Lin Yinxia, Cai Jiansheng, Liu Qiumei, Mo Xiaoting, Xu Min, Zhang Junling, Liu Shuzhen, Wei Chunmei, Wei Yanfei, Huang Shenxiang, Mai Tingyu, Tan Dechan, Lu Huaxiang, Luo Tingyu, Gou Ruoyu, Zhang Zhiyong, Qin Jian
Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, Nanning, 530021, China.
Key Laboratory of Tumor Immunology and Microenvironmental Regulation, Guilin Medical University, Guangxi Zhuang Autonomous Region, Guilin, 541004, China.
Biol Trace Elem Res. 2023 May;201(5):2240-2249. doi: 10.1007/s12011-022-03349-6. Epub 2022 Jul 6.
Extensive studies have revealed the link between heavy metals and CKD. Compared to single meta-elements, mixture of metals reflect real-life metals exposure scenarios and are of interest. However, the mechanism of action of metal mixture on renal function is unclear.
This study aimed to explore the potential relationship between urinary arsenic (As), cadmium (Cd), lead (Pb), manganese (Mn), and chromium (Cr) contents with estimated glomerular filtration rate (eGFR) levels in 2775 participants. The levels of metals in urine were determined by inductively coupled plasma-mass spectrometry. We used linear regression models and the Bayesian kernel machine regression (BKMR) to evaluate the association between metals and eGFR levels.
In linear regression analysis, urinary As (β = 2.723, 95%CI: 0.29, 5.157) and Pb (β = 3.081, 95%CI: 1.725, 4.438) were positively associated with eGFR in the total population. In the BKMR model, a mixture of the five metals had a positive joint effect on eGFR levels, while Pb (PIP = 0.996) contributed the most to eGFR levels. Pb was positively associated with eGFR levels in the total participants and women. As was positively correlated with eGFR levels in women. Pb and eGFR levels were positively correlated when the other metals were set at 25th, 50th, and 75th percentiles.
To the best of our knowledge, all five metals mixed exposure was positively associated with eGFR. Pb showed more important effects than the other four metals in the mixture, especially in women.
大量研究揭示了重金属与慢性肾脏病（CKD）之间的联系。与单一金属元素相比，金属混合物反映了现实生活中的金属暴露情况，因而备受关注。然而，金属混合物对肾功能的作用机制尚不清楚。
本研究旨在探讨2775名参与者尿中砷（As）、镉（Cd）、铅（Pb）、锰（Mn）和铬（Cr）含量与估计肾小球滤过率（eGFR）水平之间的潜在关系。采用电感耦合等离子体质谱法测定尿中金属含量。我们使用线性回归模型和贝叶斯核机器回归（BKMR）来评估金属与eGFR水平之间的关联。
在线性回归分析中，尿As（β = 2.723，95%CI：0.29，5.157）和Pb（β = 3.081，95%CI：1.725，4.438）与总人群的eGFR呈正相关。在BKMR模型中，五种金属的混合物对eGFR水平有正向联合效应，而Pb（PIP = 0.996）对eGFR水平的贡献最大。Pb与总参与者及女性的eGFR水平呈正相关。As与女性的eGFR水平呈正相关。当将其他金属设定在第25、50和75百分位数时，Pb与eGFR水平呈正相关。
据我们所知，所有五种金属的混合暴露与eGFR呈正相关。在混合物中，Pb比其他四种金属显示出更重要的作用，尤其是在女性中。
