Abstract
Evidence of associations between ambient fine particulate matter (PM2.5) and risks of decline of kidney function and hyperuricemia is limited. We aimed to investigate the associations between long-term exposure to PM2.5 with decline of kidney function and hyperuricemia in China. We conducted a two-stage study based on China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015. Cox proportional hazard regression models and restricted cubic splines were used to evaluate the associations of PM2.5 with risks of decline of kidney function and hyperuricemia. Latent class trajectory models (LCTM) were used to identify trajectories of PM2.5 from 2011 to 2015 in the sensitivity analysis. A total of 9760 participants were included in baseline analysis, and 5902 participants were in follow-up analysis. PM2.5 was associated with the risks of decline of kidney function [hazard ratio (HR): 2.14; 95% confidence interval (CI): (1.03, 4.44)] and hyperuricemia [HR 1.40 (95% CI: 1.10, 1.79)] in the second quartile group versus the lowest quartile group of PM2.5. We also observed nonlinear relationships between PM2.5 and the risks of the decline of kidney function and hyperuricemia (Pnon-linear < 0.001). In sensitivity analysis, four trajectory groups were identified. “Maintaining a high PM2.5” [odds ratio (OR): 2.20; 95%CI: (1.78, 2.73)] and “moderately high starting PM2.5 then steadily decreased” [OR (95%CI): 5.15 (1.55, 16.13)] were associated with hyperuricemia risk, using “low starting PM2.5 then steadily decreased” trajectory as reference. In conclusion, improved air quality is essential for prevention of decline of kidney function and hyperuricemia.
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Data availability
The data underlying this article are available in a public, open-access repository, and can be accessed at China Health and Retirement Longitudinal Study (CHARLS) http://charls.pku.edu.cn.
Abbreviations
- PM 2.5 :
-
Ambient fine particulate matter
- UA :
-
Uric acid
- eGFR :
-
The estimate glomerular filtration rate
- CHARLS :
-
China Health and Retirement Longitudinal Study
- MDRD :
-
Modification of Diet in Renal Disease
- BMI :
-
Body mass index
- HDL-C :
-
High-density lipoprotein cholesterol
- LDL-C :
-
Low-density lipoprotein cholesterol
- BUN :
-
Blood urea nitrogen
- SBP :
-
Systolic blood pressure
- DBP :
-
Diastolic blood pressure
- HbA1c :
-
Glycosylated hemoglobin
- SD :
-
Standard deviation
- Β :
-
Correlation coefficients
- HR :
-
The hazard ratios
- CI :
-
Confidence interval
- RCS :
-
Restricted cubic splines
- LCTM :
-
Latent class trajectory model
- BIC :
-
The Bayesian information criteria
- OR :
-
Odds ratio
- CKD :
-
Chronic kidney disease
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Acknowledgements
Thanks to the National Natural Science Foundation of China. This current study uses data from the CHARLS dataset and Codebook. The development of the CHARLS was funded by the National Institute on Aging, USA (grant number 1R01AG037031), the World Bank Group (contract number 7159234), and the National Natural Science Foundation of China, China (grant number 71130002). We are grateful for the staff of CHARLS and all the participants. We sincerely appreciate the data support provided by the CHARLS team.
Funding
This study was supported by the National Natural Science Foundation of China (81773511).
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Conceptualization and methodology: Yu-**ang Yan and Li-Kun Hu; data curation, formal analysis, and visualization: Li-Kun Hu and Yu-Hong Liu; writing—original draft: Li-Kun Hu; writing—review and editing: Yu-**ang Yan, Kun Yang, Ning Chen, and Lin-Lin Ma; funding acquisition: Yu-**ang Yan. All authors read and approved the final manuscript.
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Ethical approval for all the CHARLS waves was granted by the Institutional Review Board at Peking University.
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Hu, LK., Liu, YH., Yang, K. et al. Associations between long-term exposure to ambient fine particulate pollution with the decline of kidney function and hyperuricemia: a longitudinal cohort study. Environ Sci Pollut Res 30, 40507–40518 (2023). https://doi.org/10.1007/s11356-023-25132-3
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DOI: https://doi.org/10.1007/s11356-023-25132-3