Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang 110000, China.
Department of Health Management, Shengjing Hospital of China Medical University, Shenyang 110000, China.
Ecotoxicol Environ Saf. 2024 Nov 1;286:117159. doi: 10.1016/j.ecoenv.2024.117159. Epub 2024 Oct 8.
Exposure to brominated flame retardants (BFRs) may contribute the advancement of chronic kidney disease (CKD). The objective is to evaluate the renal effects of BFRs in patients with CKD.
Totally 7235 US participants of whom 1187 (16.41 %) were diagnosed with CKD were screened for this investigation from the National Health and Nutrition Examination Survey (NHANES) database spanning from 2005 to 2016. The isotope dilution gas chromatography high-resolution mass spectrometry (GC/IDHRMS) was employed for identification of 11 polybrominated diphenyl ethers (PBDEs) and PBB153 serving as the exposure factor. A set of covariates concerning basic characteristics, renal function indicators and suffering from diseases of these participants was considered as potential confounding factors. Subgroup analyses to examine the impact of age and gender on the relationship between serum BFRs and CKD, estimated glomerular filtration rate (eGFR), urinary albumin-to-creatinine ratio (UACR), serum creatinine (Scr), and blood urea nitrogen (BUN). Weighted Quantile Sum (WQS) regression and Quantile G-computation (QGC) analyses were applied to identify relationship of individual BFRs and other anthropometric indicators in CKD.
After adjusting for available confounding factors, PBDE100, PBDE28, PBDE85, PBDE47, PBDE99, and PBDE154 were positively correlated with CKD. PBDE28, PBDE66, PBDE47, PBDE183, PBDE100, PBDE99, PBDE85, PBDE154, and PBB153 were significantly negatively correlated with eGFR. PBDE66 and PBDE183 were positively correlated with UACR. PBDE28, PBDE17, PBDE66, PBDE100, PBDE47, PBDE85, PBDE154, PBDE99, PBDE183 and PBB153 were positively correlated with Scr. PBDE17, PBDE28, PBDE154, PBDE66, PBDE47, PBDE99, and PBDE209 were negatively associated with BUN. PBB153 was positively correlated with BUN. The subgroup results gender and age are key factors affecting the relationship of PBDEs and renal function indicators. Both WQS and QGS analyses revealed that exposure to mixed BFR was negatively correlated with eGFR and BUN, of which PBB153 and PBDE66 contributed the most, respectively, as well as positively correlated with Scr, in which PBDE66 contributed the most.
Specific BFRs exposure was significantly correlated with renal function indicators, enhancing the potential risk of CKD. This pioneer investigation shed light on an overlooked impact of BFR exposure on CKD in US.
接触溴化阻燃剂（BFRs）可能会导致慢性肾脏病（CKD）的进展。本研究旨在评估 BFRs 对 CKD 患者的肾脏影响。
本研究从 2005 年至 2016 年的国家健康和营养检查调查（NHANES）数据库中筛选出 7235 名美国参与者，其中 1187 名（16.41%）被诊断为 CKD，用于此项研究。采用同位素稀释气相色谱高分辨率质谱（GC/IDHRMS）鉴定 11 种多溴二苯醚（PBDEs）和 PBB153 作为暴露因素。考虑了一组与基本特征、肾功能指标和疾病有关的协变量作为潜在的混杂因素。进行亚组分析，以检查血清 BFRs 与 CKD、估算肾小球滤过率（eGFR）、尿白蛋白与肌酐比值（UACR）、血清肌酐（Scr）和血尿素氮（BUN）之间关系的年龄和性别影响。应用加权分位数总和（WQS）回归和分位数 G 计算（QGC）分析来确定个体 BFRs 与 CKD 中其他人体测量指标的关系。
在调整了可用的混杂因素后，PBDE100、PBDE28、PBDE85、PBDE47、PBDE99 和 PBDE154 与 CKD 呈正相关。PBDE28、PBDE66、PBDE47、PBDE183、PBDE100、PBDE99、PBDE85、PBDE154 和 PBB153 与 eGFR 呈显著负相关。PBDE66 和 PBDE183 与 UACR 呈正相关。PBDE28、PBDE17、PBDE66、PBDE100、PBDE47、PBDE85、PBDE154、PBDE99、PBDE183 和 PBB153 与 Scr 呈正相关。PBDE17、PBDE28、PBDE154、PBDE66、PBDE47、PBDE99 和 PBDE209 与 BUN 呈负相关。PBB153 与 BUN 呈正相关。亚组结果表明，性别和年龄是影响 PBDEs 与肾功能指标关系的关键因素。WQS 和 QGS 分析均表明，混合 BFR 暴露与 eGFR 和 BUN 呈负相关，其中 PBB153 和 PBDE66 的相关性最大，与 Scr 呈正相关，其中 PBDE66 的相关性最大。
特定 BFRs 的暴露与肾功能指标显著相关，增加了 CKD 的潜在风险。这项开创性的研究揭示了 BFR 暴露对美国 CKD 的潜在影响被忽视了。
