Department of Social and Environmental Medicine, Kanazawa Medical University School of Medicine, 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan.
Environ Health Prev Med. 2012 Mar;17(2):147-56. doi: 10.1007/s12199-011-0234-x. Epub 2011 Aug 24.
To clarify the renal effects of cigarette smoking in a middle-aged occupational population because the effects have previously been demonstrated mainly in community populations that included many elderly people who are thought to be vulnerable to such effects.
In 990 middle-aged men recruited from a chemical plant, proteinuria was measured by a dipstick method and the glomerular filtration rate was estimated (eGFR) using a formula proposed by the Japanese Society of Nephrology.
Proteinuria was found in 4.6% of the current smokers and 1.5% of the never-smokers. It was found in 4.8% of the subjects having a Brinkman index (BI) of 400-599 and 6.3% of those having a BI of 600 or above. The odds ratio for proteinuria in them was 2.94 (CI: 1.01-8.55) and 3.61 (CI: 1.29-10.1), respectively, adjusting for possible confounders. The mean eGFR was higher in smokers than in nonsmokers throughout middle age up to 64 years. Normal but high eGFR was found in 6.7% of the current heavy smokers and subnormal eGFR in 5.7% of the largest cumulative cigarette consumers in contrast to 3.0% or less of the never-smokers. Proteinuria was found in 13.3% of the subjects showing subnormal eGFR, specifically in 16.7% of the smokers and 8.3% of the nonsmokers.
Smoking causes proteinuria in working middle-aged men. Smokers tend to have a high eGFR, but those with subnormal eGFR showed proteinuria most frequently. Whether the high eGFR in smokers will eventually decrease and cause proteinuria remains an important focus for further studies.
在中年职业人群中阐明吸烟对肾脏的影响，因为此前的研究结果主要在包括许多被认为易受此类影响的老年人的社区人群中得出。
在一家化工厂招募的 990 名中年男性中，通过尿试纸法测量蛋白尿，并使用日本肾脏病学会提出的公式估计肾小球滤过率（eGFR）。
当前吸烟者中有 4.6%出现蛋白尿，从不吸烟者中有 1.5%出现蛋白尿。在 BrinKman 指数（BI）为 400-599 的人群中，有 4.8%出现蛋白尿，在 BI 为 600 或更高的人群中，有 6.3%出现蛋白尿。调整了可能的混杂因素后，前者蛋白尿的比值比为 2.94（95%CI：1.01-8.55），后者为 3.61（95%CI：1.29-10.1）。在整个中年时期，直至 64 岁，吸烟者的平均 eGFR 均高于不吸烟者。与从不吸烟者的 3.0%或更少相比，当前重度吸烟者中有 6.7%出现正常但偏高的 eGFR，最大累积吸烟量者中有 5.7%出现偏低的 eGFR。在 eGFR 偏低的人群中，有 13.3%出现蛋白尿，具体来说，吸烟者中有 16.7%出现蛋白尿，不吸烟者中有 8.3%出现蛋白尿。
吸烟会导致工作中年男性出现蛋白尿。吸烟者的 eGFR 往往较高，但 eGFR 偏低者最易出现蛋白尿。吸烟者的 eGFR 升高是否最终会下降并导致蛋白尿，仍是进一步研究的重点。
