Chai Sijie, You Yutong, Guo Yi, Guan Xin, Zhong Guorong, Yin Zhen, Yin Yu, Wen Yuying, Li Wenhui, Zhao Hui, Chen Shengli, Wang Xi, Wang Wenhui, Yuan Yu, Zhang Xiaomin, He Meian, Guo Huan, Long Pinpin, Wu Tangchun
Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
Environ Pollut. 2025 Oct 1;382:126721. doi: 10.1016/j.envpol.2025.126721. Epub 2025 Jun 24.
Emerging evidence suggests environmental polychlorinated biphenyls (PCBs) exposure may impair function, but prospective evidence linking PCB exposure to chronic kidney disease (CKD) incidence remains scarce. In the Dongfeng-Tongji cohort, we enrolled 1,902 CKD-free participants at baseline and measured seven serum PCB congeners (PCB-28, PCB-52, PCB-101, PCB-118, PCB-138, PCB-153, and PCB-180) using gas chromatography-tandem mass spectrometry (GC-MS/MS). Incident CKD was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m and/or urine protein ≥1+ after five-year follow-up. Multivariable logistic regression models were used to evaluate the associations of individual PCB and total PCB levels with the risk of incident CKD. We further applied Bayesian kernel machine regression (BKMR), weighted quantile sum (WQS) regression, quantile g-computation (Qgcomp), and least absolute shrinkage and selection operator (LASSO) regression to assess the combined effects of PCB mixtures. During follow-up, 287 participants (15.1%) developed incident CKD. Multivariable-adjusted logistic regression revealed significant dose-response relationships for PCB-28 and PCB-118, with participants in the highest tertiles experiencing 51% and 48% higher risks of incident CKD, respectively, compared to the lowest tertile. BKMR identified PCB-118 as the dominant contributor to the mixture effects (posterior inclusion probability = 0.72). Both WQS and Qgcomp analyses confirmed a significant association between combined PCB exposure and increased CKD risk, with PCB-118 and PCB-28 contributing most to the overall effect. Furthermore, LASSO regression retained only PCB-118 as a significant predictor, reinforcing its primary role. This study provides the first prospective evidence that both individual PCB congeners (PCB-28, PCB-118) and their combined exposures are associated with increased CKD risk. These findings underscore the importance of environmental monitoring and public health interventions to mitigate legacy PCB exposures.
新出现的证据表明，环境多氯联苯（PCBs）暴露可能损害功能，但将PCB暴露与慢性肾脏病（CKD）发病率联系起来的前瞻性证据仍然很少。在东风-同济队列中，我们在基线时纳入了1902名无CKD的参与者，并使用气相色谱-串联质谱法（GC-MS/MS）测量了七种血清PCB同系物（PCB-28、PCB-52、PCB-101、PCB-118、PCB-138、PCB-153和PCB-180）。将随访五年后估算肾小球滤过率（eGFR）<60 mL/min/1.73 m²和/或尿蛋白≥1+定义为发生CKD。使用多变量逻辑回归模型评估个体PCB和总PCB水平与发生CKD风险之间的关联。我们进一步应用贝叶斯核机器回归（BKMR）、加权分位数和（WQS）回归、分位数g计算（Qgcomp）和最小绝对收缩和选择算子（LASSO）回归来评估PCB混合物的综合影响。在随访期间，287名参与者（15.1%）发生了CKD。多变量调整后的逻辑回归显示，PCB-28和PCB-118存在显著的剂量反应关系，与最低三分位数相比，最高三分位数的参与者发生CKD的风险分别高51%和48%。BKMR确定PCB-118是混合物效应的主要贡献者（后验包含概率=0.72）。WQS和Qgcomp分析均证实，PCB联合暴露与CKD风险增加之间存在显著关联，其中PCB-118和PCB-28对总体效应的贡献最大。此外，LASSO回归仅保留PCB-118作为显著预测因子，强化了其主要作用。本研究提供了首个前瞻性证据，表明个体PCB同系物（PCB-28、PCB-118）及其联合暴露均与CKD风险增加有关。这些发现强调了环境监测和公共卫生干预措施对于减轻遗留PCB暴露的重要性。
