School of Public Health, Ningxia Medical University, Yinchuan Ningxia 750004, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan Ningxia 750004, P.R. China.
School of Public Health, Ningxia Medical University, Yinchuan Ningxia 750004, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan Ningxia 750004, P.R. China.
Ecotoxicol Environ Saf. 2023 Jul 1;259:114966. doi: 10.1016/j.ecoenv.2023.114966. Epub 2023 May 12.
Environmental metal exposure is associated with elevated triglycerides (TG) and the development of chronic kidney disease (CKD). However, the relationship between metal exposure and glomerular filtration rate (GFR) remains uncertain, and the mediating effect of TG between the two is unclear.
This study measured the concentrations of 14 metals in urine samples from 3752 elderly people in the community. The most relevant metals were screened by least absolute shrinkage and selection operator (LASSO) regression. The relationship between combined exposure to multiple metals and abnormal estimated glomerular filtration rate (eGFR) was explored using multivariate logistic regression analysis and Bayesian kernel machine regression (BKMR) analysis. Generalized linear regression models and the Karlson-Holm-Breen (KHB) method were used to assess the mediating effects of TG.
In the single-metal model, calcium (Ca), iron (Fe), selenium (Se), strontium (Sr), and thallium (Tl) showed significant negative correlations with the prevalence of abnormal eGFR (all P < 0.05). In the multi-metals model, Ca, Se, and Tl continued to show significant negative correlations, while vanadium (V) and zinc (Zn) showed significant positive correlations with abnormal eGFR (all P < 0.05). The BKMR model showed a negative joint effect of the mixture of Ca, V, Zn, Se, and Tl on the prevalence of abnormal eGFR. The generalized linear regression model showed a significant positive correlation between the concentrations of Ca (β = 0.07), Zn (β = 0.07), Se (β = 0.09), and TG levels (all P < 0.05). In the mediation analysis, TG masked a 4.30% and 5.21% correlation between Ca and Se and the prevalence of eGFR abnormalities, respectively.
Urinary concentration of multiple metals is significantly associated with eGFR abnormalities, and Ca, and Se may be among the potential protective factors. TG masked some of the protective effects of Ca and Se.
环境金属暴露与甘油三酯（TG）升高和慢性肾脏病（CKD）的发生有关。然而，金属暴露与肾小球滤过率（GFR）之间的关系尚不确定，两者之间 TG 的介导作用也不清楚。
本研究测量了来自社区的 3752 名老年人尿液样本中的 14 种金属浓度。通过最小绝对收缩和选择算子（LASSO）回归筛选出最相关的金属。使用多元逻辑回归分析和贝叶斯核机器回归（BKMR）分析探讨了多种金属联合暴露与异常估算肾小球滤过率（eGFR）之间的关系。使用广义线性回归模型和 Karlson-Holm-Breen（KHB）方法评估 TG 的中介作用。
在单金属模型中，钙（Ca）、铁（Fe）、硒（Se）、锶（Sr）和铊（Tl）与异常 eGFR 的患病率呈显著负相关（均 P<0.05）。在多金属模型中，Ca、Se 和 Tl 仍呈显著负相关，而钒（V）和锌（Zn）与异常 eGFR 呈显著正相关（均 P<0.05）。BKMR 模型显示 Ca、V、Zn、Se 和 Tl 混合物对异常 eGFR 患病率有负的联合效应。广义线性回归模型显示 Ca（β=0.07）、Zn（β=0.07）、Se（β=0.09）和 TG 水平之间存在显著正相关（均 P<0.05）。在中介分析中，TG 分别掩盖了 Ca 和 Se 与 eGFR 异常患病率之间 4.30%和 5.21%的相关性。
尿液中多种金属的浓度与 eGFR 异常显著相关，Ca 和 Se 可能是潜在的保护因素之一。TG 掩盖了 Ca 和 Se 的一些保护作用。
