Chen Jia-Jen, Wu Chia-Fang, Li Sih-Syuan, Chen Chu-Chih, Wang Yin-Han, Hsieh Chia-Jung, Wang Shu-Li, Chen Mei-Lien, Wu Ming-Tsang
Ph.D. Program in Environmental and Occupational Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Research Center for Environmental Changes, Academia Sinica, Taipei, Taiwan.
Environ Health. 2025 Jul 9;24(1):47. doi: 10.1186/s12940-025-01201-7.
Pregnant women are regularly exposed to a variety of environmental toxicants in daily life, posing a potential threat of kidney injury before presence of clinical manifestations. As there is a paucity of studies employing an exposome-based approach of kidney health in pregnant women, this study utilizes the above-mentioned strategy to identify the most significant environmental toxicants associated with early kidney injury in pregnant women in the cohort of TMICS (Taiwan Maternal and Infant Cohort Study). A total of 1,139 third-trimester pregnant women (weeks 29-40) were recruited between 2012 and 2015, and one-spot urine samples were successfully collected for study. Sixteen biomonitoring chemicals were measured in urine, including exposure measurements of melamine, 9 phthalate metabolites, nonylphenol (NP), bisphenol A (BPA), methylparaben (MP), ethylparaben (EP), propylparaben (PP), and butylparaben (BP), and outcome measurements of NAG (N-acetyl-β-d-glucosaminidase) and albumin-to-creatinine ratio (ACR). A two-tier strategy of statistical analyses was employed and data was randomly and evenly split to both training (n = 569) and validation (n = 570) sets. Using a weighted quantile sum (WQS) regression in the training set and subsequently a multivariate regression in the validation set, we found that NP was the most important chemical to link with early markers of kidney injury, both ACR and NAG. Our findings indicate that short-term exposure to NP is associated with markers of subclinical kidney injury in pregnant women in Taiwan. Further research is warranted to determine whether NP exposure is linked to clinically relevant kidney outcomes.
孕妇在日常生活中经常接触各种环境毒物，在出现临床表现之前就对肾脏造成潜在损伤威胁。由于采用基于暴露组方法研究孕妇肾脏健康的研究较少，本研究利用上述策略，在台湾母婴队列研究（TMICS）队列中，识别与孕妇早期肾脏损伤相关的最重要环境毒物。2012年至2015年期间，共招募了1139名孕晚期（29 - 40周）孕妇，并成功采集了单次尿样用于研究。检测了尿中16种生物监测化学物质，包括三聚氰胺、9种邻苯二甲酸酯代谢物、壬基酚（NP）、双酚A（BPA）、对羟基苯甲酸甲酯（MP）、对羟基苯甲酸乙酯（EP）、对羟基苯甲酸丙酯（PP）和对羟基苯甲酸丁酯（BP）的暴露量测量，以及N - 乙酰 - β - d - 氨基葡萄糖苷酶（NAG）和白蛋白与肌酐比值（ACR）的结果测量。采用了两层统计分析策略，并将数据随机均匀地分为训练集（n = 569）和验证集（n = 570）。在训练集中使用加权分位数和（WQS）回归，随后在验证集中进行多变量回归，我们发现NP是与肾脏损伤早期标志物ACR和NAG关联最重要的化学物质。我们的研究结果表明，台湾孕妇短期接触NP与亚临床肾脏损伤标志物有关。有必要进一步研究以确定NP暴露是否与临床相关的肾脏结局有关。
