Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Environ Health. 2024 Oct 30;23(1):94. doi: 10.1186/s12940-024-01135-6.
The developing kidney is vulnerable to prenatal environmental factors such as metal exposure, potentially altering the risk of later-life kidney dysfunction. This study examines the relationship between prenatal metal exposures, individually and as mixtures, and adolescent kidney function in Project Viva, a prospective longitudinal birth cohort in Massachusetts, USA.
We used data on metals measured in blood during pregnancy including 15 in the first trimester and four in the second trimester. We calculated estimated glomerular filtration rate (eGFR) in adolescents (mean: 17.7 years) using cystatin C- (eGFRcys) and creatinine-based (eGFRcreat) equations for children. We used linear regression for single metal analyses, and Bayesian kernel machine regression and quantile-based g-computation for mixture analyses, adjusting for relevant covariates. To account for multiple comparisons in the single metal analyses, we applied the Holm-Bonferroni procedure to control the false discovery rate.
This study included 371 participants with first trimester metals and adolescent eGFR, and 256 with second trimester metals. Each doubling in first trimester cadmium concentration was associated with lower adolescent eGFRcys (β:-1.51; 95% CI:-2.83, -0.18). Each doubling in first trimester chromium (β:-1.45; 95% CI:-2.71, -0.19), nickel (β:-1.91; 95% CI:-3.65, -0.16), and vanadium (β:-1.69; 95% CI:-3.21, -0.17) was associated with lower adolescent eGFRcreat. After adjusting for multiple comparisons, p-values for associations between adolescent eGFR and chromium, nickel, vanadium and cadmium did not meet the criteria for significance. Metal mixture analyses did not identify statistically significant associations with adolescent eGFR.
These findings have important implications for future studies investigating the potential mechanisms through which prenatal metal exposures affect long-term kidney health in children.
发育中的肾脏易受到金属等产前环境因素的影响，这些因素可能会改变日后发生肾功能障碍的风险。本研究在美国马萨诸塞州的前瞻性纵向出生队列项目 Viva 中，调查了产前金属暴露（包括妊娠早期的 15 种和妊娠中期的 4 种）的个体暴露与混合物暴露与青少年肾脏功能之间的关系。
我们使用妊娠期间血液中测量的金属数据，包括妊娠早期的 15 种和妊娠中期的 4 种。我们使用胱抑素 C （eGFRcys）和肌酐为基础的（eGFRcreat）方程计算青少年（平均年龄：17.7 岁）的估计肾小球滤过率（eGFR）。我们使用线性回归进行单金属分析，贝叶斯核机器回归和基于分位数的 g 计算进行混合物分析，并调整了相关协变量。为了在单金属分析中考虑到多重比较，我们应用 Holm-Bonferroni 程序来控制假发现率。
这项研究纳入了 371 名妊娠早期有金属和青少年 eGFR 的参与者，以及 256 名妊娠中期有金属和青少年 eGFR 的参与者。妊娠早期镉浓度每增加一倍，青少年 eGFRcys 就会降低（β：-1.51；95%CI：-2.83，-0.18）。妊娠早期铬（β：-1.45；95%CI：-2.71，-0.19）、镍（β：-1.91；95%CI：-3.65，-0.16）和钒（β：-1.69；95%CI：-3.21，-0.17）浓度每增加一倍，青少年 eGFRcreat 就会降低。在调整了多重比较后，青少年 eGFR 与铬、镍、钒和镉之间的关联的 p 值未达到显著水平。金属混合物分析未发现与青少年 eGFR 有统计学意义的关联。
这些发现对未来研究具有重要意义，有助于研究产前金属暴露如何通过潜在机制影响儿童的长期肾脏健康。
