Ambient particulate matter and renal function decline in HIV/AIDS patients: exploring the mediating role of TyG index.

OBJECTIVE: We aimed to explore the effect of particulate matter (PM) exposure on renal function in people living with HIV/AIDS (PWHA).

METHODS: A total of 37,739 repeated measurements were conducted on eGFR levels, serum creatinine (Scr), and the triglyceride-glucose (TyG) index in 6,958 PWHAs. The relationship between 1-28 day moving averages of PM concentrations with Scr and eGFR was assessed using linear mixed-effects models. Modified Poisson regression models were employed to assess the associations of cumulative PM exposure with the incidence of chronic kidney disease (CKD). Mediation analyses were used to examine the role of TyG index.

RESULTS: Short-term exposure to PM was related to reduced renal function. The strongest associations between exposure to PM1, PM2.5, and PM10 and percent changes in eGFR were observed at 7-day moving average exposure windows, with a respective decrease of 0.697% (-1.008%, -0.386%), 0.429% (-0.637%, -0.220%), and 0.373% (-0.581%, -0.164%) per IQR increment. Long-term exposure to PM1, PM2.5, and PM10 was positively linked with the incidence of CKD, with each IQR increment corresponding to fully adjusted RRs (95% CIs) of 1.631 (1.446, 1.839), 1.599 (1.431, 1.787), and 1.903 (1.665, 2.175), respectively. TyG index mediated 8.87%, 8.88%, and 7.58% of the relationship between cumulative exposure to PM1, PM2.5, and PM10 and increased risk of CKD, respectively.

CONCLUSION: Exposure to PM among PWHAs is linked to reduced renal function, potentially contributing to increased CKD incidence, where the TyG index might serve as a partial mediator.