Bernard A M, Vyskocil A, Roels H, Kriz J, Kodl M, Lauwerys R
Industrial Toxicology and Occupational Medicine Unit, University of Louvain, Brussels, Belgium.
Environ Res. 1995 Feb;68(2):91-5. doi: 10.1006/enrs.1995.1012.
A cross-sectional study was carried out to determine whether environmental exposure of children to lead may cause renal effects. The study involved a total of 195 children aged 12 to 15 years. One hundred forty-four children (63 boys and 81 girls) were recruited from two schools in the vicinity of a lead smelter and 51 (25 boys and 26 girls) from a school in a rural area. Compared to their referents, boys and girls from the two schools in the polluted area had significantly higher levels of lead in blood (PbB) but similar levels of cadmium (CdB) and zinc protoporphyrins (ZPP). The functional integrity of the kidney was assessed by measuring the urinary excretion of beta 2-microglobulin, Clara cell protein, retinol-binding protein (RBP), albumin and beta-N-acetyl-D-glucosaminidase. The most significant and consistent finding of the study was that children from the two schools in the polluted area showed a significant elevation of the urinary excretion of RBP that paralleled the level of lead in blood or in the dust collected on the school playgrounds. A similar pattern was observed for the prevalence of elevated values of urinary RBP which increased from 3.9% in the control area up to 17% in the most polluted school. Urinary RBP was found to be associated with PbB (partial r2 = 0.046, P = 0.005) in a stepwise regression analysis testing also the influence of age, sex, CdB, and ZPP. In conclusion, the present study suggests that lead contaminating the environment may cause slight effects on the proximal tubule function in children at exposure levels close to those associated with CNS deficit.
开展了一项横断面研究，以确定儿童环境铅暴露是否会对肾脏产生影响。该研究共涉及195名12至15岁的儿童。从铅冶炼厂附近的两所学校招募了144名儿童（63名男孩和81名女孩），从农村地区的一所学校招募了51名儿童（25名男孩和26名女孩）。与对照组相比，污染地区两所学校的男孩和女孩血铅（PbB）水平显著更高，但镉（CdB）和锌原卟啉（ZPP）水平相似。通过测量尿β2-微球蛋白、克拉拉细胞蛋白、视黄醇结合蛋白（RBP）、白蛋白和β-N-乙酰-D-氨基葡萄糖苷酶的排泄量来评估肾脏的功能完整性。该研究最显著且一致的发现是，污染地区两所学校的儿童尿RBP排泄量显著升高，这与血铅水平或学校操场收集的灰尘中的铅含量水平平行。尿RBP值升高的患病率也观察到类似模式，从对照地区的3.9%增加到污染最严重学校的17%。在逐步回归分析中，同时测试年龄、性别、CdB和ZPP的影响，发现尿RBP与PbB相关（偏r2 = 0.046，P = 0.005）。总之，本研究表明，污染环境的铅可能在接近与中枢神经系统缺陷相关的暴露水平时，对儿童近端肾小管功能产生轻微影响。
