Association of the components of ambient fine particulate matter (PM2.5) and chronic kidney disease prevalence in China

Xingyuan Zhang; Jiayi Tao; Fang Lei; Tao Sun; Lijin Lin; Xuewei Huang; Peng Zhang; Yan-Xiao Ji; Jingjing Cai; Xiao-Jing Zhang; Hongliang Li

doi:10.1016/j.jenvman.2023.117885

Association of the components of ambient fine particulate matter (PM_2.5) and chronic kidney disease prevalence in China

J Environ Manage. 2023 Aug 1:339:117885. doi: 10.1016/j.jenvman.2023.117885. Epub 2023 Apr 20.

Authors

Xingyuan Zhang¹, Jiayi Tao², Fang Lei¹, Tao Sun³, Lijin Lin³, Xuewei Huang⁴, Peng Zhang¹, Yan-Xiao Ji¹, Jingjing Cai⁴, Xiao-Jing Zhang⁵, Hongliang Li⁶

Affiliations

¹ School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China.
² Department of Urology, Huanggang Central Hospital of Yangtze University, Huanggang, China; Huanggang Institute of Translation Medicine, Huanggang, China.
³ Department of Cardiology, Renmin Hospital, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China.
⁴ Department of Cardiology, The Third Xiangya Hospital of Central South University, Changsha, China.
⁵ School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China. Electronic address: zhangxjing@whu.edu.cn.
⁶ Department of Cardiology, Renmin Hospital, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China. Electronic address: lihl@whu.edu.cn.

PMID: 37086641
DOI: 10.1016/j.jenvman.2023.117885

Abstract

Previous research has implicated PM_2.5 as a potential environmental risk factor for CKD, but little is known about the associations between its components and CKD. We conducted a nationwide cross-sectional study using the updated air pollution data in the nationwide population (N = 2,938,653). Using generalized additive models, we assessed the association between long-term exposure to PM_2.5 and its components (i.e., black carbon [BC], organic matter [OM], nitrate [NO₃^-], ammonium [NH₄⁺], sulfate [SO₄^2-]), and CKD prevalence. The air pollution data was estimated using high-resolution and high-quality spatiotemporal datasets of ground-level air pollutants in China. Besides, we adopted a novel quantile-based g-computation approach to assess the effect of a mixture of PM_2.5 constituents on CKD prevalence. The average concentration of PM_2.5 was 78.67 ± 22.5 μg/m³, which far exceeded WHO AQG. In the fully adjusted generalized additive model, at a 10 km × 10 km spatial resolution, the ORs per IQR increase in previous 1-year average PM_2.5 exposures was 1.380 (95%CI: 1.345-1.415), for NH₄⁺ was 1.094 (95%CI: 1.062-1.126), for BC was 1.604 (95%CI: 1.563-1.646), for NO₃^- was 1.094 (95%CI: 1.060-1.130), for SO₄^2- was 1.239 (95%CI: 1.208-1.272), and for the OM was 1.387 (95%CI: 1.354-1.421), respectively. Subgroup analysis showed females, younger, and healthier were more vulnerable to this effect. In the further exploration of the joint effect of PM_2.5 compositions (OR 1.234 [95%CI 1.222-1.246]) per quartile increase in all 5 PM_2.5 components, we found that PM_2.5SO₄^2- contributed the most. These findings provide important evidence for the positive relationship between long-term exposure to PM_2.5 and its chemical constituents and CKD prevalence in a Chinese health check-up population, and identified PM_2.5SO₄^2- has the highest contribution to this relationship. This study provides clinical and public health guidance for reducing specific air particle exposure for those at risk of CKD.

Keywords: Chronic kidney disease; Generalized additive models; PM(2.5) constituents; Quantile-based g-computation.

MeSH terms

Air Pollutants* / analysis
Air Pollution* / analysis
China / epidemiology
Cross-Sectional Studies
Environmental Exposure / analysis
Female
Humans
Particulate Matter / analysis
Prevalence

Substances

Particulate Matter
Air Pollutants