TY - JOUR
T1 - Acute effects of air pollution on lupus nephritis in patients with systemic lupus erythematosus
T2 - A multicenter panel study in China
AU - Bai, Heming
AU - Jiang, Lei
AU - Li, Ting
AU - Liu, Chong
AU - Zuo, Xiaoxia
AU - Liu, Yi
AU - Hu, Shaoxian
AU - Sun, Linyun
AU - Zhang, Miaojia
AU - Lin, Jin
AU - Xiao, Weiguo
AU - Wang, Qingwen
AU - Zhao, Dongbao
AU - Wu, Huaxiang
AU - Kong, Xiaodan
AU - Gao, Wenkang
AU - Hou, Wanxin
AU - Seong, Myeongsu
AU - Zhang, Yuanpeng
AU - Chen, Fangfang
AU - Chen, Sheng
AU - Wu, Xin
AU - Bao, Chunde
AU - Wang, Li
AU - Xu, Huji
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/4
Y1 - 2021/4
N2 - Air pollution may trigger systemic lupus erythematosus (SLE). However, few studies have investigated the associations between air pollution and complications of SLE, such as lupus nephritis (LN). In this study, multicenter longitudinal data from 13 hospitals in China, including 8552 SLE patients with 24,762 visits, were used. Based on the generalized estimating equation (GEE) model, we assessed the associations of LN occurrence with short-term exposures to different air pollutants including particulate matter with an aerodynamic diameter < 2.5 μm (PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3). We identified 2672 LN patients, and about half of them were from east China. Our results based on the entire data set showed that PM2.5 and NO2 were risk factors for LN within one month after exposure, with odds ratio of 1.16 (95% confidence interval (CI), 1.08–1.19) at lag 18 day and 1.19 (95% CI, 1.12–1.26) at lag 16 day relative to an interquartile range (IQR) increase in PM2.5 and NO2, respectively. This positive association between LN and NO2 was also observed for south, west, and east China. In addition, we found that the short term exposure to CO and O3 was not generally associated with LN. Finally, the negative associations of LN with SO2 were found for the entire region and east China. Our results implied that SLE patients may gain the health benefits of air quality improvement in China. Our work also provided evidence that short-term variations in air pollution may trigger LN, and further studies are needed to confirm these findings and the potential pathogenic mechanisms should be explored.
AB - Air pollution may trigger systemic lupus erythematosus (SLE). However, few studies have investigated the associations between air pollution and complications of SLE, such as lupus nephritis (LN). In this study, multicenter longitudinal data from 13 hospitals in China, including 8552 SLE patients with 24,762 visits, were used. Based on the generalized estimating equation (GEE) model, we assessed the associations of LN occurrence with short-term exposures to different air pollutants including particulate matter with an aerodynamic diameter < 2.5 μm (PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3). We identified 2672 LN patients, and about half of them were from east China. Our results based on the entire data set showed that PM2.5 and NO2 were risk factors for LN within one month after exposure, with odds ratio of 1.16 (95% confidence interval (CI), 1.08–1.19) at lag 18 day and 1.19 (95% CI, 1.12–1.26) at lag 16 day relative to an interquartile range (IQR) increase in PM2.5 and NO2, respectively. This positive association between LN and NO2 was also observed for south, west, and east China. In addition, we found that the short term exposure to CO and O3 was not generally associated with LN. Finally, the negative associations of LN with SO2 were found for the entire region and east China. Our results implied that SLE patients may gain the health benefits of air quality improvement in China. Our work also provided evidence that short-term variations in air pollution may trigger LN, and further studies are needed to confirm these findings and the potential pathogenic mechanisms should be explored.
KW - Acute effects
KW - Air pollution
KW - Lupus nephritis
KW - Systemic lupus erythematosus
UR - http://www.scopus.com/inward/record.url?scp=85100901596&partnerID=8YFLogxK
U2 - 10.1016/j.envres.2021.110875
DO - 10.1016/j.envres.2021.110875
M3 - Article
C2 - 33592226
AN - SCOPUS:85100901596
SN - 0013-9351
VL - 195
JO - Environmental Research
JF - Environmental Research
M1 - 110875
ER -