Pless-Mulloli T, Boettcher M, Steiner M, Berger J
Department of Epidemiology and Public Health, School of Health Sciences, University of Newcastle upon Tyne, UK.
Occup Environ Med. 1998 Jul;55(7):440-5. doi: 10.1136/oem.55.7.440.
To evaluate the suitability of alpha-1-microglobulin as a marker for cadmium induced renal dysfunction.
alpha-1-Microglobulin was studied in a cross sectional survey in relation to the body burden of cadmium. Concentrations of alpha-1-microglobulin in 24 h urine of 831 people aged 2-87 years were analysed in association with urinary cadmium excretion, cadmium blood concentration, age, sex, occupational and smoking history, and estimated creatinine clearance. Participants came from a population residentially exposed to cadmium and from two control populations matched for socioeconomic status.
The excretion of alpha-1-microglobulin/24 h ranged from 0.1 mg to 176.3 mg and 44.4% of samples showed concentrations near the detection limit. Ordinal logistic regression analysis of people of all ages identified a high risk only for males compared with females (odds ratio (OR) 2.14; 95% confidence interval (95% CI) 1.56 to 2.94), age group, and duration of living on contaminated soil (OR 1.03/year; 95% CI 1.02 to 1.04), but not urinary cadmium excretion (OR 1.30; 95% CI 0.96 to 1.77) as significant predictors. For people < or = 50 years of age a weaker effect of sex (OR 1.76; 95% CI 1.13 to 2.73) and age group and an effect of similar magnitude for the duration of soil exposure (OR 1.03; 95% CI 1.01 to 1.04) were found. Also, the urinary cadmium excretion (OR 2.26; 95% CI 1.38 to 3.70) and occupational exposure (OR 1.71; 95% CI 1.03 to 2.83) were found to be significant in this younger age group. The estimated creatinine clearance had no significant impact on the alpha-1-microglobulin excretion.
alpha-1-Microglobulin is a suitable marker for early tubular changes only for people < or = 50 years. It may not be sufficiently specific for cadmium, and therefore not a suitable surrogate for cadmium exposure in epidemiological studies.
评估α1微球蛋白作为镉诱导的肾功能障碍标志物的适用性。
在一项横断面调查中，研究了α1微球蛋白与镉体内负荷的关系。分析了831名年龄在2至87岁的人群24小时尿液中α1微球蛋白的浓度，并将其与尿镉排泄量、血镉浓度、年龄、性别、职业和吸烟史以及估计的肌酐清除率相关联。参与者来自一个居住环境受镉污染的人群以及两个社会经济地位匹配的对照人群。
α1微球蛋白/24小时的排泄量范围为0.1毫克至176.3毫克，44.4%的样本显示浓度接近检测限。对所有年龄段人群进行的有序逻辑回归分析表明，与女性相比，仅男性存在高风险（优势比（OR）为2.14；95%置信区间（95%CI）为1.56至2.94），此外还有年龄组以及在受污染土壤上居住的时长（OR为1.03/年；95%CI为1.02至1.04），但尿镉排泄量（OR为1.30；95%CI为0.96至1.77）并非显著预测因素。对于年龄≤50岁的人群，发现性别影响较弱（OR为1.76；95%CI为1.13至2.73）以及年龄组影响，并且土壤暴露时长的影响幅度相似（OR为1.03；95%CI为1.01至1.04）。此外，在这个较年轻的年龄组中，尿镉排泄量（OR为2.26；95%CI为1.38至3.70）和职业暴露（OR为1.71；95%CI为1.03至2.83）也具有显著性。估计的肌酐清除率对α1微球蛋白排泄量没有显著影响。
α1微球蛋白仅对年龄≤50岁的人群是早期肾小管变化的合适标志物。它对镉的特异性可能不足，因此在流行病学研究中不是镉暴露合适的替代指标。
