Journal
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
Volume 15, Issue 12, Pages -Publisher
MDPI
DOI: 10.3390/ijerph15122860
Keywords
air pollution; PM2; 5; nephrotic syndrome; retrospective study
Funding
- Ministry of Health and Welfare, Taiwan [MOHW107-TDU-B-212-123004]
- China Medical University Hospital [DMR-107-192]
- Academia Sinica Stroke Biosignature Project [BM10701010021]
- MOST Clinical Trial Consortium for Stroke [MOST 106-2321-B-039-005-]
- Tseng-Lien Lin Foundation, Taichung, Taiwan
- Katsuzo and Kiyo Aoshima Memorial Funds, Japan
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Background: Air pollution has been associated with autoimmune diseases. Nephrotic syndrome is a clinical manifestation of immune-mediated glomerulopathy. However, the association between nephrotic syndrome and air pollution constituents remains unknown. We conducted this nationwide retrospective study to investigate the association between PM2.5 and nephrotic syndrome. Methods: We used the Longitudinal Health Insurance Database (LHID) and the Taiwan Air Quality-Monitoring Database (TAQMD). We combined and stratified the LHID and the TAQMD data by residential areas of insurants linked to nearby air quality-monitoring stations. Air pollutant concentrations were grouped into four levels based on quartile. Univariable and multivariable Cox proportional hazard regression models were applied. Findings: Relative to Q1-level SO2, subjects exposed to the Q4 level were associated with a 2.00-fold higher risk of nephrotic syndrome (adjusted HR = 2.00, 95% CI = 1.66-2.41). In NOx, relative to Q1 NOx concentrations, the adjusted HRs of nephrotic syndrome risk were 1.53 (95% CI = 1.23-1.91), 1.30 (95% CI = 1.03-1.65), and 2.08 (95% CI = 1.69-2.56) for Q2, Q3, and Q4 levels, respectively. The results revealed an increasing trend for nephrotic syndrome risk correlating with increasing levels of NO, NO2, and PM2.5 concentrations. Interpretation: High concentrations of PM2.5, NO, NO2, and SO2 are associated with increased risk of nephrotic syndrome.
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