Department of Family Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Department of Emergency Medicine, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
J Hazard Mater. 2019 Aug 5;375:224-232. doi: 10.1016/j.jhazmat.2019.04.082. Epub 2019 Apr 29.
This study aimed to determine the interaction of red blood cell cadmium and lead, total urinary arsenic, and plasma selenium in chronic kidney disease (CKD). We recruited 220 CKD patients as well as 438 gender- and age-matched controls, and we defined CKD as <60 mL/min/1.73 m estimated glomerular filtration rate (eGFR) for three or more consecutive months. Plasma selenium and red blood cell cadmium and lead concentrations were measured by ICP-MS. Urinary arsenic species were determined via HPLC-HG-AAS and were summed to determine the total urinary arsenic concentration. Plasma selenium was positively correlated to eGFR, and subjects with high plasma selenium levels (>243.90 μg/L) had a significantly lower odds ratio (OR) and 95% confidence interval (CI) (0.23, 0.13-0.42) for CKD compared to those with low plasma selenium levels (≤ 196.70 μg/L). High plasma selenium and low red blood cell cadmium or lead concentrations interacted to decrease the OR and 95% CI for CKD (0.12, 0.06-0.26; 0.09, 0.04-0.19). High plasma selenium and low red blood cell lead levels also interacted to increase the eGFR (20.70, 15.56-26.01 mL/min/1.73 m). This study is the first to suggest that selenium modifies the eGFR and OR in CKD induced by environmental toxicants.
本研究旨在探讨红细胞镉和铅、总尿砷和血浆硒在慢性肾脏病（CKD）中的相互作用。我们招募了 220 名 CKD 患者和 438 名性别和年龄匹配的对照者，并将 CKD 定义为连续三个月以上肾小球滤过率（eGFR）<60ml/min/1.73m。采用 ICP-MS 测定血浆硒和红细胞镉、铅浓度。通过 HPLC-HG-AAS 测定尿砷形态，并将其相加以确定总尿砷浓度。血浆硒与 eGFR 呈正相关，高血浆硒水平（>243.90μg/L）的受试者发生 CKD 的比值比（OR）及其 95%置信区间（CI）（0.23，0.13-0.42）显著低于低血浆硒水平（≤196.70μg/L）者。高血浆硒与低红细胞镉或低铅浓度相互作用可降低 CKD 的 OR 和 95%CI（0.12，0.06-0.26；0.09，0.04-0.19）。高血浆硒和低红细胞铅水平也相互作用，可增加 eGFR（20.70，15.56-26.01ml/min/1.73m）。本研究首次表明，硒可调节环境毒物引起的 CKD 的 eGFR 和 OR。
