Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
Department of Hygiene, Kanazawa Medical University, Uchinada, Japan.
J Appl Toxicol. 2022 Sep;42(9):1458-1466. doi: 10.1002/jat.4304. Epub 2022 Mar 3.
The relationship between cadmium exposure, exposure-related renal tubular dysfunction, and mortality have been reported, mainly in the residents of Cd-contaminated areas in Japan. The aim of this study was to establish the cause-effect relationship between renal tubular dysfunction and cancer mortality in the general population in non-contaminated areas. A 19-year cohort study was conducted in 1110 men and 1703 women in 1993 or 1994, who lived in three cadmium-non-contaminated areas. Mortality risk ratios of urinary β2-microglobulin (β2MG) and N-acetyl-β-glucosaminidase (NAG) for all malignant neoplasms and specific cancers were estimated using the Fine and Gray competing risks regression model. Significant hazard ratios (HRs) for liver and pancreas cancer were observed for NAG (liver: HR corresponding to an increase of 1 IU/g cr, 1.10, 95%CI, 1.02-1.19, pancreas: HR, 1.10, 95%CI, 1.02-1.19) in men. In women, a negative HR was observed for NAG (lung cancer: HR 0.80, 95% CI, 0.67-0.96) and for β2MG (all malignant neoplasms: HR, 0.97, 95% CI, 0.93-1.00). The present study indicated that renal tubular dysfunction was significantly related to mortality in the general population of cadmium-non-contaminated areas in Japan.
镉暴露、与暴露相关的肾小管功能障碍与死亡率之间的关系已被报道，主要是在日本镉污染地区的居民中。本研究旨在确定非污染地区普通人群肾小管功能障碍与癌症死亡率之间的因果关系。对 1993 年或 1994 年居住在三个无镉污染地区的 1110 名男性和 1703 名女性进行了一项为期 19 年的队列研究。使用 Fine 和 Gray 竞争风险回归模型估计尿β2-微球蛋白 (β2MG) 和 N-乙酰-β-氨基葡萄糖苷酶 (NAG) 的所有恶性肿瘤和特定癌症的死亡率风险比。对于男性，NAG（肝：对应于 1 IU/g cr 增加的 HR，1.10，95%CI，1.02-1.19，胰腺：HR，1.10，95%CI，1.02-1.19）对肝癌和胰腺癌的危险比（HR）有显著意义。对于女性，NAG（肺癌：HR 0.80，95%CI，0.67-0.96）和β2MG（所有恶性肿瘤：HR，0.97，95%CI，0.93-1.00）呈负 HR。本研究表明，在日本无镉污染地区的普通人群中，肾小管功能障碍与死亡率显著相关。
