Shanghai Clinical College, Anhui Medical University, Shanghai, 200072, China.
Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, 301 Yanchang Road, Jing'an District, 200072, Shanghai, People's Republic of China.
Environ Sci Pollut Res Int. 2022 Sep;29(45):68410-68421. doi: 10.1007/s11356-022-20598-z. Epub 2022 May 11.
Cadmium, lead, and mercury are nephrotoxic metals that are commonly found as hazardous pollutants in many areas of the USA. We examined the relationship between exposure to cadmium, lead, and mercury with the occurrence of urgency urinary incontinence (UUI) and stress urinary incontinence (SUI) in women. This study was conducted using data on women > 20 years of age, collected between 2005 and 2016, who reported experiencing urinary incontinence in the National Health and Nutrition Examination Survey (NHANES). Restricted cubic spline analysis was used to characterize a dose-response relationship between continuous exposure to different nephrotoxic metals and the occurrence of UUI and SUI. A total of 4406 women were included in this study, with 2624 (59.6%) suffering from SUI and 3177 (72.1%) suffering from UUI in the weighted population. The results of our multivariate analysis indicated that age, race, marital status, body mass index (BMI), and exposure to nephrotoxic metals were risk factors for developing UI. The odds ratio (OR; 95% confidence interval) for developing UI was positively correlated with the exposure to cadmium and lead in women. The OR of SUI occurrence increased with increasing levels of cadmium in blood, with a peak at 4 µg/L. The OR of UUI occurrence increased with increasing levels of blood and urinary lead, with peaks at 7 µg/dL and 5 µg/L, respectively. The presence of mercury was not significantly correlated with the occurrence of SUI or UUI. Exposure to high levels of cadmium and lead, which are nephrotoxic metals, is associated with the occurrence of UI in women.
镉、铅和汞是常见的肾毒性金属,在美国许多地区都是危险污染物。我们研究了女性接触镉、铅和汞与急迫性尿失禁(UUI)和压力性尿失禁(SUI)发生之间的关系。本研究使用了 2005 年至 2016 年期间参加国家健康和营养检查调查(NHANES)的年龄在 20 岁以上的女性报告的尿失禁数据。受限立方样条分析用于描述连续接触不同肾毒性金属与 UUI 和 SUI 发生之间的剂量-反应关系。共有 4406 名女性纳入本研究,加权人群中 2624 名(59.6%)患有 SUI,3177 名(72.1%)患有 UUI。多变量分析结果表明,年龄、种族、婚姻状况、体重指数(BMI)和接触肾毒性金属是发生 UI 的危险因素。女性发生 UI 的比值比(OR;95%置信区间)与接触镉和铅呈正相关。随着血液中镉水平的升高,SUI 发生的 OR 呈上升趋势,在 4μg/L 时达到峰值。UUI 发生的 OR 随着血液和尿液中铅水平的升高而升高,峰值分别为 7μg/dL 和 5μg/L。汞的存在与 SUI 或 UUI 的发生无显著相关性。接触肾毒性金属镉和铅水平高与女性发生 UI 有关。