Department of Nephrology, Zhongshan Hospital Fudan University, Shanghai Key Laboratory of kidney and dialysis, Shanghai, China.
Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
PLoS One. 2018 Apr 10;13(4):e0195682. doi: 10.1371/journal.pone.0195682. eCollection 2018.
Cadmium exposure can cause renal tubular dysfunction. Recent studies show that vitamin D can play multiple roles in the body. However, the association between serum vitamin D levels and renal tubular dysfunction in a general population exposed to cadmium has not been clarified. We performed study to assess the effects of cadmium on serum 25(OH) D levels and the association between serum 25(OH) D levels and renal tubular dysfunction in a population environmentally exposed to cadmium. A total of 133 subjects living in control area and two cadmium polluted areas were included in the present study. Cadmium in urine (UCd) and blood (BCd), urinary β2Microglobulin (UBMG), urinary retinol binding protein (URBP) and serum 25 (OH) D were determined. Logistic regression was used to estimate the association between 25 (OH) D and prevalence of renal tubular dysfunction. No significant differences were observed in serum 25(OH) D levels among the four quartile of UCd and BCd after adjusting with cofounders. After adjusted with the confounders, the odds ratio (OR) of subjects with 25(OH) D ≥ 40 ng/ml were 0.20 (95%CI: 0.1-0.8) if UBMG was chosen as indicators of renal dysfunction and 0.28 (95%CI: 0.1-1.1) if URBP was chosen as indicators of renal dysfunction, compared with those with 25(OH) D < 30 ng/ml, respectively. Similar results were observed in those subjects living in cadmium polluted areas or with high level of UCd or BCd. Our data indicated that cadmium exposure did not affect serum 25(OH) D level and high 25 (OH) D levels were associated with a decreased risk of renal tubular dysfunction induced by cadmium.
镉暴露可导致肾小管功能障碍。最近的研究表明,维生素 D 在体内可发挥多种作用。然而,在接触镉的普通人群中,血清维生素 D 水平与肾小管功能障碍之间的关系尚不清楚。我们进行了这项研究,以评估镉对血清 25(OH)D 水平的影响,以及在接触环境镉的人群中,血清 25(OH)D 水平与肾小管功能障碍之间的关系。本研究共纳入了居住在对照区和两个镉污染区的 133 名受试者。测定了尿镉(UCd)和血镉(BCd)、尿β2微球蛋白(UBMG)、尿视黄醇结合蛋白(URBP)和血清 25(OH)D。采用 logistic 回归估计 25(OH)D 与肾小管功能障碍患病率之间的关系。在校正混杂因素后,在 UCd 和 BCd 四分位的四个四分位数中,血清 25(OH)D 水平无显著差异。在校正混杂因素后,若以 UBMG 作为肾功能障碍的指标,25(OH)D≥40ng/ml 的受试者发生肾功能障碍的比值比(OR)为 0.20(95%CI:0.1-0.8),若以 URBP 作为肾功能障碍的指标,25(OH)D≥40ng/ml 的受试者发生肾功能障碍的 OR 为 0.28(95%CI:0.1-1.1),与 25(OH)D<30ng/ml 的受试者相比。在居住在镉污染区或 UCd 或 BCd 水平较高的受试者中也观察到了类似的结果。我们的数据表明,镉暴露不会影响血清 25(OH)D 水平,而高 25(OH)D 水平与镉引起的肾小管功能障碍风险降低有关。