Wang I J, Wu Y N, Wu W C, Leonardi G, Sung Y J, Lin T J, Wang C L, Kuo C F, Wu K Y, Cheng W C, Chan C C, Chen P C, Lin S-L
Department of Pediatrics,Taipei Hospital, Taipei, Taiwan.
Arch Dis Child. 2009 Nov;94(11):883-7. doi: 10.1136/adc.2009.163477. Epub 2009 Jul 15.
Little is known about the exposure profiles of melamine in children. We evaluated the association of clinical findings, exposure patterns and biomarkers with nephrolithiasis in children with potential exposure to melamine.
A case-control study was conducted in children aged 0-16 years with potential exposure to contaminated dairy products. Cases were defined as nephrolithiasis detected by renal ultrasonography. On the basis of different brands of contaminated dairy products consumed, subjects were classified into high exposure, low exposure and control groups with estimated melamine exposure levels of higher than 2.5 ppm, 0.05-2.5 ppm and lower than detection limits <0.05 ppm. We measured urine melamine for those with nephrolithiasis and age-matched and gender-matched controls within the subset of the study population.
The duration of consumption of contaminated products was longer in children with nephrolithiasis in the high exposure group than in controls (median (IQR) 12.0 (3.3-24.0) vs 6.0 (4.0-7.0) months; p = 0.048). High melamine exposure levels were significantly associated with nephrolithiasis (OR 61.04 (95% CI 12.73 to 292.84)). The risk was found to increase with estimate melamine exposure levels (p for trend <0.001). Two among 10 affected subjects with nephrolithiasis showed elevated urine melamine levels. In comparison, levels of all 20 controls were lower than the detection limit.
The risk of melamine-associated nephrolithiasis was related to duration of consumption of contaminated products and estimated melamine exposure levels. Though urine melamine was not a sensitive test, it might serve as an exposure biomarker in melamine-associated nephrolithiasis.
关于儿童中三聚氰胺的暴露情况知之甚少。我们评估了有三聚氰胺潜在暴露的儿童的临床发现、暴露模式和生物标志物与肾结石的关联。
对0至16岁有食用受污染乳制品潜在暴露的儿童进行了一项病例对照研究。病例定义为通过肾脏超声检查发现的肾结石。根据食用的不同品牌受污染乳制品，将受试者分为高暴露组、低暴露组和对照组，估计三聚氰胺暴露水平分别高于2.5 ppm、0.05 - 2.5 ppm和低于检测限<0.05 ppm。我们在研究人群子集中对患有肾结石的儿童以及年龄和性别匹配的对照测量了尿三聚氰胺。
高暴露组中患有肾结石的儿童食用受污染产品的持续时间比对照组更长（中位数（四分位间距）12.0（3.3 - 24.0）个月对6.0（4.0 - 7.0）个月；p = 0.048）。高三聚氰胺暴露水平与肾结石显著相关（比值比61.04（95%置信区间12.73至292.84））。发现风险随着估计的三聚氰胺暴露水平增加（趋势p<0.001）。10名受影响的肾结石受试者中有2名尿三聚氰胺水平升高。相比之下，所有20名对照的水平均低于检测限。
三聚氰胺相关肾结石的风险与受污染产品的食用持续时间和估计的三聚氰胺暴露水平有关。虽然尿三聚氰胺不是一项敏感检测，但它可能作为三聚氰胺相关肾结石的暴露生物标志物。
