代谢综合征组分异常人群PM_(2.5)长期暴露与慢性肾脏疾病的关联  

Association between exposure to PM_(2.5)and chronic kidney disease in a population with metabolic syndrome

作　　者：赵泽濛 刘露露 田雪 罗丽丽 罗会 康晓平 王肖南 刘相佟 郭秀花 罗艳侠 Zhao Zemeng;Liu Lulu;Tian Xue;Luo Lili;Luo Hui;Kang Xiaoping;Wang Xiaonan;Liu Xiangtong;Guo Xiuhua;Luo Yanxia(School of Public Health,Capital Medical University,Beijing Key Laboratory of Clinical Epidemiology,Beijing 100069,China;Department of Disease Prevention,Beijing Hospital of Traditional Chinese Medicine,Beijing 100010,China;Beijing Xiaotangshan Hospital,Beijing 102211,China)

机构地区：[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

出　　处：《卫生研究》2024年第3期427-434,共8页Journal of Hygiene Research

基　　金：国家自然科学基金(No.81773512)。

摘　　要：目的探究细颗粒物(fine particulate matter,PM_(2.5))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PM_(2.5)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,PM_(2.5)两年年均浓度[中位数(四分位间距)]为57.57(17.61)μg/m^(3)。PM_(2.5)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,PM_(2.5)暴露每增加10μg/m^(3),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,PM_(2.5)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PM_(2.5)与CKD相关健康影响更强。结论长期暴露于PM_(2.5)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。OBJECTIVE To investigate the association between long-term fine particulate matter(PM_(2.5))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 PM_(2.5)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 PM_(2.5)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 10μg/m^(3) increase in PM_(2.5)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 PM_(2.5)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 PM_(2.5)exposure a

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 

分 类 号：R122[医药卫生—环境卫生学] R181.2[医药卫生—公共卫生与预防医学]