Okaneku Jolene, Vearrier David, Mckeever Rita, Lasala Gregory, Greenberg Michael I
a Department of Emergency Medicine , Drexel University College of Medicine , Philadelphia , PA , USA.
Clin Toxicol (Phila). 2015;53(10):931-4. doi: 10.3109/15563650.2015.1094704. Epub 2015 Oct 15.
Animal model studies have demonstrated that subchronic oral uranium exposure is associated with renal dysfunction. Little is known about the effects of environmental exposure to uranium in humans.
To determine whether environmental exposure to uranium is associated with alterations in renal function among residents of the United States.
We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2001-2010. Inclusion criteria included the measurement of urine uranium concentration, serum creatinine (sCr), and urine albumin-creatinine ratio. Exclusion criteria included a reported history of diabetes mellitus. Urine uranium concentrations were normalized to urinary creatinine. Respondents with and without detectable urine uranium concentrations were compared using Welch's t-test for urine albumin-creatinine ratio and sCr and using Fisher's exact test for a reported history of renal disease. Regression analysis was performed to assess for an association between urine uranium concentration and urine albumin-creatinine ratio, sCr, or a reported history of renal disease.
Uranium was detectable in the urine of 74.1% (n = 9025) of respondents. Urine albumin-creatinine ratio was significantly greater in respondents with detectable urine uranium concentrations (mean 4.84 ± 45.8 mg/g) compared to respondents without detectable urine uranium concentrations (mean 0.77 ± 3.7 mg/g) (p < 0.001). There was no significant difference between the groups with respect to sCr or a reported history of renal disease. Regression analysis did not show a statistically significant association between urine uranium concentration and urine albumin-creatinine ratio (p = 0.45), sCr (p = 0.71), or a reported history of renal disease (p = 0.05).
In this study, a high proportion of the U.S. population had exposure to uranium. We demonstrated an association between detectable urine uranium concentrations and microalbuminuria in residents of the United States but no association with clinical renal disease.
动物模型研究表明，亚慢性口服铀暴露与肾功能障碍有关。关于人类环境暴露于铀的影响知之甚少。
确定美国居民环境暴露于铀是否与肾功能改变有关。
我们分析了2001 - 2010年美国国家健康和营养检查调查（NHANES）的数据。纳入标准包括尿铀浓度、血清肌酐（sCr）和尿白蛋白 - 肌酐比值的测量。排除标准包括报告有糖尿病病史。尿铀浓度以尿肌酐进行标准化。对尿铀浓度可检测和不可检测的受访者，使用韦尔奇t检验比较尿白蛋白 - 肌酐比值和sCr，并使用费舍尔精确检验比较报告的肾脏疾病史。进行回归分析以评估尿铀浓度与尿白蛋白 - 肌酐比值、sCr或报告的肾脏疾病史之间的关联。
74.1%（n = 9025）的受访者尿中可检测到铀。尿铀浓度可检测的受访者的尿白蛋白 - 肌酐比值（平均4.84±45.8mg/g）显著高于尿铀浓度不可检测的受访者（平均0.77±3.7mg/g）（p < 0.001）。两组在sCr或报告的肾脏疾病史方面无显著差异。回归分析未显示尿铀浓度与尿白蛋白 - 肌酐比值（p = 0.45）、sCr（p = 0.71）或报告的肾脏疾病史（p = 0.05）之间存在统计学显著关联。
在本研究中，很大比例的美国人口暴露于铀。我们证明了美国居民尿铀浓度可检测与微量白蛋白尿之间存在关联，但与临床肾脏疾病无关联。
