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日本自然富含镉的未受污染地区居民尿液中的镉和管状功能障碍标志物水平。

Cadmium and tubular dysfunction marker levels in urine of residents in non-polluted areas with natural abundance of cadmium in Japan.

机构信息

Kyoto Industrial Health Association (Health Service Center), 4-1 Mibu-Shujakucho, Nakagyo-ku, Kyoto, 604-8871, Japan.

出版信息

Int Arch Occup Environ Health. 2010 Apr;83(4):455-66. doi: 10.1007/s00420-009-0483-9. Epub 2009 Nov 10.

Abstract

OBJECTIVES

Literature survey has suggested that cadmium (Cd) in the general environment is more abundant in the northern part of the coast on the sea of Japan. The present survey was initiated to examine if the exposure to Cd in the area has been higher than other parts of Japan, and if so, the higher exposure has been associated with tubular dysfunction among the local residents.

METHODS

In three prefectures of Akita, Yamagata and Ishikawa in the region, adult women (about 700 subjects per prefecture) were invited to participate in the survey. Each of the participants provided informed consents, offered spot urine samples and filled questionnaires (on age etc.). The urine samples were analyzed for Cd, alpha(1)-microglobulin (alpha(1)-MG), beta(2)-microglobulin (beta(2)-MG) and N-acetyl-beta-D: -glucosaminidase, together with creatinine and specific gravity. The results were combined with published data on two other prefectures of Niigata and Toyama (both in the area), as well as Japan as a whole (all Japan-A excluding Niigata prefecture, which was studied separately in the present study), and subjected to analysis for possible difference from all Japan-A in terms of the levels of internal Cd burden, and prevalence of beta(2)-MG-uria.

RESULTS

Geometric means (GMs) for urinary Cd in the five prefectures were in a range from a low of 1.20 to a high of 2.65 microg/l, being higher than the GM (0.99 microg/l) for all Japan-A. GMs for alpha(1)-MG (2.15-2.80 mg/l) and beta(2)-MG (99-107 microg/l) were only slightly higher or even lower than all Japan-A values depending on the prefectures. Elevation in the prevalence of beta(2)-MG-uria was significant in Akita prefecture, but the elevation in beta(2)-MG was not associated with elevation in Cd in urine. Literature survey on general population Cd epidemiology showed that Cd, alpha(1)-MG and beta(2)-MG levels in urine of the residents in the five prefectures were within the levels reported for non-polluted areas, and such was also the case for prevalence of beta(2)-MG-uria.

CONCLUSIONS

In an over-all evaluation, no clear-cut evidence was available for increased prevalence of Cd exposure-associated renal tubular dysfunction among general populations in the five prefectures in the northern part on the coast of Sea of Japan than in other prefectures in Japan, despite moderate elevation in urinary Cd levels.

摘要

目的

文献综述表明,日本海沿海地区北部的镉(Cd)在一般环境中更为丰富。本调查旨在检验该地区的 Cd 暴露是否高于日本其他地区,如果是这样,较高的暴露是否与当地居民的管状功能障碍有关。

方法

在秋田、山形和石川三个县,邀请成年女性(每个县约 700 名参与者)参加调查。每位参与者都提供了知情同意书,提供了现场尿液样本并填写了问卷(年龄等)。尿液样本用于分析 Cd、α(1)-微球蛋白(α(1)-MG)、β(2)-微球蛋白(β(2)-MG)和 N-乙酰-β-D:-葡萄糖苷酶,以及肌酐和比重。将结果与日本其他两个县(新泻和富山,均在该地区)以及日本全国(不包括新泻县的全日本-A,新泻县在本研究中单独进行了研究)的已发表数据相结合,并对 Cd 内负荷水平以及 β(2)-MG-尿的患病率是否与全日本-A 存在差异进行了分析。

结果

五个县的尿 Cd 几何平均值(GMs)范围从低 1.20 到高 2.65μg/l,高于全日本-A 的 GM(0.99μg/l)。α(1)-MG(2.15-2.80mg/l)和β(2)-MG(99-107μg/l)的 GMs 仅略高于或甚至低于全日本-A 值,具体取决于县。秋田县β(2)-MG-尿的患病率升高具有统计学意义,但β(2)-MG 的升高与尿液中 Cd 的升高无关。对一般人群 Cd 流行病学的文献综述表明,五个县居民尿液中的 Cd、α(1)-MG 和 β(2)-MG 水平处于无污染地区报告的水平范围内,β(2)-MG-尿的患病率也是如此。

结论

总的来说,尽管尿 Cd 水平中度升高,但在日本海沿海北部五个县的一般人群中,没有明确证据表明与 Cd 暴露相关的肾小管功能障碍的患病率高于日本其他县。

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