From the Department of Pharmacy, College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Sunchon, Jeonnam, Republic of Korea.
Menopause. 2023 Mar 1;30(3):296-305. doi: 10.1097/GME.0000000000002131. Epub 2023 Jan 4.
To evaluate the relationships between heavy metals (cadmium, lead, and mercury) and their mixtures and estimated glomerular filtration rate (eGFR) in premenopausal and postmenopausal women.
Using data from the Korean National Health and Nutrition Examination Survey (2009-2017), multivariate linear regression models, marginal effects, and weighted quantile sum regression, we assessed the associations between single heavy metals and their mixtures and eGFR among 5,372 women.
Risks of reduced eGFR, comorbidities, and heavy metal exposure were found to be higher in postmenopausal women than in premenopausal women. A negative association of cadmium ( β = -2.97; 95% CI, -5.10 to -0.85) and a positive association of mercury ( β = 2.97; 95% CI, 1.49 to 4.44), with eGFR in postmenopausal women. Inverse associations of lead with eGFR in both premenopausal women ( β = -4.75; 95% CI, -6.04 to -3.46) and postmenopausal women ( β = -4.54; 95% CI, -6.96 to -2.13). Interactions were identified between lead and mercury, as well as cadmium and lead for eGFR among premenopausal women ( β = -2.04; 95% CI, -2.98 to -1.10) and postmenopausal women ( β = -3.52; 95% CI, -6.04 to -1.01), respectively. There was a negative association between mixed heavy metals and eGFR in both premenopausal women ( β = -2.23; 95% CI, -3.51 to -0.96) and postmenopausal women ( β = -3.86; 95% CI, -6.89 to -0.83). Lead was found as a key chemical related to reduced eGFR. Cutoff values for each heavy metal concentration related to eGFR were provided.
Postmenopausal women were more influenced by mixed heavy metals' effects on kidney function than premenopausal women. Early interventions (eg, water filtering, heavy metal yearly screening) in women, especially postmenopausal women, are needed to reduce the incidence of chronic kidney disease.
评估重金属（镉、铅和汞）及其混合物与绝经前和绝经后妇女估算肾小球滤过率（eGFR）之间的关系。
使用来自韩国国家健康和营养检查调查（2009-2017 年）的数据，采用多元线性回归模型、边际效应和加权分位数总和回归，我们评估了单一重金属及其混合物与 eGFR 之间的关联，研究对象为 5372 名女性。
与绝经前妇女相比，绝经后妇女的 eGFR 降低、合并症和重金属暴露的风险更高。镉（β=-2.97；95%置信区间，-5.10 至-0.85）与 eGFR 呈负相关，汞（β=2.97；95%置信区间，1.49 至 4.44）与 eGFR 呈正相关，这在绝经后妇女中得到了证实。铅与 eGFR 呈负相关，在绝经前妇女（β=-4.75；95%置信区间，-6.04 至-3.46）和绝经后妇女（β=-4.54；95%置信区间，-6.96 至-2.13）中均有体现。铅与汞之间以及镉与铅之间的相互作用在绝经前妇女（β=-2.04；95%置信区间，-2.98 至-1.10）和绝经后妇女（β=-3.52；95%置信区间，-6.04 至-1.01）中分别得到了证实。混合重金属与 eGFR 呈负相关，在绝经前妇女（β=-2.23；95%置信区间，-3.51 至-0.96）和绝经后妇女（β=-3.86；95%置信区间，-6.89 至-0.83）中均有体现。铅被认为是与 eGFR 降低相关的关键化学物质。提供了与 eGFR 相关的每种重金属浓度的临界值。
与绝经前妇女相比，绝经后妇女受混合重金属对肾功能影响更大。需要对女性（尤其是绝经后女性）进行早期干预（例如，水过滤、重金属每年筛查），以降低慢性肾病的发病率。
