Occupational Health and Safety, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand.
Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80160, Thailand.
Int J Environ Res Public Health. 2022 Feb 16;19(4):2259. doi: 10.3390/ijerph19042259.
Environmental exposure to cadmium (Cd) or lead (Pb) is independently associated with increased risks of type 2 diabetes, and chronic kidney disease. The aim of this study was to examine the effects of concurrent exposure to these toxic metals on the risks of diabetes and kidney functional impairment. The Cd and Pb exposure levels among study subjects were low to moderate, evident from the means for blood concentrations of Cd and Pb ([Cd] and [Pb]) of 0.59 µg/L and 4.67 µg/dL, respectively. Of 176 study subjects (mean age 60), 71 (40.3%) had abnormally high fasting plasma glucose levels. Based on their [Cd] and [Pb], 53, 71, and 52 subjects were assigned to Cd and Pb exposure profiles 1, 2, and 3, respectively. The diagnosis of diabetes was increased by 4.2-fold in those with an exposure profile 3 ( = 0.002), and by 2.9-fold in those with the estimated glomerular filtration (eGFR) ≤ 60 mL/min/1.73 m ( = 0.029). The prevalence odds ratio (POR) for albuminuria was increased by 5-fold in those with plasma glucose levels above kidney threshold of 180 mg/dL ( = 0.014), and by 3.1-fold in those with low eGFR) ( = 0.050). Collectively, these findings suggest that the Cd and Pb exposure profiles equally impact kidney function and diabetes risk.
环境暴露于镉（Cd）或铅（Pb）与 2 型糖尿病和慢性肾病的风险增加独立相关。本研究旨在研究同时接触这些有毒金属对糖尿病和肾功能损害风险的影响。研究对象的 Cd 和 Pb 暴露水平较低，血液中 Cd 和 Pb 的浓度均值分别为 0.59µg/L 和 4.67µg/dL，表明暴露水平处于低至中度。在 176 名研究对象（平均年龄 60 岁）中，71 名（40.3%）空腹血糖水平异常升高。根据他们的血 Cd 和血 Pb 值，53、71 和 52 名研究对象分别被分配到 Cd 和 Pb 暴露谱 1、2 和 3。暴露谱 3 的糖尿病诊断增加了 4.2 倍（=0.002），eGFR≤60mL/min/1.73m 增加了 2.9 倍（=0.029）。血糖水平超过 180mg/dL 的蛋白尿患病率比值比（POR）增加了 5 倍（=0.014），eGFR 低的蛋白尿患病率比值比增加了 3.1 倍（=0.050）。综上所述，这些发现表明，Cd 和 Pb 暴露谱同样影响肾功能和糖尿病风险。
