个体和全血中金属暴露的联合作用与美国 40 岁及以上成年人肾功能的关系。

Associations Between Individual and Combined Metal Exposures in Whole Blood and Kidney Function in U.S. Adults Aged 40 Years and Older.

机构信息

Gansu University of Chinese Medicine, Lanzhou, 730000, China.

College of Earth and Environmental Sciences, Lanzhou University, Dong Gang Xi Road 199, Lanzhou, Gansu, 730000, China.

出版信息

Biol Trace Elem Res. 2024 Mar;202(3):850-865. doi: 10.1007/s12011-023-03722-z. Epub 2023 Jun 8.

Abstract

The effects of metal exposure on kidney function have been reported in previous literature. There is limited and inconsistent information on the associations between individual and combined exposures to metals and kidney function among the middle-aged and older population. The aim of this study was to clarify the associations of exposure to individual metals with kidney function while accounting for potential coexposure to metal mixtures and to evaluate the joint and interactive associations of blood metals with kidney function. A total of 1669 adults aged 40 years and older were enrolled in the present cross-sectional study using the 2015-2016 National Health and Nutrition Examination Survey (NHANES). Single-metal and multimetal multivariable logistic regression models, quantile G-computation, and Bayesian kernel machine regression models (BKMR) were fitted to explore the individual and joint associations of whole blood metals [lead (Pb), cadmium (Cd), mercury (Hg), cobalt (Co), manganese (Mn), and selenium (Se)] with the odds of decreased estimated glomerular filtration rate (eGFR) and albuminuria. A decreased eGFR was defined as an eGFR ≤ 60 mL/min per 1.73 m, and albuminuria was categorized as a urinary albumin-creatinine ratio (UACR) of ≥ 30.0 mg/g. The results from quantile G-computation and BKMR indicated positive associations between exposure to the metal mixture and the prevalence of decreased eGFR and albuminuria (all P values < 0.05). These positive associations were mainly driven by blood Co, Cd, and Pb. Furthermore, blood Mn was identified as an influential element contributing to an inverse correlation with kidney dysfunction within metal mixtures. Increasing blood Se levels were negatively associated with the prevalence of decreased eGFR and positively associated with albuminuria. In addition, a potential pairwise interaction between Mn-Co on decreased eGFR was identified by BKMR analysis. Findings from our study suggested a positive association between exposure to the whole blood metal mixture and decreased kidney function, with blood Co, Pb, and Cd being the main contributors to this association, while Mn demonstrated an inverse relationship with renal dysfunction. However, as our study was cross-sectional in nature, further prospective studies are warranted to better understand the individual and combined effects of metals on kidney function.

摘要

先前的文献报道了金属暴露对肾功能的影响。在中年和老年人中,关于个体和多种金属暴露与肾功能之间的关联,信息有限且不一致。本研究旨在阐明在考虑金属混合物潜在共同暴露的情况下,个体金属暴露与肾功能之间的关联,并评估血液金属与肾功能的联合和交互关联。本研究共纳入了 1669 名年龄在 40 岁及以上的成年人,他们来自于 2015-2016 年全国健康与营养调查(NHANES)。采用单金属和多金属多变量逻辑回归模型、分位数 G 计算和贝叶斯核机器回归模型(BKMR),探讨全血金属[铅(Pb)、镉(Cd)、汞(Hg)、钴(Co)、锰(Mn)和硒(Se)]与估算肾小球滤过率(eGFR)降低和蛋白尿的比值比(OR)的个体和联合关联。定义 eGFR 降低为 eGFR≤60 mL/min per 1.73 m,蛋白尿分为尿白蛋白/肌酐比(UACR)≥30.0 mg/g。分位数 G 计算和 BKMR 的结果表明,金属混合物暴露与 eGFR 降低和蛋白尿的患病率呈正相关(所有 P 值均<0.05)。这些正相关主要由血液 Co、Cd 和 Pb 驱动。此外,血液 Mn 被确定为金属混合物中与肾功能障碍呈负相关的一个有影响力的元素。血液 Se 水平升高与 eGFR 降低的患病率呈负相关,与蛋白尿呈正相关。此外,BKMR 分析还发现 Mn-Co 对 eGFR 降低存在潜在的两两相互作用。本研究结果表明,全血金属混合物暴露与肾功能降低呈正相关,血液 Co、Pb 和 Cd 是导致这种相关性的主要因素,而 Mn 与肾功能障碍呈负相关。然而,由于本研究是横断面研究,因此需要进一步的前瞻性研究来更好地了解金属对肾功能的单独和联合影响。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索