低水平镉暴露增加慢性肾脏病风险：NHANES1999-2006 分析。
Low level exposure to cadmium increases the risk of chronic kidney disease: analysis of the NHANES 1999-2006.
机构信息
Division of Nephrology and Dialysis, Columbus-Gemelli University Hospital, Renal Program, Catholic University, Rome, Italy.
出版信息
BMC Public Health. 2010 Jun 3;10:304. doi: 10.1186/1471-2458-10-304.
BACKGROUND
Environmental factors have been associated with the outbreak of chronic kidney disease (CKD). We evaluated the association of Cadmium (Cd) exposure with the risk of CKD in U.S. adults who participated in the 1999-2006 National Health and Nutrition Examination Surveys (NHANES).
METHODS
5426 subjects > or = 20 years were stratified for values of urinary and blood Cd and a multivariate logistic regression was performed to test the association between blood and urinary Cd, CKD and albuminuria (ALB) after adjustment for age, gender, race/ethnicity, body mass index and smoking habits.
RESULTS
Subjects with urinary Cd > 1 mcg/g and subjects with blood Cd > 1 mcg/L showed a higher association with ALB (OR 1.63, 95% CI 1.23, 2.16; P = 0.001). Subjects with blood Cd > 1 mcg/L showed a higher association with both CKD (OR 1.48, 95% CI 1.01, 2.17; P = 0.046) and ALB (OR 1.41, 95% CI 1.10, 1.82; P = 0.007). An interaction effect on ALB was found for high levels of urinary and blood Cd (P = 0.014).
CONCLUSIONS
Moderately high levels of urinary and blood Cd are associated with a higher proportion of CKD and ALB in the United States population.
背景
环境因素与慢性肾脏病（CKD）的爆发有关。我们评估了美国成年人中镉（Cd）暴露与 CKD 风险之间的关系，这些成年人参加了 1999-2006 年的国家健康和营养检查调查（NHANES）。
方法
5426 名年龄大于或等于 20 岁的受试者按尿和血 Cd 值分层，并进行多元逻辑回归分析，以检验血和尿 Cd 与 CKD 和白蛋白尿（ALB）之间的关联，调整年龄、性别、种族/族裔、体重指数和吸烟习惯。
结果
尿 Cd > 1 mcg/g 和血 Cd > 1 mcg/L 的受试者与 ALB 呈更高的相关性（OR 1.63，95% CI 1.23，2.16；P = 0.001）。血 Cd > 1 mcg/L 的受试者与 CKD（OR 1.48，95% CI 1.01，2.17；P = 0.046）和 ALB（OR 1.41，95% CI 1.10，1.82；P = 0.007）均呈更高的相关性。在尿和血 Cd 高水平之间发现了对 ALB 的交互作用效应（P = 0.014）。
结论
美国人群中，中高水平的尿和血 Cd 与更高比例的 CKD 和 ALB 相关。
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