Hong Feng, Jin Tai-yi, Zhang Ai-hua
Department of Toxicology, School of Public Health, Guiyang Medical College, Guiyang 550004, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2004 Nov;38(6):374-8.
To research the impairment of renal function and the combined effects of arsenic and cadmium exposure in population residing in polluted area, and to calculate the benchmark doses of urinary arsenic (UAs) and cadmium (UCd) in renal dysfunction.
The concentrations of Uas and UCd were used as as exposure biomarker. Urinary beta(2)-microglobulin (Ubeta(2)-MG), N-acetyl-beta-glucosaminidase (UNAG), and albumin were calculated as biomarkers of renal dysfunction. The benchmark dose (BMD) and the lower confidence limit of the benchmark dose (BMDL) were calculated. Totally 245 patients were enrolled in the study, them, of 122 were from the exposed area, and 123 from the control area.
UAs and UCd concentrations in the exposed group were shown significantly higher than those in the control group (P < 0.01). The levels of Ubeta(2)-MG, UNAG and urinary albumin in the exposed group were significantly higher than those of the controls (P < 0.01). There existed positive correlation among the concentrations of UAs, UCd, Ubeta(2)-MG, urinary albumin and UNAG, showing a significant dose-effect relationship. The combination of cadmium and arsenic caused even more renal injury than by chemicals alone in a same dose. The BMD/BMDL of UAs were estimated as 121.91-171.88 microg/g Cr and 102.11-144.44 microg/g Cr. Of UCd, the BMD/BMDL were 1.05-1.48 microg/g Cr and 0.88-1.24 microg/g Cr.
This study indicates the combination of cadmium and arsenic might cause even more renal injury than by chemicals given alone, and cadmium might cause potential arsenic nephrotoxicity during long-term coexposure to arsenic and cadmium in human beings. It also suggests that UAs and UCd should be kept below 102.11 and 0.88 microg/g creatinine as to preventing renal damage from coexposure to arsenic and cadmium. The BMD method should be used in calculating the BMD of UAs and UCd on renal dysfunction.
研究污染地区人群肾功能损害情况以及砷和镉联合暴露的影响，并计算肾功能不全时尿砷（UAs）和尿镉（UCd）的基准剂量。
将Uas和UCd浓度用作暴露生物标志物。计算尿β2-微球蛋白（Uβ2-MG）、N-乙酰-β-氨基葡萄糖苷酶（UNAG）和白蛋白作为肾功能不全的生物标志物。计算基准剂量（BMD）和基准剂量的下限置信区间（BMDL）。共有245名患者参与本研究，其中122名来自暴露地区，123名来自对照地区。
暴露组的UAs和UCd浓度显著高于对照组（P<0.01）。暴露组的Uβ2-MG、UNAG和尿白蛋白水平显著高于对照组（P<0.01）。UAs、UCd、Uβ2-MG、尿白蛋白和UNAG浓度之间存在正相关，呈现显著的剂量-效应关系。与相同剂量的单一化学物质相比，镉和砷的联合作用导致的肾损伤更严重。UAs的BMD/BMDL估计为121.91-171.88μg/g肌酐和102.11-144.44μg/g肌酐。UCd的BMD/BMDL为1.05-1.48μg/g肌酐和0.88-1.24μg/g肌酐。
本研究表明，镉和砷的联合作用可能比单一化学物质导致更严重的肾损伤，在人类长期同时暴露于砷和镉的过程中，镉可能会引发潜在的砷肾毒性。这也表明，为防止同时暴露于砷和镉导致肾损伤，UAs和UCd应分别保持在102.11μg/g肌酐和0.88μg/g肌酐以下。应采用BMD方法计算UAs和UCd对肾功能不全的BMD。
