,PM2.5长期暴露与MS组分异常人群CKD患病风险增加的关联仍然稳定.亚组分析结果发现,年龄≥45岁,未患MS、TG＜1.7 mmol/L、HDL-C≥1.04 mmol/L、未患高血压、患有中心性肥胖和高血糖的人群中PM2.5与CKD相关健康影响更强.结论 长期暴露于PM2.5后,MS组分异常人群CKD患病风险增加.年龄≥45岁的中老年人,以及患有中心性肥胖和高血糖者应成为重点关注人群.
Abstract
OBJECTIVE To investigate the association between long-term fine particulate matter(PM2.5)exposure and the risk of chronic kidney disease(CKD)in people with abnormal metabolism syndrome(MS)components.METHODS Based on health checkup data from a hospital in Beijing,a retrospective cohort study was used to collect annual checkup data from 2013-2019.A questionnaire was used to obtain information on demographic characteristics and lifestyle habits.We measured blood pressure,height,weight,waist circumference,concentrations of triglycerides(TG),fasting glucose,and high-density lipoprotein cholesterol(HDL-C).Longitude and latitude were also extracted from the addresses of the study subjects for pollutant exposure data estimation.Logistic regression models were used to explore the estimated effect of long-term PM2.5 exposure on the risk of CKD prevalence in people with abnormal MS components.Two-pollutant and multi-pollutant models were developed to test the stability of these result.Subgroup analysis was conducted based on age,the presence of MS,individual MS component abnormalities,and dual-component MS abnormalities.RESULTS The study included 1540 study subjects with abnormal MS components at baseline,206 with CKD during the study period.The association between long-term PM2.5 exposure and increased risk of CKD in people with abnormal MS fractions was statistically significant,with a 2.26-fold increase in risk of CKD for every 10 µg/m3 increase in PM2.5 exposure(OR=3.26,95％CI 2.72-3.90).The result in the dual-pollutant models and multi-pollutant models suggested that the association between long-term PM2 5 exposure and increased risk of CKD in people with abnormal MS fractions remained stable after controlling for contemporaneous confounding by other air pollutants.The result of subgroup analysis revealed that individuals aged 45 or older,without MS,with TG＜1.7 mmol/L,HDL-C≥ 1.04 mmol/L,without hypertension,and with central obesity and high blood sugar had a stronger association between PM2.5 exposure and CKD-related health effects.CONCLUSION Long-term exposure to PM2.5 may increase the risk of CKD in people with abnormal MS components.More attention should be paid to middle-aged and elderly people aged≥45 years,people with central obesity and hyperglycemia.
关键词
空气污染/细颗粒物/长期暴露/慢性肾脏疾病/代谢综合征组分Key words
air pollution/fine particulate matter/long-term exposure/chronic kidney disease/components of metabolic syndrome引用本文复制引用
出版年
2024
NETL
NSTL
万方数据