Department of a Nagasaki Clinical Studies, Radiation Effects Research Foundation, Nagasaki, Japan.
Radiat Res. 2013 Jan;179(1):46-52. doi: 10.1667/RR2863.1. Epub 2012 Nov 13.
Atomic bomb (A-bomb) radiation is associated with cardiovascular disease (CVD) and metabolic CVD risk factors. Chronic kidney disease (CKD) is also known to be a risk factor for CVD and little is known whether CKD is associated with A-bomb radiation. To examine whether CKD is associated with CVD risk factors or with A-bomb radiation in A-bomb survivors, we classified renal dysfunction in 1,040 A-bomb survivors who were examined in 2004-2007 as normal [n = 121; estimated glomerular filtration rate (eGFR) ≥ 90 ml/min/1.73 m(2)]; mild (n = 686; eGFR 60-89 ml/min/1.73 m(2)); moderate (n = 217; eGFR 30-59 ml/min/1.73 m(2)); or severe (n = 16; eGFR <30 ml/min/1.73 m(2)). Also, we diagnosed subjects in the moderate and severe renal dysfunction groups as having CKD (n = 233; eGFR <59 ml/min/1.73 m(2)). After adjusting for age, gender, and smoking and drinking habits, we looked for an association between renal dysfunction and hypertension, diabetes mellitus (DM), hyperlipidemia, and metabolic syndrome (MetS), and between renal dysfunction and A-bomb radiation. Hypertension [odds ratio (OR), 1.57; 95% confidence interval (CI), 1.12-2.20, P = 0.009]; DM (OR, 1.79; 95% CI, 1.23-2.61, P = 0.002); hyperlipidemia (OR, 1.55; 95% CI, 1.12-2.14, P = 0.008); and MetS (OR, 1.86; 95% CI, 1.32-2.63, P < 0.001) were associated with CKD (moderate/severe renal dysfunction), and hyperlipidemia and MetS were also associated with mild renal dysfunction. CKD (OR/Gy, 1.29; 95% CI, 1.01-1.63, P = 0.038) and severe renal dysfunction (OR/Gy, 3.19; 95% CI, 1.63-6.25, P < 0.001) were significantly associated with radiation dose. CKD associated with radiation may have played a role in the development of CVD among A-bomb survivors.
原子弹（A 炸弹）辐射与心血管疾病（CVD）和代谢性 CVD 风险因素有关。慢性肾脏病（CKD）也是 CVD 的一个已知风险因素，但尚不清楚 CKD 是否与原子弹辐射有关。为了研究 CKD 是否与原子弹幸存者的 CVD 风险因素或原子弹辐射有关，我们将 2004-2007 年接受检查的 1040 名原子弹幸存者的肾功能障碍分为正常（n=121；估计肾小球滤过率[eGFR]≥90 ml/min/1.73 m(2)）；轻度（n=686；eGFR 60-89 ml/min/1.73 m(2)）；中度（n=217；eGFR 30-59 ml/min/1.73 m(2)）；或重度（n=16；eGFR<30 ml/min/1.73 m(2)）。此外，我们将中重度肾功能障碍组的患者诊断为 CKD（n=233；eGFR<59 ml/min/1.73 m(2)）。在调整年龄、性别、吸烟和饮酒习惯后，我们观察肾功能障碍与高血压、糖尿病（DM）、血脂异常和代谢综合征（MetS）之间的关系，以及肾功能障碍与原子弹辐射之间的关系。高血压[比值比（OR），1.57；95%置信区间（CI），1.12-2.20，P=0.009]；DM（OR，1.79；95%CI，1.23-2.61，P=0.002）；血脂异常（OR，1.55；95%CI，1.12-2.14，P=0.008）；代谢综合征（OR，1.86；95%CI，1.32-2.63，P<0.001）与 CKD（中重度肾功能障碍）有关，血脂异常和代谢综合征也与轻度肾功能障碍有关。CKD（OR/Gy，1.29；95%CI，1.01-1.63，P=0.038）和重度肾功能障碍（OR/Gy，3.19；95%CI，1.63-6.25，P<0.001）与辐射剂量显著相关。与辐射相关的 CKD 可能在原子弹幸存者 CVD 的发展中发挥了作用。
