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Epidemiology and Population Health

Effects of abdominal obesity on the association between air pollution and kidney function



This study aimed to evaluate the associations between ambient air pollutants, obesity, and kidney function.


We enrolled 3345 people who had undergone health checkups at Seoul National University Hospital. We recorded the annual average concentrations of ambient air pollutants, including particulate matter with an aerodynamic diameter of ≤10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO), in each subject’s residential area. Various obesity traits, such as body mass index, waist circumference, and visceral and subcutaneous adipose tissue areas, were measured by quantified computerized tomography (CT), and kidney function was assessed in relation to estimated glomerular filtration rate as an indicator of kidney function.


High PM10, NO2, SO2, and CO concentrations were significantly associated with decreased kidney function (β = −2.39 and standard error = 0.32, −1.00 and 0.31, −1.23 and 0.28, and −1.32 and 0.29, respectively), and with the prevalence of chronic kidney disease (CKD). The association between air pollutant concentrations and decreased kidney function, including CKD, was stronger among those with high abdominal adiposity, as defined by CT measurement. For example, the association between increased concentrations of air pollutants and the prevalence of CKD was stronger in the group with greater visceral adiposity than in the group with less visceral adiposity (aORs = 1.29 vs 1.16 for PM10, 1.42 vs 1.21 for SO2, and 1.27 vs 1.11 for CO).


Long-term exposure to higher concentrations of air pollutants was unfavorably associated with kidney function and CKD prevalence, especially in people with abdominal obesity. This may indicate a high susceptibility to air pollutants in obese people.

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  1. World Health Organization. Ambient air pollution: a global assessment of exposure and burden of disease. Geneva: World Health Organization; 2016.

  2. Brook RD, Rajagopalan S, Pope CA, Brook JR, Bhatnagar A, Diez-Roux AV, et al. Particulate matter air pollution and cardiovascular disease: an update to the scientific statement from the american heart associatione. Circulation. 2010;121:2331–78.

  3. Nemmar A, Al-Salam S, Zia S, Yasin J, Al Husseni I, Ali BH. Diesel exhaust particles in the lung aggravate experimental acute renal failure. Toxicol Sci. 2010;113:267–77.

    Article  CAS  Google Scholar 

  4. Chade AR, Lerman A, Lerman LO. Kidney in early atherosclerosis. Hypertension. 2005;45:1042–9.

    Article  CAS  Google Scholar 

  5. Kim HJ, Min JY, Seo YS, Min KB. Association between exposure to ambient air pollution and renal function in Korean adults. Ann Occup Environ Med. 2018;30:14.

    Article  Google Scholar 

  6. Yang YR, Chen YM, Chen SY, Chan CC. Associations between long-term particulate matter exposure and adult renal function in the taipei metropolis. Environ Health Perspect. 2017;125:602–7.

    Article  CAS  Google Scholar 

  7. Bragg-Gresham J, Morgenstern H, McClellan W, Saydah S, Pavkov M, Williams D, et al. County-level air quality and the prevalence of diagnosed chronic kidney disease in the US Medicare population. PLoS ONE. 2018;13:e0200612.

    Article  Google Scholar 

  8. Mehta AJ, Zanobetti A, Bind MA, Kloog I, Koutrakis P, Sparrow D, et al. Long-term exposure to ambient fine particulate matter and renal function in older men: the veterans administration normative aging study. Environ Health Perspect. 2016;124:1353–60.

    Article  CAS  Google Scholar 

  9. Kim HJ, Park JH, Min JY, Min KB, Seo YS, Yun JM, et al. Abdominal adiposity intensifies the negative effects of ambient air pollution on lung function in Korean men. Int J Obes. 2017;41:1218–23.

    Article  CAS  Google Scholar 

  10. Zhao Y, Qian Z, Wang J, Vaughn MG, Liu Y-Q, Ren W-H, et al. Does obesity amplify the association between ambient air pollution and increased blood pressure and hypertension in adults? Findings from the 33 Communities Chinese Health Study. Int J Cardiol. 2013;168:e148–150.

    Article  Google Scholar 

  11. Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S, et al. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med. 2006;145:247–54.

    Article  CAS  Google Scholar 

  12. Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, et al. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Int Med. 2003;139:137–47.

    Article  Google Scholar 

  13. World Health Organization. Regional Office for the Western Pacific. The Asia-Pacific perspective: redefining obesity and its treatment. Health Communications Australia: Melbourne; 2000.

  14. Yoon YS, Oh SW. Optimal waist circumference cutoff values for the diagnosis of abdominal obesity in Korean adults. Endocrinol Metab. 2014;29:418–26.

    Article  Google Scholar 

  15. Kim HJ, Park JH, Lee S, Son HY, Hwang J, Chae J, et al. A common variant of NGEF is associated with abdominal visceral fat in Korean men. PLoS ONE. 2015;10:e0137564.

    Article  Google Scholar 

  16. Kim HI, Kim JT, Yu SH, Kwak SH, Jang HC, Park KS, et al. Gender differences in diagnostic values of visceral fat area and waist circumference for predicting metabolic syndrome in Koreans. J Korean Med Sci. 2011;26:906–13.

    Article  Google Scholar 

  17. Bowe B, Xie Y, Li T, Yan Y, Xian H, Al-Aly Z. Associations of ambient coarse particulate matter, nitrogen dioxide, and carbon monoxide with the risk of kidney disease: a cohort study. Lancet Planet Health. 2017;1:e267–76.

    Article  Google Scholar 

  18. Lue SH, Wellenius GA, Wilker EH, Mostofsky E, Mittleman MA. Residential proximity to major roadways and renal function. J Epidemiol Commun Health. 2013;67:629–34.

    Article  Google Scholar 

  19. Brook Robert D, Brook Jeffrey R, Urch B, Vincent R, Rajagopalan S, Silverman F. Inhalation of fine particulate air pollution and ozone causes acute arterial vasoconstriction in healthy adults. Circulation. 2002;105:1534–6.

    Article  CAS  Google Scholar 

  20. Gold DR, Litonjua A, Schwartz J, Lovett E, Larson A, Nearing B, et al. Ambient pollution and heart rate variability. Circulation. 2000;101:1267–73.

    Article  CAS  Google Scholar 

  21. Blantz RC. Pathophysiology of pre-renal azotemia. Kidney Int. 1998;53:512–23.

    Article  CAS  Google Scholar 

  22. Aztatzi-Aguilar OG, Uribe-Ramírez M, Narváez-Morales J, De Vizcaya-Ruiz A, Barbier O. Early kidney damage induced by subchronic exposure to PM2.5 in rats. Particle Fibre Toxicol. 2016;13:68.

    Article  CAS  Google Scholar 

  23. Remuzzi G, Perico N, Macia M, Ruggenenti P. The role of renin-angiotensin-aldosterone system in the progression of chronic kidney disease. Kidney Int. 2005;99:S57–65.

  24. Pope CA 3rd, Bhatnagar A, McCracken JP, Abplanalp W, Conklin DJ, et al. Exposure to fine particulate air pollution is associated with endothelial injury and systemic inflammation. Circ Res. 2016;119:1204–14.

    Article  CAS  Google Scholar 

  25. Blundell JE, Dulloo AG, Salvador J, Frühbeck G. On behalf of the Easo Sab Working Group on Bmi G. Beyond BMI—phenotyping the obesities. Obes Facts. 2014;7:322–8.

    Article  Google Scholar 

  26. Li W, Dorans Kirsten S, Wilker Elissa H, Rice Mary B, Ljungman Petter L, Schwartz Joel D, et al. Short-term exposure to ambient air pollution and biomarkers of systemic inflammation. Arterioscler Thromb Vasc Biol. 2017;37:1793–1800.

    Article  CAS  Google Scholar 

  27. Xing X, Hu L, Guo Y, Bloom MS, Li S, Chen G, et al. Interactions between ambient air pollution and obesity on lung function in children: the Seven Northeastern Chinese Cities (SNEC) Study. Sci Total Environ. 2020;699:134397.

    Article  CAS  Google Scholar 

  28. McCormack MC, Belli AJ, Kaji DA, Matsui EC, Brigham EP, Peng RD, et al. Obesity as a susceptibility factor to indoor particulate matter health effects in COPD. Eur Respir J. 2015;45:1248–57.

    Article  Google Scholar 

  29. Sun L, Liu C, Xu X, Ying Z, Maiseyeu A, Wang A, et al. Ambient fine particulate matter and ozone exposures induce inflammation in epicardial and perirenal adipose tissues in rats fed a high fructose diet. Part Fibre Toxicol. 2013;10:43.

    Article  Google Scholar 

  30. Sun Q, Yue P, Deiuliis JA, Lumeng CN, Kampfrath T, Mikolaj MB, et al. Ambient air pollution exaggerates adipose inflammation and insulin resistance in a mouse model of diet-induced obesity. Circulation. 2009;119:538–46.

    Article  CAS  Google Scholar 

  31. Decleves AE, Sharma K. Obesity and kidney disease: differential effects of obesity on adipose tissue and kidney inflammation and fibrosis. Curr Opin Nephrol Hypertens. 2015;24:28–36.

    Article  CAS  Google Scholar 

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This research was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education, Science and Technology (grant number 2018R1D1A1A09083190).

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Correspondence to Jin-Ho Park or Hyun-Jin Kim.

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Jeong, SM., Park, JH., Kim, HJ. et al. Effects of abdominal obesity on the association between air pollution and kidney function. Int J Obes 44, 1568–1576 (2020).

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