Tsukahara T, Ezaki T, Moriguchi J, Furuki K, Fukui Y, Ukai H, Okamoto S, Sakurai H, Ikeda M
Kyoto Industrial Health Association, 67 Nishinokyo-Kitatsuboicho, Nakagyo-ku, 604-8472 Kyoto, Japan.
Int Arch Occup Environ Health. 2003 May;76(4):275-81. doi: 10.1007/s00420-003-0432-y. Epub 2003 Apr 29.
To examine if iron-deficient conditions modify body burden or health effects of cadmium among women in the general population in Japan.
In 2002, 1,482 women aged 20 to 74 years in six prefectures in Japan provided informed consent to participate in this study. They offered peripheral blood and spot urine samples, and answered questionnaires on their social habits and health conditions. Never-smoking, non-pregnant and non-lactating healthy women (1,190 subjects) were selected from the volunteers. Blood samples were analyzed for serum iron, ferritin and total iron-binding capacity (TIBC) in addition to red blood cell (RBC) counts and hemoglobin (Hb) concentration as markers of anemia and iron deficiency. Urine samples were analyzed for cadmium (Cd), alpha(1)-microglobulin (alpha(1)-MG), beta(2)-microglobulin (beta(2)-MG) as markers of Cd burden and Cd-induced tubular dysfunction; the measures were expressed after being corrected for creatinine (cr) as, e.g., Cd-Ucr.
The subjects were classified into anemic (37 women) and iron-deficient (388 women) groups separately from healthy controls (765 women), taking ferritin (<20 ng/ml) and Hb (<10 g/100 ml) as classification indicators. Strictly matched pairs (with regard to age and prefecture) were established for 36 anemic and 280 iron-deficient cases. Comparison between the cases and the matched controls showed that serum iron was lower and TIBC was higher in accordance with lower levels of ferritin and Hb in the anemic and iron-deficient groups, although the RBC count was only slightly reduced (the anemic group) or stayed essentially unchanged (the iron-deficient group). In contrast, no significant increase in Cd-Ucr, alpha(1)-MG, or beta(2)-MG was observed in either the anemic group or the iron-deficient group compared with the matched controls. Cd-Ucr in one case of clinical anemia, however, tended to be higher than the levels among women of the same age range and from the same prefecture. Her alpha(1)-MG-Ucr and beta(2)-MG-Ucr, however, remained un-elevated.
The current level of iron deficiency among women in the general population in Japan may not induce significant increase in Cd body burden or Cd-induced tubular dysfunction.
研究缺铁状况是否会改变日本普通人群中女性体内镉的负荷或镉对健康的影响。
2002年，日本六个县的1482名年龄在20至74岁之间的女性自愿参与本研究。她们提供了外周血和晨尿样本，并回答了关于其社会习惯和健康状况的问卷。从不吸烟、非孕期且非哺乳期的健康女性（1190名受试者）从志愿者中选出。除了红细胞（RBC）计数和血红蛋白（Hb）浓度作为贫血和缺铁的标志物外，还对血样进行血清铁、铁蛋白和总铁结合力（TIBC）分析。对尿样进行镉（Cd）、α1微球蛋白（α1-MG）、β2微球蛋白（β2-MG）分析，作为镉负荷和镉诱导肾小管功能障碍的标志物；这些指标经肌酐（cr）校正后表示，例如Cd-Ucr。
以铁蛋白（<20 ng/ml）和Hb（<10 g/100 ml）作为分类指标，将受试者分别分为贫血组（37名女性）、缺铁组（388名女性）和健康对照组（765名女性）。为36名贫血患者和280名缺铁患者建立了严格匹配的配对（在年龄和所在县方面）。病例组与匹配对照组之间的比较表明，贫血组和缺铁组中，血清铁较低而TIBC较高，同时铁蛋白和Hb水平较低，尽管红细胞计数仅略有降低（贫血组）或基本保持不变（缺铁组）。相比之下，与匹配对照组相比，贫血组或缺铁组中Cd-Ucr、α1-MG或β2-MG均未显著增加。然而，1例临床贫血患者的Cd-Ucr往往高于同年龄范围和同县女性的水平。不过，她的α1-MG-Ucr和β2-MG-Ucr并未升高。
日本普通人群中女性目前的缺铁水平可能不会导致镉体内负荷或镉诱导的肾小管功能障碍显著增加。
