Department of Occupational Health and Toxicology, School of Public Health, Nanchang University, 461 Bayi Road, Donghu District, Nanchang, Jiangxi, 330006, People's Republic of China.
Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, 461 Bayi Road, Donghu District, Nanchang, Jiangxi, 330006, People's Republic of China.
Environ Sci Pollut Res Int. 2023 Sep;30(41):94552-94564. doi: 10.1007/s11356-023-29001-x. Epub 2023 Aug 3.
In the real world, humans are exposed to multiple metal(loid)s (designated hereafter metals) that contain essential metals as well as toxic metals. Exposure to the metal mixture was assumed to be associated with renal function impairment; however, there is no consensus on available studies. Therefore, we here explored the association between multiple metals exposure and indicators of renal function in the general population from southeastern China. A total of 11 metals with 6 human essential metals and 5 toxic metals were determined in the selected 720 subjects. In addition, serum uric acid (SUA), serum creatinine (SCR), and the estimated glomerular filtration rate (eGFR) were measured or calculated as indicators of renal function. Using multiple flexible statistical models of generalized linear model, elastic net regression, and Bayesian kernel machine regression, the joint as well as the individual effect of metals within the mixture, and the interactions between metals were explored. When exposed to the metal mixture, the statistically non-significantly increased SUA, the significantly increased SCR, and the significantly declined eGFR were observed. In addition, the declined renal function may be primarily attributed to lead (Pb), arsenic (As), and nickel (Ni) exposure. Finally, interactions, such as the synergistic effect between Pb and Mo on SUA, whereas the antagonistic effect between Ni and Cd on SCR and eGFR were identified. Our finding suggests that combined exposure to multiple metals would impair renal function. Therefore, reducing exposure to toxic heavy metals of Pb, As, and Cd and limiting exposure to the human essential metal of Ni would protect renal function.
在现实世界中，人类会接触到多种包含必需金属和有毒金属的金属（以下简称金属）。人们认为，接触金属混合物与肾功能损害有关；然而，现有的研究并没有达成共识。因此，我们在这里探讨了来自中国东南部的一般人群中，多种金属暴露与肾功能指标之间的关系。在选定的 720 名受试者中，共测定了 11 种金属，其中包括 6 种人体必需金属和 5 种有毒金属。此外，血清尿酸（SUA）、血清肌酐（SCR）和估计肾小球滤过率（eGFR）被测量或计算为肾功能的指标。使用广义线性模型、弹性网络回归和贝叶斯核机器回归的多种灵活统计模型，探讨了混合物中金属的联合和个体效应以及金属之间的相互作用。当暴露于金属混合物中时，观察到 SUA 统计学上无显著增加、SCR 显著增加和 eGFR 显著下降。此外，肾功能下降可能主要归因于铅（Pb）、砷（As）和镍（Ni）暴露。最后，还确定了一些相互作用，如 Pb 和 Mo 对 SUA 的协同作用，以及 Ni 和 Cd 对 SCR 和 eGFR 的拮抗作用。我们的研究结果表明，多种金属的联合暴露会损害肾功能。因此，减少 Pb、As 和 Cd 等有毒重金属的暴露，并限制 Ni 等人体必需金属的暴露，将有助于保护肾功能。
