长期暴露于大气颗粒物对慢性肾脏病发病风险的影响

Effects of Long-term Exposure to Atmospheric Particulate Matter on the Risk of Chronic Kidney Disease

【目的】探讨长期暴露于大气颗粒物对慢性肾脏病(CKD)发病风险的影响。【方法】对本院体检中心1378例体检者使用基于卫星的时空模型,基于气溶胶光学深度(AOD)数据计算其环境中暴露于空气动力学直径小于2.5μm(PM_(2.5))的颗粒物浓度。计算估计肾小球滤过率(eGFR)水平,CKD被定义为eGFR<60 mL/(min·1.73 m^(2))。采用一般线性模型分析影响eGFR的危险因素。采用多因素Logistic回归分析影响CKD的危险因素。【结果】1378例对象中103例患有CKD,占7.47%(103/1378)。有无CKD两组患者年龄、吸烟、饮酒、体重指数(BMI)、SEP、DEP、空腹血糖及eGFR相比较差异有显著性(P<0.05),性别和受教育水平相比较差异无显著性(P>0.05)。与第一四分位数PM_(2.5)组(PM_(2.5)浓度最低组)相比,第二、三及四分位数患者eGFR水平均有所降低[β(95%CI)分别为:-0.241(-0.307-0.216),-0.283(-0.321-0.224),-0.346(-0.493〜-0.287)]。PM_(2.5)浓度每增加5μg/m^(3),eGFR降低0.297(95%CI:0.216-0.336)。多因素Logistic回归分析表明,吸烟、饮酒、空腹血糖及PM_(2.5)是CKD发生的危险因素。【结论】长期暴露于PM_(2.5)与CKD发生风险增加有关,减少空气污染可防止CKD的发生和发展。

【Objective】To investigate the effect of long-term exposure to atmospheric particulates on the risk of chronic kidney disease(CKD).【Methods】A total of 1378 patients who participated in the health examination in our hospital's medical examination center were selected.PM2.5 concentrations were calculated based on aerosol optical depth(AOD)data using satellite-based space-time models.The estimated glomerular filtration rate(eGFR)level was calculated.CKD was defined as eGFR V60 mL/(min·1.73 m^(2)).The general linear regression model was used to analyze the risk factors affecting eGFR.Multivariate Logistic regression was used to analyze the risk factors affecting CKD.【Results】Of the 1378 patients,103 cases had CKD,accounting for 7.47%.There were significant differences in age,smoking,drinking,body mass index(BMI),SBP,DBP,fasting blood glucose,and eGFR between the CDK group and non-CDK group(P<0.05).There was no significant difference in gender and education level in the two groups(P>0.05).Compared to the first quartile of PM_(2.5)group(the lowest PM_(2.5)concentration group),the eGFR levels of patients in the second,third,and forth quartiles were reduced[β(95%CI):-0.241(-0.307〜-0.216),-0.283(-0.321〜-0.224),-0.346(-0.493〜-0.287),respectively].For every 5μg/m^(3)increase in PM^(2.5)concentration,eGFR decreases by 0.297(95%CI:0.216-0.336).Multivariate Logistic regression analysis showed that smoking,drinking,fasting blood glucose and PM^(2.5)were risk factors for CKD.【Conclusion】Long-term exposure to PM_(2.5)is associated with an increased risk of CKD.Reducing air pollution can prevent the occurrence and development of CKD.