环境镉暴露与肾结石风险：一项系统评价和剂量反应荟萃分析。
Environmental cadmium exposure and the risk of kidney stones: a systematic review and dose-response meta-analysis.
作者信息
Ren Zheng-Ju, Zhang Qin, Tang Na-Xian, Li Ya-Dong, Lu Dong-Liang, Lin An-Long, Yang Chuan, Wang Feng
机构信息
Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Radiology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China.
出版信息
Front Med (Lausanne). 2025 Jul 30;12:1555028. doi: 10.3389/fmed.2025.1555028. eCollection 2025.
BACKGROUND
Recent studies have investigated the relationship between cadmium exposure and kidney stones. Nevertheless, the results remain controversial. Therefore, we performed a comprehensive systematic review and meta-analysis based on the latest evidence to address gaps in the research.
METHODS
Medline, Embase, and the Web of Science databases were searched to identify relevant studies up until 31 July 2024. Characteristics and outcomes of the included studies were extracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines. A random effects model was used to determine the association between cadmium exposure and the risk of kidney stones.
RESULTS
A total of 17 studies involving 159,011 individuals were included in the meta-analysis. When comparing the highest versus lowest cadmium exposure levels, the overall relative risk (RR) for kidney stones was 1.19 [95% confidence interval (CI): 1.10-1.29]. Subgroup analysis showed that urinary (RR = 1.19; 95%CI: 1.08-1.30) and blood (RR = 1.49; 95% CI: 1.10-2.02) cadmium levels were associated with an increased risk of kidney stones. In contrast to non-cadmium-contaminated areas, both blood (RR = 1.08; 95% CI: 1.00-1.15) and urinary (RR = 1.16; 95% CI: 1.05-1.27) cadmium levels were associated with an increased risk of kidney stones in cadmium-contaminated areas. In the dose-response meta-analysis, we observed a consistent linear positive association between cadmium exposure and the risk of kidney stones. The overall RR for every 1.0 μg/L increase in urinary cadmium levels was 1.07 (95% CI: 1.01-1.13).
CONCLUSION
Our findings suggest that cadmium exposure is associated with the risk of kidney stones. These findings reinforce the importance of environmental cadmium exposure as a risk factor for kidney stones, extending beyond the influence of conventional risk factors. Efforts to reduce cadmium exposure in the population may help reduce the individual, economic, and societal burdens associated with kidney stones.
SYSTEMATIC REVIEW REGISTRATION
背景
近期研究调查了镉暴露与肾结石之间的关系。然而，结果仍存在争议。因此，我们基于最新证据进行了全面的系统评价和荟萃分析，以填补研究空白。
方法
检索了Medline、Embase和Web of Science数据库，以识别截至2024年7月31日的相关研究。按照系统评价和荟萃分析的首选报告项目（PRISMA）指南以及流行病学观察性研究的荟萃分析（MOOSE）指南，提取纳入研究的特征和结果。采用随机效应模型确定镉暴露与肾结石风险之间的关联。
结果
荟萃分析共纳入17项研究，涉及159,011名个体。比较镉暴露最高水平与最低水平时，肾结石的总体相对风险（RR）为1.19[95%置信区间（CI）：1.10 - 1.29]。亚组分析显示，尿镉（RR = 1.19；95%CI：1.08 - 1.30）和血镉（RR = 1.49；95%CI：1.10 - 2.02）水平与肾结石风险增加相关。与非镉污染地区相比，在镉污染地区，血镉（RR = 1.08；95%CI：1.00 - 1.15）和尿镉（RR = 1.16；95%CI：1.05 - 1.27）水平均与肾结石风险增加相关。在剂量反应荟萃分析中，我们观察到镉暴露与肾结石风险之间存在一致的线性正相关。尿镉水平每增加1.0μg/L，总体RR为1.07（95%CI：1.01 - 1.13）。
结论
我们的研究结果表明，镉暴露与肾结石风险相关。这些发现强化了环境镉暴露作为肾结石风险因素的重要性，其影响超出了传统风险因素。减少人群中镉暴露的努力可能有助于减轻与肾结石相关的个人、经济和社会负担。
系统评价注册
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