Beijing Institute of Occupational Disease Prevention and Control, Beijing, 100093, China.
Department of Nutrition, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; School of Public Health, Shanxi Medical University, Taiyuan, 030001, Shanxi, China.
Chemosphere. 2024 Oct;366:143467. doi: 10.1016/j.chemosphere.2024.143467. Epub 2024 Oct 4.
Solar greenhouse workers, a unique farmer group, have been reported to have a higher risk of chronic kidney disease (CKD) compared to the general population, possible due to exposure to multiple metals.
This study aimed to investigate the associations between exposure to multiple metals and the estimated glomerular filtration rate (eGFR).
A cross-sectional study was conducted in the Northwest China. Urine samples were tested for concentration of 14 metals, including chromium, manganese, iron et al. Blood creatinine was measured to calculate eGFR, which was to evaluate the kidney function. Linear model and the Bayesian Kernel Machine Regression (BKMR) models were used to evaluate the associations between metals exposure and eGFR.
The study included 281 solar greenhouse workers, with 128 (45.6%) males and 153 (54.4%) females. The highest median concentrations of metals were zinc (418.55 μg/L), strontium (368.77 μg/L), and iron (55.73 μg/L), respectively. The linear model analysis showed that urinary levels of copper and zinc were negatively associated with eGFR [β = -0.021, 95% CI (-0.048, -0.007); β = -0.018, 95% CI (-0.068, -0.005)] considering a false discovery rate. BKMR results indicated a significant overall negative effect of 14 metals exposure on the eGFR when all metal levels were above the 50th percentile compared to the median value.
The decrease in eGFR among solar greenhouse workers was related to mixed metal exposure. Reducing exposure to the metals of copper, zinc, and lead could effectively protects kidney function. Further prospective studies are needed to resolve concerns about reverse causality.
与一般人群相比，日光温室工人作为一个独特的农民群体，据报道其慢性肾脏病（CKD）的风险更高，这可能是由于接触多种金属所致。
本研究旨在探讨暴露于多种金属与估计肾小球滤过率（eGFR）之间的关系。
在中国西北地区进行了一项横断面研究。检测了尿液样本中 14 种金属（包括铬、锰、铁等）的浓度。通过测量血肌酐来计算 eGFR，以评估肾功能。采用线性模型和贝叶斯核机器回归（BKMR）模型来评估金属暴露与 eGFR 之间的关系。
该研究共纳入 281 名日光温室工人，其中男性 128 人（45.6%），女性 153 人（54.4%）。金属浓度中位数最高的分别为锌（418.55μg/L）、锶（368.77μg/L）和铁（55.73μg/L）。线性模型分析表明，尿铜和锌水平与 eGFR 呈负相关[β=-0.021，95%置信区间（-0.048，-0.007）；β=-0.018，95%置信区间（-0.068，-0.005）]，考虑到假发现率。BKMR 结果表明，当所有金属水平均高于中位数的第 50 百分位数时，14 种金属暴露对 eGFR 的总体负效应显著。
日光温室工人 eGFR 的下降与混合金属暴露有关。减少铜、锌和铅等金属的暴露可以有效保护肾功能。需要进一步的前瞻性研究来解决关于反向因果关系的担忧。
