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Satarug S. Is Chronic Kidney Disease Due to Cadmium Exposure Inevitable and Can It Be Reversed? Biomedicines 2024; 12:718. [PMID: 38672074 PMCID: PMC11048639 DOI: 10.3390/biomedicines12040718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/09/2024] [Accepted: 03/21/2024] [Indexed: 04/28/2024] Open
Abstract
Cadmium (Cd) is a metal with no nutritional value or physiological role. However, it is found in the body of most people because it is a contaminant of nearly all food types and is readily absorbed. The body burden of Cd is determined principally by its intestinal absorption rate as there is no mechanism for its elimination. Most acquired Cd accumulates within the kidney tubular cells, where its levels increase through to the age of 50 years but decline thereafter due to its release into the urine as the injured tubular cells die. This is associated with progressive kidney disease, which is signified by a sustained decline in the estimated glomerular filtration rate (eGFR) and albuminuria. Generally, reductions in eGFR after Cd exposure are irreversible, and are likely to decline further towards kidney failure if exposure persists. There is no evidence that the elimination of current environmental exposure can reverse these effects and no theoretical reason to believe that such a reversal is possible. This review aims to provide an update on urinary and blood Cd levels that were found to be associated with GFR loss and albuminuria in the general populations. A special emphasis is placed on the mechanisms underlying albumin excretion in Cd-exposed persons, and for an accurate measure of the doses-response relationships between Cd exposure and eGFR, its excretion rate must be normalised to creatinine clearance. The difficult challenge of establishing realistic Cd exposure guidelines such that human health is protected, is discussed.
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Affiliation(s)
- Soisungwan Satarug
- Kidney Disease Research Collaborative, Translational Research Institute, Woolloongabba, Brisbane, QLD 4102, Australia
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Chen H, Cheng J, Li Y, Li Y, Wang J, Tang Z. Occurrence and potential release of heavy metals in female underwear manufactured in China: Implication for women's health. CHEMOSPHERE 2023; 342:140165. [PMID: 37709063 DOI: 10.1016/j.chemosphere.2023.140165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/04/2023] [Accepted: 09/11/2023] [Indexed: 09/16/2023]
Abstract
Underwear is a potential source of women's exposure to heavy metals owing to its direct contact with the skin, especially the skin of the vagina and vulva, which has a strong absorptive capacity. However, information regarding the prevalence of metals in female underwear, and its potential hazards, remains scarce. In the present study, we examined the concentrations and potential release of Cr, Co, Ni, Cu, As, Cd, Sb, and Pb in brassieres and briefs manufactured in China. We detected higher levels of Pb and moderate levels of other metals, relative to the metal levels reported for other textiles in the literature. Cu, As, Ni and Cd, had higher migration rates (MRs) from the underwear, with medians of 100%, 100%, 30.1%, and 20.7%, respectively. The median MRs of the other metals were in the range 1.07%-15.7%. On the whole, the total and extractable concentrations of these metals differed by item and fabric type. The pollution of raw materials and the use of chemical additives containing metals commonly contributed to the metals in the underwear. On the basis of the exposure estimation, the non-carcinogenic risks posed by the underwear metals were acceptable, but the carcinogenic risks from the metals in 5.18% of brassiere samples exceeded the acceptable level.
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Affiliation(s)
- Hanzhi Chen
- Key Laboratory of Ecology and Environment in Minority Areas (Minzu University of China), National Ethnic Affairs Commission, Beijing, 100081, China; College of Life and Environmental Sciences, Minzu University of China, Beijing, 100081, China; School of Biological, Earth and Environmental Sciences, University College Cork, Distillery Fields, North Mall, T23 N73K, Cork, Ireland.
| | - Jiali Cheng
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China.
| | - Yuan Li
- Key Laboratory of Ecology and Environment in Minority Areas (Minzu University of China), National Ethnic Affairs Commission, Beijing, 100081, China; College of Life and Environmental Sciences, Minzu University of China, Beijing, 100081, China.
| | - Yonghong Li
- Key Laboratory of Ecology and Environment in Minority Areas (Minzu University of China), National Ethnic Affairs Commission, Beijing, 100081, China; College of Life and Environmental Sciences, Minzu University of China, Beijing, 100081, China.
| | - Jiayu Wang
- Key Laboratory of Ecology and Environment in Minority Areas (Minzu University of China), National Ethnic Affairs Commission, Beijing, 100081, China; College of Life and Environmental Sciences, Minzu University of China, Beijing, 100081, China.
| | - Zhenwu Tang
- Key Laboratory of Ecology and Environment in Minority Areas (Minzu University of China), National Ethnic Affairs Commission, Beijing, 100081, China; College of Life and Environmental Sciences, Minzu University of China, Beijing, 100081, China.
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Huang Y, Wan Z, Zhang M, Hu L, Song L, Wang Y, Lv Y, Wang L. The association between urinary metals/metalloids and chronic kidney disease among general adults in Wuhan, China. Sci Rep 2023; 13:15321. [PMID: 37714886 PMCID: PMC10504376 DOI: 10.1038/s41598-023-42282-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/07/2023] [Indexed: 09/17/2023] Open
Abstract
The relation between exposure to single metal/metalloid and the risk of chronic kidney disease (CKD) remains unclear. We aimed to determine the single and mixed associations of 21 heavy metals/metalloids exposure and the risk of CKD. We performed a cross-sectional study that recruited 4055 participants. Multivariate logistic regression, linear regression and weighted quantile sum (WQS) regression were conducted to explore the possible effects of single and mixed metals/metalloids exposure on the risk of CKD, the risk of albuminuria and changes in the estimated glomerular filtration rate (eGFR). In single-metal models, Cu, Fe, and Zn were positively associated with increased risks of CKD (P-trend < 0.05). Compared to the lowest level, the highest quartiles of Cu (OR = 2.94; 95% CI: 1.70, 5.11; P-trend < 0.05), Fe (OR = 2.39; 95% CI: 1.42, 4.02; P-trend < 0.05), and Zn (OR = 2.35; 95% CI: 1.31, 4.24; P-trend < 0.05) were associated with an increased risk of CKD. After multi-metal adjustment, the association with the risk of CKD remained robust for Cu (P < 0.05). Weighted quantile sum regression revealed a positive association between mixed metals/metalloids and the risk of CKD, and the association was largely driven by Cu (43.7%). Specifically, the mixture of urinary metals/metalloids was positively associated with the risk of albuminuria and negatively associated with eGFR.
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Affiliation(s)
- Yuchai Huang
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhengce Wan
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Mingye Zhang
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liu Hu
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lulu Song
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Youjie Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yongman Lv
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Le Wang
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, Hubei, China.
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Smereczański NM, Brzóska MM, Rogalska J, Hutsch T. The Protective Potential of Aronia melanocarpa L. Berry Extract against Cadmium-Induced Kidney Damage: A Study in an Animal Model of Human Environmental Exposure to This Toxic Element. Int J Mol Sci 2023; 24:11647. [PMID: 37511414 PMCID: PMC10381010 DOI: 10.3390/ijms241411647] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
The impact of cadmium (Cd) on the function and structure of the kidney and the potential protective effect of an extract from Aronia melanocarpa L. berries were investigated in a rat model of low- and moderate-level environmental exposure to this heavy metal (1 and 5 mg Cd/kg feed for up to 24 months). The sensitive biomarkers of Cd-induced damage to the kidney tubules (N-acetyl-β-D-glucosaminidase (NAG), alkaline phosphatase (ALP), β2-microglobulin (β2-MG), and kidney injury molecule-1 (KIM-1) in the urine), clinically relevant early markers of glomerular damage (albumin in the urine and creatinine clearance), and other markers of the general functional status of this organ (urea, uric acid, and total protein in the serum and/or urine) and Cd concentration in the urine, were evaluated. The morphological structure of the kidney and inflammatory markers (chemerin, macrophage inflammatory protein 1 alpha (MIP1a), and Bcl2-associated X protein (Bax)) were also estimated. Low-level and moderate exposure to Cd led to damage to the function and structure of the kidney tubules and glomeruli. The co-administration of A. melanocarpa berry extract significantly protected against the injurious impact of this toxic element. In conclusion, even low-level, long-term exposure to Cd poses a risk of kidney damage, whereas an intake of Aronia berry products may effectively protect from this outcome.
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Affiliation(s)
- Nazar M Smereczański
- Department of Toxicology, Medical University of Bialystok, Adama Mickiewicza 2C Street, 15-222 Bialystok, Poland
| | - Małgorzata M Brzóska
- Department of Toxicology, Medical University of Bialystok, Adama Mickiewicza 2C Street, 15-222 Bialystok, Poland
| | - Joanna Rogalska
- Department of Toxicology, Medical University of Bialystok, Adama Mickiewicza 2C Street, 15-222 Bialystok, Poland
| | - Tomasz Hutsch
- Department of Pathology and Veterinary Diagnostics, Institute of Veterinary Medicine, Warsaw University of Life Sciences, Nowoursynowska 159C Street, 02-776 Warsaw, Poland
- Veterinary Diagnostic Laboratory ALAB Bioscience, Stępińska 22/30 Street, 00-739 Warsaw, Poland
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Yimthiang S, Vesey DA, Pouyfung P, Khamphaya T, Gobe GC, Satarug S. Chronic Kidney Disease Induced by Cadmium and Diabetes: A Quantitative Case-Control Study. Int J Mol Sci 2023; 24:ijms24109050. [PMID: 37240395 DOI: 10.3390/ijms24109050] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/18/2023] [Accepted: 05/20/2023] [Indexed: 05/28/2023] Open
Abstract
Kidney disease associated with chronic cadmium (Cd) exposure is primarily due to proximal tubule cell damage. This results in a sustained decline in glomerular filtration rate (GFR) and tubular proteinuria. Similarly, diabetic kidney disease (DKD) is marked by albuminuria and a declining GFR and both may eventually lead to kidney failure. The progression to kidney disease in diabetics exposed to Cd has rarely been reported. Herein, we assessed Cd exposure and the severity of tubular proteinuria and albuminuria in 88 diabetics and 88 controls, matched by age, gender and locality. The overall mean blood and Cd excretion normalized to creatinine clearance (Ccr) as ECd/Ccr were 0.59 µg/L and 0.0084 µg/L filtrate (0.96 µg/g creatinine), respectively. Tubular dysfunction, assessed by β2-microglobulin excretion rate normalized to Ccr(Eβ2M/Ccr) was associated with both diabetes and Cd exposure. Doubling of Cd body burden, hypertension and a reduced estimated GFR (eGFR) increased the risks for a severe tubular dysfunction by 1.3-fold, 2.6-fold, and 84-fold, respectively. Albuminuria did not show a significant association with ECd/Ccr, but hypertension and eGFR did. Hypertension and a reduced eGFR were associated with a 3-fold and 4-fold increases in risk of albuminuria. These findings suggest that even low levels of Cd exposure exacerbate progression of kidney disease in diabetics.
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Affiliation(s)
- Supabhorn Yimthiang
- Occupational Health and Safety, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - David A Vesey
- The Centre for Kidney Disease Research, Translational Research Institute, Brisbane 4102, Australia
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane 4102, Australia
| | - Phisit Pouyfung
- Occupational Health and Safety, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Tanaporn Khamphaya
- Occupational Health and Safety, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Glenda C Gobe
- The Centre for Kidney Disease Research, Translational Research Institute, Brisbane 4102, Australia
- School of Biomedical Sciences, The University of Queensland, Brisbane 4072, Australia
- NHMRC Centre of Research Excellence for CKD QLD, UQ Health Sciences, Royal Brisbane and Women's Hospital, Brisbane 4029, Australia
| | - Soisungwan Satarug
- The Centre for Kidney Disease Research, Translational Research Institute, Brisbane 4102, Australia
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Smereczański NM, Brzóska MM. Current Levels of Environmental Exposure to Cadmium in Industrialized Countries as a Risk Factor for Kidney Damage in the General Population: A Comprehensive Review of Available Data. Int J Mol Sci 2023; 24:ijms24098413. [PMID: 37176121 PMCID: PMC10179615 DOI: 10.3390/ijms24098413] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
The growing number of reports indicating unfavorable outcomes for human health upon environmental exposure to cadmium (Cd) have focused attention on the threat to the general population posed by this heavy metal. The kidney is a target organ during chronic Cd intoxication. The aim of this article was to critically review the available literature on the impact of the current levels of environmental exposure to this xenobiotic in industrialized countries on the kidney, and to evaluate the associated risk of organ damage, including chronic kidney disease (CKD). Based on a comprehensive review of the available data, we recognized that the observed adverse effect levels (NOAELs) of Cd concentration in the blood and urine for clinically relevant kidney damage (glomerular dysfunction) are 0.18 μg/L and 0.27 μg/g creatinine, respectively, whereas the lowest observed adverse effect levels (LOAELs) are >0.18 μg/L and >0.27 μg/g creatinine, respectively, which are within the lower range of concentrations noted in inhabitants of industrialized countries. In conclusion, the current levels of environmental exposure to Cd may increase the risk of clinically relevant kidney damage, resulting in, or at least contributing to, the development of CKD.
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Affiliation(s)
- Nazar M Smereczański
- Department of Toxicology, Medical University of Bialystok, Adama Mickiewicza 2C Street, 15-222 Bialystok, Poland
| | - Małgorzata M Brzóska
- Department of Toxicology, Medical University of Bialystok, Adama Mickiewicza 2C Street, 15-222 Bialystok, Poland
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Satarug S, Yimthiang S, Pouyfung P, Khamphaya T, Vesey DA. Cadmium-Induced Tubular Dysfunction in Type 2 Diabetes: A Population-Based Cross-Sectional Study. TOXICS 2023; 11:390. [PMID: 37112617 PMCID: PMC10144654 DOI: 10.3390/toxics11040390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/24/2023] [Accepted: 04/20/2023] [Indexed: 06/19/2023]
Abstract
The global prevalence of diabetes, and its major complication, diabetic nephropathy, have reached epidemic proportions. The toxic metal cadmium (Cd) also induces nephropathy, indicated by a sustained reduction in the estimated glomerular filtration rate (eGFR) and the excretion of β2-microglobulin (β2M) above 300 µg/day, which reflects kidney tubular dysfunction. However, little is known about the nephrotoxicity of Cd in the diabetic population. Here, we compared Cd exposure, eGFR, and tubular dysfunction in both diabetics (n = 81) and non-diabetics (n = 593) who were residents in low- and high-Cd exposure areas of Thailand. We normalized the Cd and β2M excretion rates (ECd and Eβ2M) to creatinine clearance (Ccr) as ECd/Ccr and Eβ2M/Ccr. Tubular dysfunction and a reduced eGFR were, respectively, 8.7-fold (p < 0.001) and 3-fold (p = 0.012) more prevalent in the diabetic than the non-diabetic groups. The doubling of ECd/Ccr increased the prevalence odds ratios for a reduced eGFR and tubular dysfunction by 50% (p < 0.001) and 15% (p = 0.002), respectively. In a regression model analysis of diabetics from the low-exposure locality, Eβ2M/Ccr was associated with ECd/Ccr (β = 0.375, p = 0.001) and obesity (β = 0.273, p = 0.015). In the non-diabetic group, Eβ2M/Ccr was associated with age (β = 0.458, p < 0.001) and ECd/Ccr (β = 0.269, p < 0.001). However, after adjustment for age, and body mass index (BMI), Eβ2M/Ccr was higher in the diabetics than non-diabetics of similar ECd/Ccr ranges. Thus, tubular dysfunction was more severe in diabetics than non-diabetics of similar age, BMI, and Cd body burden.
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Affiliation(s)
- Soisungwan Satarug
- The Centre for Kidney Disease Research, Translational Research Institute, Brisbane 4102, Australia
| | - Supabhorn Yimthiang
- Occupational Health and Safety, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Phisit Pouyfung
- Occupational Health and Safety, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Tanaporn Khamphaya
- Occupational Health and Safety, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - David A. Vesey
- The Centre for Kidney Disease Research, Translational Research Institute, Brisbane 4102, Australia
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane 4102, Australia
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Xu P, Lai S, Wu L, Chen W, Chen Y, Xu D, Xiang J, Cheng P, Chen Z, Wang X, Lou X, Tang J. Insights into the health status of the general population living near an electroplating industry zone: metal elevations and renal impairment. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:31905-31915. [PMID: 36459323 DOI: 10.1007/s11356-022-24411-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
A cross-sectional study was conducted in 2016 in Zhejiang Province, China, to evaluate the body burdens of metals and metalloids associated with renal dysfunction in populations living near electroplating industries. We recruited 236 subjects and performed physical examinations, determined the blood and urinary levels of arsenic (As), cadmium (Cd), chromium (Cr), manganese (Mn), nickel (Ni), lead (Pb), antimony (Sb), and selenium (Se) by an inductively coupled plasma mass spectrometer (ICP-MS), and measured three renal impairment biomarkers, namely nacetyl-β-D-glucosaminidase (NAG), retinol-binding protein (RBP), and β2-microglobulin (BMG). The proportion of abnormal nasal symptoms in the exposure group (10.1%) was much higher than in the control group (0; p < 0.05). The blood and urinary levels of As, Cd, and Se in the exposure group were significantly higher than those in the control group (p < 0.05). The blood levels of Mn and Pb, as well as the urinary levels of Cr and Ni, were significantly higher in the exposure group than in the control group (p < 0.05). The exposure group demonstrated higher levels of NAG, RBP, and BMG than the control group (0.51 vs. 0.14 mg/g creatinine, 12.79 vs. 9.26 IU/g creatinine, and 1.39 vs. 0.78 mg/g creatinine, respectively; p < 0.05). Urinary BMG was positively correlated with urinary Cd levels (r = 0.223, p < 0.05), while urinary RBP was correlated with blood Cd levels (r = 0.151, p < 0.05) and urinary Cd, Cr, Ni, and Se levels (r = 0.220, 0.303, 0.162, and 0.306, respectively; p < 0.05). In conclusion, our study indicated that a population living in the vicinity of electroplating industries had high body burdens of certain metals and metalloids associated with non-negligible renal dysfunction.
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Affiliation(s)
- Peiwei Xu
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Shiming Lai
- Quzhou Center for Disease Control and Prevention, 154 Xi'an Road, Xin'an District, Quzhou, 324003, China
| | - Lizhi Wu
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Weizhong Chen
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Yuan Chen
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Dandan Xu
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Jie Xiang
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Ping Cheng
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Zhijian Chen
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Xiaofeng Wang
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Xiaoming Lou
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Jun Tang
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China.
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Nguyen HD. Effects of mixed heavy metals on kidney function in premenopausal and postmenopausal women. Menopause 2023; 30:296-305. [PMID: 36728565 DOI: 10.1097/gme.0000000000002131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To evaluate the relationships between heavy metals (cadmium, lead, and mercury) and their mixtures and estimated glomerular filtration rate (eGFR) in premenopausal and postmenopausal women. METHODS Using data from the Korean National Health and Nutrition Examination Survey (2009-2017), multivariate linear regression models, marginal effects, and weighted quantile sum regression, we assessed the associations between single heavy metals and their mixtures and eGFR among 5,372 women. RESULTS Risks of reduced eGFR, comorbidities, and heavy metal exposure were found to be higher in postmenopausal women than in premenopausal women. A negative association of cadmium ( β = -2.97; 95% CI, -5.10 to -0.85) and a positive association of mercury ( β = 2.97; 95% CI, 1.49 to 4.44), with eGFR in postmenopausal women. Inverse associations of lead with eGFR in both premenopausal women ( β = -4.75; 95% CI, -6.04 to -3.46) and postmenopausal women ( β = -4.54; 95% CI, -6.96 to -2.13). Interactions were identified between lead and mercury, as well as cadmium and lead for eGFR among premenopausal women ( β = -2.04; 95% CI, -2.98 to -1.10) and postmenopausal women ( β = -3.52; 95% CI, -6.04 to -1.01), respectively. There was a negative association between mixed heavy metals and eGFR in both premenopausal women ( β = -2.23; 95% CI, -3.51 to -0.96) and postmenopausal women ( β = -3.86; 95% CI, -6.89 to -0.83). Lead was found as a key chemical related to reduced eGFR. Cutoff values for each heavy metal concentration related to eGFR were provided. CONCLUSION Postmenopausal women were more influenced by mixed heavy metals' effects on kidney function than premenopausal women. Early interventions (eg, water filtering, heavy metal yearly screening) in women, especially postmenopausal women, are needed to reduce the incidence of chronic kidney disease.
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Affiliation(s)
- Hai Duc Nguyen
- From the Department of Pharmacy, College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Sunchon, Jeonnam, Republic of Korea
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10
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Satarug S, Vesey DA, Gobe GC, Phelps KR. Estimation of health risks associated with dietary cadmium exposure. Arch Toxicol 2023; 97:329-358. [PMID: 36592197 DOI: 10.1007/s00204-022-03432-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 12/13/2022] [Indexed: 01/03/2023]
Abstract
In much of the world, currently employed upper limits of tolerable intake and acceptable excretion of cadmium (Cd) (ECd/Ecr) are 0.83 µg/kg body weight/day and 5.24 µg/g creatinine, respectively. These figures were derived from a risk assessment model that interpreted β2-microglobulin (β2MG) excretion > 300 μg/g creatinine as a "critical" endpoint. However, current evidence suggests that Cd accumulation reduces glomerular filtration rate at values of ECd/Ecr much lower than 5.24 µg/g creatinine. Low ECd/Ecr has also been associated with increased risks of kidney disease, type 2 diabetes, osteoporosis, cancer, and other disorders. These associations have cast considerable doubt on conventional guidelines. The goals of this paper are to evaluate whether these guidelines are low enough to minimize associated health risks reliably, and indeed whether permissible intake of a cumulative toxin like Cd is a valid concept. We highlight sources and levels of Cd in the human diet and review absorption, distribution, kidney accumulation, and excretion of the metal. We present evidence for the following propositions: excreted Cd emanates from injured tubular epithelial cells of the kidney; Cd excretion is a manifestation of current tissue injury; reduction of present and future exposure to environmental Cd cannot mitigate injury in progress; and Cd excretion is optimally expressed as a function of creatinine clearance rather than creatinine excretion. We comprehensively review the adverse health effects of Cd and urine and blood Cd levels at which adverse effects have been observed. The cumulative nature of Cd toxicity and the susceptibility of multiple organs to toxicity at low body burdens raise serious doubt that guidelines concerning permissible intake of Cd can be meaningful.
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Affiliation(s)
- Soisungwan Satarug
- Kidney Disease Research Collaborative, Level 5, Translational Research Institute, Brisbane, QLD, Australia.
| | - David A Vesey
- Kidney Disease Research Collaborative, Level 5, Translational Research Institute, Brisbane, QLD, Australia
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Glenda C Gobe
- Kidney Disease Research Collaborative, Level 5, Translational Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia
- NHMRC Centre of Research Excellence for CKD QLD, UQ Health Sciences, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Kenneth R Phelps
- Stratton Veterans Affairs Medical Center and Albany Medical College, Albany, NY, USA
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Grau-Perez M, Domingo-Relloso A, Garcia-Barrera T, Gomez-Ariza JL, Leon-Latre M, Casasnovas JA, Moreno-Franco B, Laclaustra M, Guallar E, Navas-Acien A, Pastor-Barriuso R, Redon J, Tellez-Plaza M. Association of single and joint metals with albuminuria and estimated glomerular filtration longitudinal change in middle-aged adults from Spain: The Aragon workers health study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 318:120851. [PMID: 36509352 DOI: 10.1016/j.envpol.2022.120851] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
The nephrotoxicity of low-chronic metal exposures is unclear, especially considering several metals simultaneously. We assessed the individual and joint association of metals with longitudinal change in renal endpoints in Aragon Workers Health Study participants with available measures of essential (cobalt [Co], copper [Cu], molybdenum [Mo] and zinc [Zn]) and non-essential (As, barium [Ba], Cd, chromium [Cr], antimony [Sb], titanium [Ti], uranium [U], vanadium [V] and tungsten [W]) urine metals and albumin-to-creatinine ratio (ACR) (N = 707) and estimated glomerular filtration rate (eGFR) (N = 1493) change. Median levels were 0.24, 7.0, 18.6, 295, 3.1, 1.9, 0.28, 1.16, 9.7, 0.66, 0.22 μg/g for Co, Cu, Mo, Zn, As, Ba, Cd, Cr, Sb, Ti, V and W, respectively, and 52.5 and 27.2 ng/g for Sb and U, respectively. In single metal analysis, higher As, Cr and W concentrations were associated with increasing ACR annual change. Higher Zn, As and Cr concentrations were associated with decreasing eGFR annual change. The shape of the longitudinal dose-responses, however, was compatible with a nephrotoxic role for all metals, both in ACR and eGFR models. In joint metal analysis, both higher mixtures of Cu-Zn-As-Ba-Ti-U-V-W and Co-Cd-Cr-Sb-V-W showed associations with increasing ACR and decreasing eGFR annual change. As and Cr were main drivers of the ACR change joint metal association. For the eGFR change joint metal association, while Zn and Cr were main drivers, other metals also contributed substantially. We identified potential interactions for As, Zn and W by other metals with ACR change, but not with eGFR change. Our findings support that Zn, As, Cr and W and suggestively other metals, are nephrotoxic at relatively low exposure levels. Metal exposure reduction and mitigation interventions may improve prevention and decrease the burden of renal disease in the population.
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Affiliation(s)
- Maria Grau-Perez
- Cardiometabolic and Renal Risk Unit, Biomedical Research Institute INCLIVA, Valencia, Spain; Department of Preventive Medicine and Microbiology, Universidad Autonoma de Madrid, Madrid, Spain; Department of Statistics and Operations Research, University of Valencia, Valencia, Spain.
| | - Arce Domingo-Relloso
- Department of Statistics and Operations Research, University of Valencia, Valencia, Spain; Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Carlos III Health Institutes, Madrid, Spain; Department of Environmental Health Sciences, Columbia University, New York, NY, USA
| | - Tamara Garcia-Barrera
- Research Center for Natural Resources, Health and the Environment (RENSMA), University of Huelva, Spain
| | - Jose L Gomez-Ariza
- Research Center for Natural Resources, Health and the Environment (RENSMA), University of Huelva, Spain
| | - Montserrat Leon-Latre
- Universidad de Zaragoza, Instituto de Investigación Sanitaria Aragón e Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain
| | - J Antonio Casasnovas
- Universidad de Zaragoza, Instituto de Investigación Sanitaria Aragón e Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain
| | - Belen Moreno-Franco
- Universidad de Zaragoza, Instituto de Investigación Sanitaria Aragón e Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain
| | - Martin Laclaustra
- Universidad de Zaragoza, Instituto de Investigación Sanitaria Aragón e Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain
| | - Eliseo Guallar
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University, New York, NY, USA
| | - Roberto Pastor-Barriuso
- Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Carlos III Health Institutes, Madrid, Spain
| | - Josep Redon
- Cardiometabolic and Renal Risk Unit, Biomedical Research Institute INCLIVA, Valencia, Spain; CIBERObn, Carlos III Health Institutes, Madrid, Spain
| | - Maria Tellez-Plaza
- Department of Preventive Medicine and Microbiology, Universidad Autonoma de Madrid, Madrid, Spain; Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Carlos III Health Institutes, Madrid, Spain
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12
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Hu W, Li G, He J, Zhao H, Zhang H, Lu H, Liu J, Huang F. Association of exposure to multiple serum metals with the risk of chronic kidney disease in the elderly: a population-based case-control study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:17245-17256. [PMID: 36194333 DOI: 10.1007/s11356-022-23303-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
In the world, chronic kidney disease (CKD) has been recognized as one of the critical public health problems, and the prevalence is higher in the elderly people. However, there are few studies on the association between exposure to multiple serum metal levels and CKD. A case-control study, we established, for elderly people in Anhui Province, China, to explore the effects of different metals and analyze the effect of mixed exposure on CKD. In this study, 287 cases of CKD and 287 controls were selected in the elderly health physical examination project in Tongling City, Anhui Province. Questionnaire survey, physical examination, and blood collection were conducted. Graphite furnace atomic absorption spectrometry (GFAAS) and inductively coupled plasma optical emission spectrometry (ICP-OES) were used to measure the concentration of serum metals. After selecting by least absolute shrinkage and selection operator (LASSO), 5 metals were brought into the multi-metal model. After adjusting all potential covariates additionally, the concentrations of lead (Pb), cadmium (Cd), cobalt (Co), and manganese (Mn) were significantly associated with CKD risk, whereas Pb, Se, and Cd had significant non-linearity with CKD. Besides, patients with highest quartiles of cobalt (Co), lead (Pb), and manganese (Mn) were 1.64, 1.39, and 0.64 times more possible to have CKD, respectively, as compared with the lowest levels. In the Bayesian kernel machine regression (BKMR) model, cadmium (Cd) had a combined effect with lead (Pb) possibly. This study suggested that the CKD risk was associated with exposure of multiple metals in elderly people. The underlying mechanisms of serum metals and CKD need more experimental and prospective studies to elucidate.
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Affiliation(s)
- Wenlei Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Guoao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Jialiu He
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Huanhuan Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Hanshuang Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Huanhuan Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Jianjun Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China.
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13
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Cadmium-Induced Proteinuria: Mechanistic Insights from Dose-Effect Analyses. Int J Mol Sci 2023; 24:ijms24031893. [PMID: 36768208 PMCID: PMC9915107 DOI: 10.3390/ijms24031893] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/21/2023] Open
Abstract
Cadmium (Cd) is a toxic metal that accumulates in kidneys, especially in the proximal tubular epithelial cells, where virtually all proteins in the glomerular ultrafiltrate are reabsorbed. Here, we analyzed archived data on the estimated glomerular filtration rate (eGFR) and excretion rates of Cd (ECd), total protein (EProt), albumin (Ealb), β2-microglobulin (Eβ2M), and α1-microglobulin (Eα1M), which were recorded for residents of a Cd contamination area and a low-exposure control area of Thailand. Excretion of Cd and all proteins were normalized to creatinine clearance (Ccr) as ECd/Ccr and EProt/Ccr to correct for differences among subjects in the number of surviving nephrons. Low eGFR was defined as eGFR ≤ 60 mL/min/1.73 m2, while proteinuria was indicted by EPro/Ccr ≥ 20 mg/L of filtrate. EProt/Ccr varied directly with ECd/Ccr (β = 0.263, p < 0.001) and age (β = 0.252, p < 0.001). In contrast, eGFR values were inversely associated with ECd/Ccr (β = -0.266, p < 0.001) and age (β = -0.558, p < 0.001). At ECd/Ccr > 8.28 ng/L of filtrate, the prevalence odds ratios for proteinuria and low eGFR were increased 4.6- and 5.1-fold, respectively (p < 0.001 for both parameters). Thus, the eGFR and tubular protein retrieval were both simultaneously diminished by Cd exposure. Of interest, ECd/Ccr was more closely correlated with EProt/Ccr (r = 0.507), Eβ2M (r = 0.430), and Eα1M/Ccr (r = 0.364) than with EAlb/Ccr (r = 0.152). These data suggest that Cd may differentially reduce the ability of tubular epithelial cells to reclaim proteins, resulting in preferential reabsorption of albumin.
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14
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Satarug S, Vesey DA, Gobe GC, Yimthiang S, Buha Đorđević A. Health Risk in a Geographic Area of Thailand with Endemic Cadmium Contamination: Focus on Albuminuria. TOXICS 2023; 11:68. [PMID: 36668794 PMCID: PMC9866753 DOI: 10.3390/toxics11010068] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
An increased level of cadmium (Cd) in food crops, especially rice is concerning because rice is a staple food for over half of the world’s population. In some regions, rice contributes to more than 50% of the total Cd intake. Low environmental exposure to Cd has been linked to an increase in albumin excretion to 30 mg/g creatinine, termed albuminuria, and a progressive reduction in the estimated glomerular filtration rate (eGFR) to below 60 mL/min/1.73 m2, termed reduced eGFR. However, research into albuminuria in high exposure conditions is limited. Here, we applied benchmark dose (BMD) analysis to the relevant data recorded for the residents of a Cd contamination area and a low-exposure control area. We normalized the excretion rates of Cd (ECd) and albumin (Ealb) to creatinine clearance (Ccr) as ECd/Ccr and Ealb/Ccr to correct for differences among subjects in the number of surviving nephrons. For the first time, we defined the excretion levels of Cd associated with clinically relevant adverse kidney health outcomes. Ealb/Ccr varied directly with ECd/Ccr (β = 0.239, p < 0.001), and age (β = 0.203, p < 0.001), while normotension was associated with lower Ealb/Ccr (β = −0.106, p = 0.009). ECd/Ccr values between 16.5 and 35.5 ng/L of the filtrate were associated with a 10% prevalence of albuminuria, while the ECd/Ccr value of 59 ng/L of the filtrate was associated with a 10% prevalence of reduced eGFR. Thus, increased albumin excretion and eGFR reduction appeared to occur at low body burdens, and they should form toxicity endpoints suitable for the calculation of health risk due to the Cd contamination of food chains.
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Affiliation(s)
- Soisungwan Satarug
- Kidney Disease Research Collaborative, Translational Research Institute, Brisbane 4102, Australia
| | - David A. Vesey
- Kidney Disease Research Collaborative, Translational Research Institute, Brisbane 4102, Australia
- Department of Nephrology, Princess Alexandra Hospital, Brisbane 4102, Australia
| | - Glenda C. Gobe
- Kidney Disease Research Collaborative, Translational Research Institute, Brisbane 4102, Australia
- School of Biomedical Sciences, The University of Queensland, Brisbane 4072, Australia
- NHMRC Centre of Research Excellence for CKD QLD, UQ Health Sciences, Royal Brisbane and Women’s Hospital, Brisbane 4029, Australia
| | - Supabhorn Yimthiang
- Occupational Health and Safety, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Aleksandra Buha Đorđević
- Department of Toxicology “Akademik Danilo Soldatović”, University of Belgrade-Faculty of Pharmacy, 11000 Belgrade, Serbia
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15
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BAÑERAS J, IGLESIES-GRAU J, TÉLLEZ-PLAZA M, ARRARTE V, BÁEZ-FERRER N, BENITO B, CAMPUZANO RUIZ R, CECCONI A, DOMÍNGUEZ-RODRÍGUEZ A, RODRÍGUEZ-SINOVAS A, UJUETA F, VOZZI C, LAMAS GA, NAVAS-ACIÉN A. [Environment and cardiovascular health: causes, consequences and opportunities in prevention and treatment]. Rev Esp Cardiol 2022; 75:1050-1058. [PMID: 36570815 PMCID: PMC9785336 DOI: 10.1016/j.recesp.2022.05.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The environment is a strong determinant of cardiovascular health. Environmental cardiology studies the contribution of environmental exposures with the aim of minimizing the harmful influences of pollution and promoting cardiovascular health through specific preventive or therapeutic strategies. The present review focuses on particulate matter and metals, which are the pollutants with the strongest level of scientific evidence, and includes possible interventions. Legislation, mitigation and control of pollutants in air, water and food, as well as environmental policies for heart-healthy spaces, are key measures for cardiovascular health. Individual strategies include the chelation of divalent metals such as lead and cadmium, metals that can only be removed from the body via chelation. The TACT (Trial to Assess Chelation Therapy, NCT00044213) clinical trial demonstrated cardiovascular benefit in patients with a previous myocardial infarction, especially in those with diabetes. Currently, the TACT2 trial (NCT02733185) is replicating the TACT results in people with diabetes. Data from the United States and Argentina have also shown the potential usefulness of chelation in severe peripheral arterial disease. More research and action in environmental cardiology could substantially help to improve the prevention and treatment of cardiovascular disease.
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Affiliation(s)
- Jordi BAÑERAS
- Servei de Cardiologia, Hospital Universitari Vall d’Hebron, Vall d’Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, España
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), España
| | - Josep IGLESIES-GRAU
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canadá
| | - María TÉLLEZ-PLAZA
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España
| | - Vicente ARRARTE
- Servicio de Cardiología, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, España
| | - Néstor BÁEZ-FERRER
- Servicio de Cardiología, Hospital Universitario de Canarias, Universidad Europea de Canarias, Santa Cruz de Tenerife, España
| | - Begoña BENITO
- Servei de Cardiologia, Hospital Universitari Vall d’Hebron, Vall d’Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, España
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), España
| | - Raquel CAMPUZANO RUIZ
- Servicio de Cardiología, Hospital Universitario Fundación de Alcorcón, Alcorcón, Madrid, España
| | - Alberto CECCONI
- Servicio de Cardiología, Hospital Universitario de la Princesa, Madrid, España
| | - Alberto DOMÍNGUEZ-RODRÍGUEZ
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), España
- Servicio de Cardiología, Hospital Universitario de Canarias, Universidad Europea de Canarias, Santa Cruz de Tenerife, España
| | - Antonio RODRÍGUEZ-SINOVAS
- Servei de Cardiologia, Hospital Universitari Vall d’Hebron, Vall d’Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, España
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), España
| | - Francisco UJUETA
- Columbia University Division of Cardiology, Mount Sinai Medical Center, Miami Beach, Florida, Estados Unidos
| | - Carlos VOZZI
- Departamento de Cardiología, Instituto Vozzi, Rosario, Argentina
| | - Gervasio A. LAMAS
- Columbia University Division of Cardiology, Mount Sinai Medical Center, Miami Beach, Florida, Estados Unidos
- Department of Medicine, Mount Sinai Medical Center, Miami Beach, Florida, Estados Unidos
| | - Ana NAVAS-ACIÉN
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, Nueva York, Estados Unidos
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16
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Bañeras J, Iglesies-Grau J, Téllez-Plaza M, Arrarte V, Báez-Ferrer N, Benito B, Campuzano Ruiz R, Cecconi A, Domínguez-Rodríguez A, Rodríguez-Sinovas A, Ujueta F, Vozzi C, Lamas GA, Navas-Acién A. Environment and cardiovascular health: causes, consequences and opportunities in prevention and treatment. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2022; 75:1050-1058. [PMID: 35931285 PMCID: PMC10266758 DOI: 10.1016/j.rec.2022.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 06/15/2023]
Abstract
The environment is a strong determinant of cardiovascular health. Environmental cardiology studies the contribution of environmental exposures with the aim of minimizing the harmful influences of pollution and promoting cardiovascular health through specific preventive or therapeutic strategies. The present review focuses on particulate matter and metals, which are the pollutants with the strongest level of scientific evidence, and includes possible interventions. Legislation, mitigation and control of pollutants in air, water and food, as well as environmental policies for heart-healthy spaces, are key measures for cardiovascular health. Individual strategies include the chelation of divalent metals such as lead and cadmium, metals that can only be removed from the body via chelation. The TACT (Trial to Assess Chelation Therapy, NCT00044213) clinical trial demonstrated cardiovascular benefit in patients with a previous myocardial infarction, especially in those with diabetes. Currently, the TACT2 trial (NCT02733185) is replicating the TACT results in people with diabetes. Data from the United States and Argentina have also shown the potential usefulness of chelation in severe peripheral arterial disease. More research and action in environmental cardiology could substantially help to improve the prevention and treatment of cardiovascular disease.
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Affiliation(s)
- Jordi Bañeras
- Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Josep Iglesies-Grau
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada
| | - María Téllez-Plaza
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Vicente Arrarte
- Servicio de Cardiología, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, Spain
| | - Néstor Báez-Ferrer
- Servicio de Cardiología, Hospital Universitario de Canarias, Universidad Europea de Canarias, Santa Cruz de Tenerife, Spain
| | - Begoña Benito
- Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Raquel Campuzano Ruiz
- Servicio de Cardiología, Hospital Universitario Fundación de Alcorcón, Alcorcón, Madrid, Spain
| | - Alberto Cecconi
- Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid, Spain
| | - Alberto Domínguez-Rodríguez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario de Canarias, Universidad Europea de Canarias, Santa Cruz de Tenerife, Spain
| | - Antonio Rodríguez-Sinovas
- Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Francisco Ujueta
- Columbia University Division of Cardiology, Mount Sinai Medical Center, Miami Beach, Florida, United States
| | - Carlos Vozzi
- Departamento de Cardiología, Instituto Vozzi, Rosario, Argentina
| | - Gervasio A Lamas
- Columbia University Division of Cardiology, Mount Sinai Medical Center, Miami Beach, Florida, United States; Department of Medicine, Mount Sinai Medical Center, Miami Beach, Florida, United States
| | - Ana Navas-Acién
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, Nueva York, United States.
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17
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Satarug S, Vesey DA, Gobe GC, Đorđević AB. The Validity of Benchmark Dose Limit Analysis for Estimating Permissible Accumulation of Cadmium. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192315697. [PMID: 36497771 PMCID: PMC9736539 DOI: 10.3390/ijerph192315697] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 06/01/2023]
Abstract
Cadmium (Cd) is a toxic metal pollutant that accumulates, especially in the proximal tubular epithelial cells of kidneys, where it causes tubular cell injury, cell death and a reduction in glomerular filtration rate (GFR). Diet is the main Cd exposure source in non-occupationally exposed and non-smoking populations. The present study aimed to evaluate the reliability of a tolerable Cd intake of 0.83 μg/kg body weight/day, and its corresponding toxicity threshold level of 5.24 μg/g creatinine. The PROAST software was used to calculate the lower 95% confidence bound of the benchmark dose (BMDL) values of Cd excretion (ECd) associated with injury to kidney tubular cells, a defective tubular reabsorption of filtered proteins, and a reduction in the estimated GFR (eGFR). Data were from 289 males and 445 females, mean age of 48.1 years of which 42.8% were smokers, while 31.7% had hypertension, and 9% had chronic kidney disease (CKD). The BMDL value of ECd associated with kidney tubular cell injury was 0.67 ng/L of filtrate in both men and women. Therefore, an environmental Cd exposure producing ECd of 0.67 ng/L filtrate could be considered as Cd accumulation levels below which renal effects are likely to be negligible. A reduction in eGFR and CKD may follow when ECd rises from 0.67 to 1 ng/L of filtrate. These adverse health effects occur at the body burdens lower than those associated with ECd of 5.24 µg/g creatinine, thereby arguing that current health-guiding values do not provide a sufficient health protection.
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Affiliation(s)
- Soisungwan Satarug
- Kidney Disease Research Collaborative, Translational Research Institute, Brisbane 4102, Australia
| | - David A. Vesey
- Kidney Disease Research Collaborative, Translational Research Institute, Brisbane 4102, Australia
- Department of Nephrology, Princess Alexandra Hospital, Brisbane 4102, Australia
| | - Glenda C. Gobe
- Kidney Disease Research Collaborative, Translational Research Institute, Brisbane 4102, Australia
- School of Biomedical Sciences, The University of Queensland, Brisbane 4072, Australia
- NHMRC Centre of Research Excellence for CKD QLD, UQ Health Sciences, Royal Brisbane and Women’s Hospital, Brisbane 4029, Australia
| | - Aleksandra Buha Đorđević
- Department of Toxicology “Akademik Danilo Soldatović”, Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, Serbia
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18
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Satarug S, Gobe GC, Vesey DA. Multiple Targets of Toxicity in Environmental Exposure to Low-Dose Cadmium. TOXICS 2022; 10:toxics10080472. [PMID: 36006151 PMCID: PMC9412446 DOI: 10.3390/toxics10080472] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/06/2022] [Accepted: 08/12/2022] [Indexed: 05/06/2023]
Abstract
Dietary assessment reports and population surveillance programs show that chronic exposure to low levels of environmental cadmium (Cd) is inevitable for most people, and adversely impacts the health of children and adults. Based on a risk assessment model that considers an increase in the excretion of β2-microglobulin (β2M) above 300 μg/g creatinine to be the "critical" toxicity endpoint, the tolerable intake level of Cd was set at 0.83 µg/kg body weight/day, and a urinary Cd excretion rate of 5.24 µg/g creatinine was considered to be the toxicity threshold level. The aim of this review is to draw attention to the many other toxicity endpoints that are both clinically relevant and more appropriate to derive Cd exposure limits than a β2M endpoint. In the present review, we focus on a reduction in the glomerular filtration rate and diminished fecundity because chronic exposure to low-dose Cd, reflected by its excretion levels as low as 0.5 µg/g creatinine, have been associated with dose-dependent increases in risk of these pathological symptoms. Some protective effects of the nutritionally essential elements selenium and zinc are highlighted. Cd-induced mitochondrial dysfunction is discussed as a potential mechanism underlying gonadal toxicities and infertility.
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Affiliation(s)
- Soisungwan Satarug
- Kidney Disease Research Collaborative, Translational Research Institute, Brisbane 4102, Australia
- Correspondence:
| | - Glenda C. Gobe
- Kidney Disease Research Collaborative, Translational Research Institute, Brisbane 4102, Australia
- School of Biomedical Sciences, The University of Queensland, Brisbane 4072, Australia
- NHMRC Centre of Research Excellence for CKD QLD, UQ Health Sciences, Royal Brisbane and Women’s Hospital, Brisbane 4029, Australia
| | - David A. Vesey
- Kidney Disease Research Collaborative, Translational Research Institute, Brisbane 4102, Australia
- Department of Nephrology, Princess Alexandra Hospital, Brisbane 4075, Australia
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19
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Effects of Environmental Exposure to Cadmium and Lead on the Risks of Diabetes and Kidney Dysfunction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042259. [PMID: 35206446 PMCID: PMC8871722 DOI: 10.3390/ijerph19042259] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 02/01/2023]
Abstract
Environmental exposure to cadmium (Cd) or lead (Pb) is independently associated with increased risks of type 2 diabetes, and chronic kidney disease. The aim of this study was to examine the effects of concurrent exposure to these toxic metals on the risks of diabetes and kidney functional impairment. The Cd and Pb exposure levels among study subjects were low to moderate, evident from the means for blood concentrations of Cd and Pb ([Cd]b and [Pb]b) of 0.59 µg/L and 4.67 µg/dL, respectively. Of 176 study subjects (mean age 60), 71 (40.3%) had abnormally high fasting plasma glucose levels. Based on their [Cd]b and [Pb]b, 53, 71, and 52 subjects were assigned to Cd and Pb exposure profiles 1, 2, and 3, respectively. The diagnosis of diabetes was increased by 4.2-fold in those with an exposure profile 3 (p = 0.002), and by 2.9-fold in those with the estimated glomerular filtration (eGFR) ≤ 60 mL/min/1.73 m2 (p = 0.029). The prevalence odds ratio (POR) for albuminuria was increased by 5-fold in those with plasma glucose levels above kidney threshold of 180 mg/dL (p = 0.014), and by 3.1-fold in those with low eGFR) (p = 0.050). Collectively, these findings suggest that the Cd and Pb exposure profiles equally impact kidney function and diabetes risk.
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Rahman HH, Niemann D, Munson-McGee SH. Association of albumin to creatinine ratio with urinary arsenic and metal exposure: evidence from NHANES 2015-2016. Int Urol Nephrol 2021; 54:1343-1353. [PMID: 34643861 DOI: 10.1007/s11255-021-03018-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 10/05/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE Urinary metals can be used to identify metal exposure in humans from various sources in the environment. Decreased renal function and cardiovascular dysfunction may occur due to low levels of metal exposure in the general population. The purpose of this study is to assess the association between urinary arsenic and metals and a higher albumin to creatinine ratio (ACR) among adults in the general US population. METHODS We conducted a cross sectional analyses using the 2015-2016 National Health and Nutrition Examination Survey (NHANES) dataset. Multiple linear logistic models were used to examine the association between 21 urinary arsenic and metal concentrations (arsenous acid, arsenic acid, arsenobetaine, arsenocholine, dimethylarsinic acid, monomethylarsonic acid, total arsenic, mercury, barium, cadmium, cobalt, cesium, molybdenum, manganese, lead, antinomy, tin, strontium, thallium, tungsten, uranium) and increased ACR (≥ 30 mg/g). RESULTS The sample included 4122 adults, of whom approximately 9.4% of males and 10.7% females had increased ACRs. The exposure included urinary arsenic compounds (7) and urinary metal compounds (14) at or above the limit of detection. Urinary dimethylarsinic acid [OR 38.9, 95% CI 3.6-414.6], urinary monomethylarsonic acid [OR 18.6, 95% CI 1.1-308.2], urinary cadmium [OR 11.9, 95% CI 1.2-122.0], urinary cesium [OR 17.0, 95% CI 2.7-105.8], and urinary antimony [OR 10.7, 95% CI 2.2-51.3] were associated with an increased ACR. No other urinary metals were significantly associated with increased ACR. CONCLUSION Increased ACR was positively associated with urinary dimethylarsinic acid, monomethylarsonic acid, cadmium, cesium, and antimony.
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Madrim MF, Ja'afar MH, Hod R. Prevalence of abnormal urinary cadmium and risk of albuminuria as a primary bioindicator for kidney problems among a healthy population. PeerJ 2021; 9:e12014. [PMID: 34466292 PMCID: PMC8380425 DOI: 10.7717/peerj.12014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/28/2021] [Indexed: 12/25/2022] Open
Abstract
Background The prevalence of chronic kidney disease is increasing globally, ranking 27th as the cause of death in the 1990s, rising to 18th in 2010 and 10th in 2019. Non-communicable diseases such as diabetes and hypertension have been identified as the common contributing factors, while there is also evidence linking environmental pollutants, especially cadmium, to kidney disease. This study aimed at investigating the level of urinary cadmium and its relationship to albuminuria as an early indicator of kidney problems in the Kepong community. Methods Respondents were surveyed as part of several health-related programs organized by the Kepong District Health Office involving local communities in and around the district from April 2019 to December 2019. Urinalysis of two urine samples was carried out using a Mission reagent strip and an Inductively Coupled Plasma Mass Spectrometry (ICP-MS) test to detect the presence and level of urinary cadmium. Results A total of 240 respondents were enrolled from April 2019 to December 2019. Urinalysis of two urine samples was carried out using a Mission reagent strip and an Inductively Coupled Plasma Mass Spectrometry (ICP-MS) test to detect the level of urinary cadmium. The respondents’ average age was 41-year-old (±13.23). Among them, 49.6% were male, 85.0% Malay, 5.8% Chinese and 8.3% Indian. 55.0% had background of tertiary, 39.6% secondary and 5.4% primary level of education. 52.1% were categorized in B40, 34.6% in M40 and 13.3% in T20 based on monthly household income category. 26.7% were hypertensive, 6.7% diabetic, 4.2% had dyslipidemia, 51.7% had urinary cadmium above the alert level, and 27.1% had albuminuria. Discussion Risk factors for albuminuria that have been identified are age with adjusted odds ratio (AOR) 3.53 (1.41–8.83; p < 0.05), highest educational level with AOR 2.18 (1.14–4.17; p < 0.05), diabetes with AOR 3.36 (1.07–10.52; p < 0.05), and urinary cadmium with AOR 4.72 (2.33–9.59; p < 0.001), with future screening programs placing greater attention to those at risk and further research is required to determine the cause of exposure to cadmium.
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Affiliation(s)
- Mohd Faizal Madrim
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia.,Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Mohd Hasni Ja'afar
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
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22
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Chen X, Chen X, Wang X, Wang M, Liang Y, Zhu G, Jin T. The association between estimated glomerular filtration rate and cadmium exposure: An 8-year follow-up study. Int J Hyg Environ Health 2021; 235:113774. [PMID: 34052740 DOI: 10.1016/j.ijheh.2021.113774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/07/2021] [Accepted: 05/16/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND The associations between cadmium exposure and chronic kidney disease have rarely been reported in longitudinal studies. In this study, we investigated the associations between the estimated glomerular filtration rate and cadmium exposure in a cross-sectional study in a longitudinal cohort. MATERIALS AND METHODS In total, 790 subjects (≥35 years of age) living in southeastern China were included at 1998. Cadmium in blood (BCd) and urine (UCd) as well as renal dysfunction biomarkers, urinary N-acetyl-β d-glucosaminidase (UNAG) and albumin (UALB), were determined. 497 subjects were followed at 2006 and a total of 456 subjects were finally included after excluding subjects that did not have exposure or effects biomarkers. The BCd, UCd, UNAG and UALB were determined using baseline methods. At follow-up, the estimated glomerular filtration rate (eGFR) was computed using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Single nucleotide polymorphisms (SNPs) in metallothioneins 1A (MT1A) rs11076161 and MT2A rs28366003 in blood sample were detected using TaqMan allelic discrimination assays. RESULTS The median of UCd and BCd at baseline was 5.38 μg/g cr and 4.69 μg/L, respectively, and the median UCd and BCd at follow-up was 4.88 μg/g cr and 2.20 μg/L at follow-up. The mean eGFR at follow-up was 88.0 mL/min/1.73 m2 and 15 subjects had new onset of eGFR <60 mL/min/1.73 m2. The eGFR at follow-up was associated with baseline age (β = -0.66, 95% confidence interval (CI): 0.80 to -0.52), BCd (β = -0.46, 95% CI: 0.68 to -0.25) and UALB (β = -0.29, 95% CI: 0.41 to -0.16) after adjusting for confounders. Subgroup analysis in subjects who had low baseline UALB or subjects with or without hypertension showed similar results. A logistic regression model further showed that baseline BCd and UALB were independent risk factors for follow-up CKD. The odds ratios (ORs) were 1.09 (95% CI:1.03-1.16) for UALB, 1.16 (95% CI:1.01-1.33) for BCd, and 6.74 (0.87-29.63) for current hypertension. Baseline BCd, UALB and current hypertension were used to construct the nomogram. Linear discriminant analysis (LCA) showed that 87.6% of CKD was accurately predicted based on the three factors. CONCLUSION Baseline age, BCd and UALB were associated with follow-up eGFR, and baseline BCd and UALB were predictive factors for incidence of CKD.
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Affiliation(s)
- Xiao Chen
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China.
| | - Xin Chen
- Department of Radiology, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, #600 Yishan Road, Shanghai, 200233, China
| | - Xinru Wang
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China
| | - Miaomiao Wang
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China
| | - Yihuai Liang
- Department of Occupational and Environmental Medicine, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Guoying Zhu
- Institute of Radiation Medicine, Fudan University, Shanghai, 200032, China
| | - Taiyi Jin
- Department of Occupational and Environmental Medicine, School of Public Health, Fudan University, Shanghai, 200032, China.
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Jalili C, Kazemi M, Cheng H, Mohammadi H, Babaei A, Taheri E, Moradi S. Associations between exposure to heavy metals and the risk of chronic kidney disease: a systematic review and meta-analysis. Crit Rev Toxicol 2021; 51:165-182. [PMID: 33960873 DOI: 10.1080/10408444.2021.1891196] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
We performed a systematic review and meta-analysis to examine the relationship between heavy metals (HMs) exposure and the risk of chronic kidney disease (CKD). Databases of Web of Science, Embase, MEDLINE, and Scopus were searched through June 2020 to identify studies assessing the relationships between exposure to HMs (i.e. cadmium, lead, arsenic, mercury) and the risk of CKD, evaluated by decreased estimated glomerular filtration rate (eGFR) and/or increased proteinuria risks in adults (≥18 years). Data were pooled by random-effects models and expressed as weighted mean differences and 95% confidence intervals. The risk of bias was assessed by the Newcastle-Ottawa scale (NOS). Twenty-eight eligible articles (n = 107,539 participants) were included. Unlike eGFR risk (p = 0.10), Cadmium exposure was associated with an increased proteinuria risk (OR = 1.35; 95% CI: 1.13, 1.61; p < 0.001; I2 = 79.7%). Lead exposure was associated with decreased eGFR (OR = 1.12; 95%CI: 1.03, 1.22; p = 0.008; I2 = 87.8%) and increased proteinuria (OR = 1.25; 95% CI: 1.04, 1.49; p = 0.02; I2 = 79.6) risks. Further, arsenic exposure was linked to a decreased eGFR risk (OR = 1.55; 95% CI: 1.05, 2.28; p = 0.03; I2 = 89.1%) in contrast to mercury exposure (p = 0.89). Only two studies reported the link between arsenic exposure and proteinuria risk, while no study reported the link between mercury exposure and proteinuria risk. Exposure to cadmium, lead, and arsenic may increase CKD risk in adults, albeit studies were heterogeneous, warranting further investigations. Our observations support the consideration of these associations for preventative, diagnostic, monitoring, and management practices of CKD.
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Affiliation(s)
- Cyrus Jalili
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Kazemi
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, New York, USA
| | - Hefa Cheng
- MOE Key Laboratory for Earth Surface Processes, College of Urban and Environmental Sciences, Peking University, Beijing, China
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Atefeh Babaei
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ensiyeh Taheri
- Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sajjad Moradi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.,Halal Research Center of IRI, FDA, Tehran, Iran
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García-Esquinas E, Téllez-Plaza M, Pastor-Barriuso R, Ortolá R, Olmedo P, Gil F, López-García E, Navas-Acien A, Rodríguez-Artalejo F. Blood cadmium and physical function limitations in older adults. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 276:116748. [PMID: 33639488 DOI: 10.1016/j.envpol.2021.116748] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Cadmium (Cd) is a toxic metal found in tobacco, air and food. Recent cross-sectional studies have suggested that Cd negatively impacts physical performance, but the prospective association is uncertain. METHODS We used data from 2548 older adults from the Seniors-ENRICA II cohort in Madrid, Spain. Whole blood Cd levels were measured at baseline using inductively coupled plasma-mass spectrometry. At baseline (2017) and follow-up (2019), overall physical function was evaluated using the physical component summary (PCS) of the SF 12-Item Health questionnaire, lower-extremity performance with the Short Physical Performance Battery (SPPB), muscle weakness with a hand dynamometer, and frailty with a Deficit Accumulation index. Mobility limitations and disability in instrumental activities of daily living (IADL) were ascertained with standardized questionnaires. Analyses were adjusted for relevant confounders, including tobacco smoke, number of cigarettes smoked per day and time since cessation in former smokers. RESULTS In cross-sectional analyses, odds ratios (95% confidence interval) per two-fold increase in blood Cd were 1.16 (1.03; 1.31) for low PCS scores, 1.08 (0.97; 1.20) for impaired lower-extremity performance, 1.10 (0.98; 1.23) for low grip strength, 1.11 (1.02; 1.20) for mobility limitations, 1.16 (1.02; 1.31) for frailty, and 1.26 (1.08; 1.47) for IADL disability. In longitudinal analyses, corresponding hazard ratios were 1.25 (1.03; 1.51) for low PCS scores, 1.14 (1.03; 1.27) for impaired lower-extremity performance, 1.02 (0.92; 1.13) for low grip strength, 1.03 (0.91; 1.16) for mobility limitations, and 1.16 (1.00; 1.35) for frailty. All the associations where consistent when current smokers were excluded from the analyses. CONCLUSIONS Our results support the role of Cd as a risk factor for physical function impairments in older adults.
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Affiliation(s)
- Esther García-Esquinas
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; IdiPaz (Hospital Universitario La Paz-Universidad Autónoma de Madrid), Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
| | - María Téllez-Plaza
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain; Biomedical Research Institute Hospital Clinic de Valencia (INCLIVA), Valencia, Valencia, Spain
| | - Roberto Pastor-Barriuso
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; IdiPaz (Hospital Universitario La Paz-Universidad Autónoma de Madrid), Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Pablo Olmedo
- Department of Legal Medicine, Toxicology, and Physical Anthropology, School of Medicine, University of Granada, Granada, Spain
| | - Fernando Gil
- Department of Legal Medicine, Toxicology, and Physical Anthropology, School of Medicine, University of Granada, Granada, Spain
| | - Esther López-García
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; IdiPaz (Hospital Universitario La Paz-Universidad Autónoma de Madrid), Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, USA
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; IdiPaz (Hospital Universitario La Paz-Universidad Autónoma de Madrid), Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain
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Analysis of Cadmium, Mercury, and Lead Concentrations in Erythrocytes of Renal Transplant Recipients from Northwestern Poland. BIOLOGY 2021; 10:biology10010062. [PMID: 33467071 PMCID: PMC7829764 DOI: 10.3390/biology10010062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/11/2021] [Accepted: 01/14/2021] [Indexed: 01/16/2023]
Abstract
Simple Summary The aim of this study is to determine the blood erythrocyte concentrations of toxic metals (Cd, Pb, and Hg) in renal transplant recipients. Additionally, we analyzed the effect of selected biological and environmental factors, including the intake of various immunosuppressive drug regimens and smoking, on these xenobiotic concentrations. In summary, our data suggest that, smoking is associated with Pb and Cd concentrations, and gender, age change depending on Pb concentration in erythrocytes of renal transplant recipients. Additionally, this is the first research that suggests that immunosuppressive regimen, depending on type of immunosuppressive drugs combination affects Pb concentration in erythrocytes of the mentioned group of patients. It seems to be crucial information for patients who use immunosuppressive drugs. Abstract Cadmium (Cd), mercury (Hg), and lead (Pb) exhibit highly nephrotoxic properties, and their high concentrations can lead to renal failure. Much research has been conducted on the concentrations of heavy metals, microelements, and macroelements in the blood, but little is known about the concentration of Cd, Pb, and Hg in erythrocytes of renal recipients. The aim of this study is to determine the blood erythrocyte concentrations of toxic metals (Cd, Pb, and Hg) in renal transplant recipients (RTRs). Additionally, we analyzed the effect of selected biological and environmental factors, including the intake of various immunosuppressive drug regimens and smoking, on these xenobiotic concentrations. The material consisted of erythrocyte samples from 115 patients of the Department of Nephrology, Transplantology, and Internal Medicine at Independent Public Clinical Hospital No. 2, Pomeranian Medical University, Szczecin, in northwestern Poland. Cd, Hg, and Pb levels in the erythrocytes were quantified by inductively coupled mass spectroscopy (ICP-MS). Equal concentrations of Cd were found in erythrocytes of both female and male transplant recipients. The highest level of Hg was seen in women, and women overall had statistically higher concentrations of Pb than men. Comparison of metal concentrations between those over 50 years and those under it showed that Pb concentration was also significantly higher in renal transplant recipients over 50. Pb concentration was almost twice as high in RTRs who used tacrolimus with mycophenolate mofetil than in RTRs who used cyclosporine A with mycophenolate mofetil. The highest level of Cd was seen in smokers, who had 3.25 µg/L. This value was significantly higher than in ex-smokers (p = 0.001) and with RTRs who had never smoked. There were significantly higher levels of Pb in the erythrocytes of RTRs who were ex-smokers than in those who had never smoked. A statistically significant correlation was found between Cd and Pb concentrations. Additionally, we have noticed significant positive correlation between Pb and age (R = 0.37), gender (R = 0.24) and significant negative correlation of Pb with GFR (R = −0.33). We have also found significant positive correlation between Hg and age (R = 0.21). In summary, our data suggest that, smoking is associated with Pb and Cd concentrations, and gender, age change depending on Pb concentration in erythrocytes of RTRs. Additionally, this is the first research that suggests that immunosuppressive regimen, depending on type of immunosuppressive drugs combination affects Pb concentration in erythrocytes of RTRs. It seems to be crucial information for patients who use immunosuppressive drugs.
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Gender Differences in Zinc and Copper Excretion in Response to Co-Exposure to Low Environmental Concentrations of Cadmium and Lead. Stress 2020. [DOI: 10.3390/stresses1010002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Disruption of the homeostasis of zinc (Zn) and copper (Cu) has been associated with nephrotoxicity of cadmium (Cd). Herein, we report the results of a cross sectional analysis of urinary excretion of Zn, Cu, Cd and lead (Pb) in 392 Thais (mean age 33.6) living in an area of low-level environmental exposure to Cd and Pb, reflected by the respective median Cd and Pb excretion rates of 0.44 and 1.75 μg/g creatinine. Evidence for dysregulation of Zn and Cu homeostasis has emerged together with gender differentiated responses. In men, excretion rates for Zn and Cu were increased concomitantly, and their urinary Zn-to-Cu ratios were maintained. In women, only Cu excretion rose, causing a reduction in urinary Zn-to-Cu ratios. Only in women, urinary Zn-to-Cu ratios were associated with worse kidney function, assessed by estimated glomerular filtration rate (eGFR) (β = −7.76, p = 0.015). Only in men, a positive association was seen between eGFR and body iron stores, reflected by serum ferritin (β = 5.32, p = 0.030). Thus, co-exposure to Cd and Pb may disrupt the homeostasis of Zn and Cu more severely in women than men, while urinary Zn-to-Cu ratios and body iron stores can serve as predictors of an adverse effect of co-exposure to Cd and Pb.
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Escolar E, Ujueta F, Kim H, Mark DB, Boineau R, Nahin RL, Goertz C, Lee KL, Anstrom KJ, Lamas GA. Possible differential benefits of edetate disodium in post-myocardial infarction patients with diabetes treated with different hypoglycemic strategies in the Trial to Assess Chelation Therapy (TACT). J Diabetes Complications 2020; 34:107616. [PMID: 32446881 PMCID: PMC9434823 DOI: 10.1016/j.jdiacomp.2020.107616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/03/2020] [Accepted: 05/03/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The NIH-funded Trial to Assess Chelation Therapy (TACT) randomized 1708 stable patients age ≥50 who were ≥6 months post myocardial infarction to 40 infusions of an edetate disodium-based regimen or placebo. In 633 patients with diabetes, edetate disodium significantly reduced the primary composite endpoint of mortality, recurrent myocardial infarction, stroke, coronary revascularization, or hospitalization for angina (hazard ratio [HR] 0.59, 95% confidence interval [CI] 0.44-0.79, p < 0.001). The principal secondary endpoint of a composite of cardiovascular death, myocardial infarction, or stroke was also reduced (HR 0.60, 95% CI 0.39-0.91, p = 0.017). It is unknown if the treatment effect differs by diabetes therapy. METHODS We grouped the subset of 633 patients with diabetes according to glucose-lowering therapy at time of randomization. The log-rank test was used to compare active therapy versus placebo. All treatment comparisons were performed using 2-sided significance tests at the significance level of 0.05 and were as randomized. Relative risks were expressed as HR with associated 95% CI, calculated using the Cox proportional hazards model. RESULTS There were 162 (25.7%) patients treated with insulin; 301 (47.5%) with oral hypoglycemics only; and 170 (26.8%) receiving no pharmacologic treatment for diabetes. Patients on insulin reached the primary endpoint more frequently than patients on no pharmacologic treatment [61 (38%) vs 49 (29%) (HR 1.56, 95% CI 1.07-2.27, p = 0.022)] or oral hypoglycemics [61 (38%) vs 87 (29%) (HR 1.46, 1.05-2.03, p = 0.024)]. The primary endpoint occurred less frequently with edetate disodium based therapy versus placebo in patients on insulin [19 (26%) vs 42 (48%) (HR 0.42, 95% CI 0.25-0.74, log-rank p = 0.002)], marginally in patients on oral hypoglycemics [38 (25%) vs 49 (34%) (HR 0.66, 95% CI 0.43-1.01, log-rank p = 0.041)], and no significant difference in patients not treated with a pharmacologic therapy [23 (25%) vs 26 (34%) (HR 0.69, 95% CI 0.39-1.20, log-rank p = 0.225)]. The interaction between randomized intravenous treatment and type of diabetes therapy was not statistically significant (p = 0.203). CONCLUSIONS Edetate disodium treatment in stable, post-myocardial infarction patients with diabetes suggests that patients on insulin therapy at baseline may accrue the greatest benefit. CLINICAL TRIAL REGISTRATION clinicaltrials.gov identifier: http://clinicaltrials.gov/ct2/show/NCT00044213?term=TACT&rank=7 identifier Trial to Assess Chelation Therapy (TACT), NCT00044213.
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Affiliation(s)
- Esteban Escolar
- Columbia University Division of Cardiology at Mount Sinai Medical Center, Miami, FL, United States of America
| | - Francisco Ujueta
- Columbia University Division of Cardiology at Mount Sinai Medical Center, Miami, FL, United States of America
| | - Hwasoon Kim
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, United States of America; Duke University, Durham, NC, United States of America
| | - Daniel B Mark
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, United States of America; Duke University, Durham, NC, United States of America
| | - Robin Boineau
- National Heart, Lung, and Blood Institute, Bethesda, MD, United States of America
| | - Richard L Nahin
- National Heart, Lung, and Blood Institute, Bethesda, MD, United States of America
| | - Christine Goertz
- Duke Department of Orthopaedic Surgery, Duke University, Durham, NC, United States of America
| | - Kerry L Lee
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, United States of America; Duke University, Durham, NC, United States of America
| | - Kevin J Anstrom
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, United States of America; Duke University, Durham, NC, United States of America
| | - Gervasio A Lamas
- Columbia University Division of Cardiology at Mount Sinai Medical Center, Miami, FL, United States of America.
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Zhang Q, Jiang C, Li H, Zhang C, Wu H, Huang F. Effect of the Interaction Between Cadmium Exposure and CLOCK Gene Polymorphisms on Thyroid Cancer: a Case-Control Study in China. Biol Trace Elem Res 2020; 196:86-95. [PMID: 31637582 DOI: 10.1007/s12011-019-01904-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 09/12/2019] [Indexed: 12/20/2022]
Abstract
The exposure to endocrine disruptors and the disruption of the circadian rhythms can both affect thyroid hormones, with results that are most likely carcinogenic in humans. The effects of cadmium (Cd) level and circadian-related single-nucleotide polymorphisms (SNPs) on thyroid cancer (TC) risk have rarely been reported. In this study, the associations of urine Cd, CLOCK gene polymorphisms, and TC risk were evaluated, in addition to the effect of the gene-environment interaction on TC risk. In this case-control study, 218 TC cases and 218 controls were enrolled. Cd in urinary samples was determined by atomic absorption spectrometry. Three SNPs (rs3805151, rs3805154, and rs78929565) were genotyped with an improved multiplex ligation detection reaction technique. The individuals with a high Cd level were 1.72-fold more likely to have TC (OR = 1.72, 95%CI 1.04-2.85), and a high Cd level was associated with higher tumor T stage and N stage (OR = 2.42, 95%CI 1.28-4.58; OR = 3.26, 95%CI 1.67-6.33, respectively). Individuals with TT genotype of rs78929565 had a 107 % increase in TC risk (OR = 2.07, 95%CI 1.00-4.29). Cases with CT genotype tended to have a higher AJCC stage (OR = 2.79, 95% CI 1.01-7.78). A significant interaction was detected between the rs78929565 variant and Cd exposure (p interaction = 0.04). The TT genotype carriers of rs78929565 with a high Cd level were more susceptible to thyroid cancer than the major homozygotes carriers who were exposed to a low cadmium level (OR = 2.66, 95%CI 1.07-6.59). These findings suggested that Cd exposure and the CLOCK variant genotypes were associated with TC risk and tumor severity. Individuals with minor allele of rs78929565 and higher Cd exposure had increased susceptibility to TC. Further studies are required to confirm these findings.
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Affiliation(s)
- Qian Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Chunxiao Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Haibo Li
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Chi Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Huabing Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China.
- Central Laboratory of Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China.
- Laboratory for Environmental Toxicology, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China.
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Domingo-Relloso A, Riffo-Campos AL, Haack K, Rentero-Garrido P, Ladd-Acosta C, Fallin DM, Tang WY, Herreros-Martinez M, Gonzalez JR, Bozack AK, Cole SA, Navas-Acien A, Tellez-Plaza M. Cadmium, Smoking, and Human Blood DNA Methylation Profiles in Adults from the Strong Heart Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:67005. [PMID: 32484362 PMCID: PMC7265996 DOI: 10.1289/ehp6345] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 03/18/2020] [Accepted: 04/22/2020] [Indexed: 05/03/2023]
Abstract
BACKGROUND The epigenetic effects of individual environmental toxicants in tobacco remain largely unexplored. Cadmium (Cd) has been associated with smoking-related health effects, and its concentration in tobacco smoke is higher in comparison with other metals. OBJECTIVES We studied the association of Cd and smoking exposures with human blood DNA methylation (DNAm) profiles. We also evaluated the implication of findings to relevant methylation pathways and the potential contribution of Cd exposure from smoking to explain the association between smoking and site-specific DNAm. METHODS We conducted an epigenome-wide association study of urine Cd and self-reported smoking (current and former vs. never, and cumulative smoking dose) with blood DNAm in 790,026 CpGs (methylation sites) measured with the Illumina Infinium Human MethylationEPIC (Illumina Inc.) platform in 2,325 adults 45-74 years of age who participated in the Strong Heart Study in 1989-1991. In a mediation analysis, we estimated the amount of change in DNAm associated with smoking that can be independently attributed to increases in urine Cd concentrations from smoking. We also conducted enrichment analyses and in silico protein-protein interaction networks to explore the biological relevance of the findings. RESULTS At a false discovery rate (FDR)-corrected level of 0.05, we found 6 differentially methylated positions (DMPs) for Cd; 288 and 17, respectively, for current and former smoking status; and 77 for cigarette pack-years. Enrichment analyses of these DMPs displayed enrichment of 58 and 6 Gene Ontology and Kyoto Encyclopedia of Genes and Genomes gene sets, respectively, including biological pathways for cancer and cardiovascular disease. In in silico protein-to-protein networks, we observed key proteins in DNAm pathways directly and indirectly connected to Cd- and smoking-DMPs. Among DMPs that were significant for both Cd and current smoking (annotated to PRSS23, AHRR, F2RL3, RARA, and 2q37.1), we found statistically significant contributions of Cd to smoking-related DNAm. CONCLUSIONS Beyond replicating well-known smoking epigenetic signatures, we found novel DMPs related to smoking. Moreover, increases in smoking-related Cd exposure were associated with differential DNAm. Our integrative analysis supports a biological link for Cd and smoking-associated health effects, including the possibility that Cd is partly responsible for smoking toxicity through epigenetic changes. https://doi.org/10.1289/EHP6345.
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Affiliation(s)
- Arce Domingo-Relloso
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
- Department of Chronic Diseases Epidemiology, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain
- Department of Statistics and Operations Research, University of Valencia, Spain
| | | | - Karin Haack
- Population Health Program, Texas Biomedical Research Institute, San Antonio, Texas, USA
| | - Pilar Rentero-Garrido
- Precision Medicine Unit, Institute for Biomedical Research INCLIVA, Valencia, Spain
- Department of Mental Health, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Daniele M Fallin
- Department of Mental Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Wan Yee Tang
- Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Juan R Gonzalez
- Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain
| | - Anne K Bozack
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Shelley A Cole
- Population Health Program, Texas Biomedical Research Institute, San Antonio, Texas, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Maria Tellez-Plaza
- Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
- Area of Cardiometabolic and Renal Risk, Institute for Biomedical Research INCLIVA, Valencia, Spain
- Department of Chronic Diseases Epidemiology, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain
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A Comparison of the Nephrotoxicity of Low Doses of Cadmium and Lead. TOXICS 2020; 8:toxics8010018. [PMID: 32131418 PMCID: PMC7151741 DOI: 10.3390/toxics8010018] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/06/2020] [Accepted: 02/25/2020] [Indexed: 11/29/2022]
Abstract
Environmental exposure to moderate-to-high levels of cadmium (Cd) and lead (Pb) is associated with nephrotoxicity. In comparison, the health impacts of chronic low-level exposure to Cd and Pb remain controversial. The aim of this study was to therefore evaluate kidney dysfunction associated with chronic low-level exposure to Cd and Pb in a population of residents in Bangkok, Thailand. The mean age and the estimated glomerular filtration rate (eGFR) for 392 participants (195 men and 197 women) were 34.9 years and 104 mL/min/1.73 m2, respectively, while the geometric mean concentrations of urinary Cd and Pb were 0.25 μg/L (0.45 μg/g of creatinine) and 0.89 μg/L (1.52 μg/g of creatinine), respectively. In a multivariable regression analysis, the eGFR varied inversely with blood urea nitrogen in both men (β = −0.125, p = 0.044) and women (β = −0.170, p = 0.008), while inverse associations of the eGFR with urinary Cd (β = −0.132, p = 0.043) and urinary Pb (β = −0.130, p = 0.044) were seen only in women. An increased urinary level of Cd to the median level of 0.38 μg/L (0.44 μg/g of creatinine) was associated with a decrease in the eGFR by 4.94 mL/min/1.73 m2 (p = 0.011). The prevalence odds of a reduced eGFR rose 2.5-, 2.9- and 2.3-fold in the urinary Cd quartile 3 (p = 0.013), the urinary Cd quartile 4 (p = 0.008), and the urinary Pb quartile 4 (p = 0.039), respectively. This study suggests that chronic exposure to low-level Cd is associated with a decline in kidney function and that women may be more susceptible than men to nephrotoxicity due to an elevated intake of Cd and Pb.
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Chen X, Cui W, Duan N, Zhu G, Jin T, Wang Z. The Association Between Alcohol Consumption and Renal Tubular Dysfunction Induced by Cadmium Exposure. Biol Trace Elem Res 2020; 194:58-65. [PMID: 31134451 DOI: 10.1007/s12011-019-01748-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 05/06/2019] [Indexed: 12/25/2022]
Abstract
Alcohol consumption is inversely associated with the risk of chronic kidney diseases. However, this association has not been reported in populations exposed to cadmium. In the present study, we examined the association between alcohol consumption and renal tubular dysfunction in populations living in cadmium-polluted areas. A total of 446 subjects (170 men and 276 women) were finally included in our analysis. The urinary cadmium (UCd) and cadmium in blood (BCd) were determined as the exposure biomarkers. Urinary N-acetyl-β-D-glucosaminidase (UNAG) and β2-microgloblin (UBMG) were measured as renal indicators. Alcohol drinking patterns were obtained from a questionnaire and divided into four categories: non-drinking, light drinking (< 3 drinks/week), moderate drinking (3-7 drinks/week), and heavy drinking (> 7 drinks /week). If UNAG was the indicator of renal dysfunction, the prevalence of renal tubular dysfunction was decreased in subjects with alcohol consumption both in men (χ2 = 8.5, p < 0.01) and women (χ2 = 8.3, p < 0.01). The odds ratio (OR) of subjects with light and moderate alcohol drinking was 0.31 (95% confidence interval (CI), 0.1-0.99) and 0.30 (95%CI, 0.1-0.96), respectively, compared with those of non-drinkers after adjusting with the confounders in men. Similar results were observed in women with light drinking (OR = 0.33, 95%CI, 0.15-0.70). Similar trends were observed in those subjects with high BCd (> 3.0 μg/L) or UCd (> 5.0 μg/g creatinine). Our data show that alcohol consumption is inversely associated with cadmium-induced renal tubular dysfunction.
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Affiliation(s)
- Xiao Chen
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, 150 Hanzhong road, Nanjing, 210029, China.
- Department of Nephrology, Zhongshan Hospital Fudan University, 180 Fenglin road, Shanghai, 200032, China.
| | - Wenjing Cui
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, 150 Hanzhong road, Nanjing, 210029, China
| | - Na Duan
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, 150 Hanzhong road, Nanjing, 210029, China
| | - Guoying Zhu
- Institute of Radiation Medicine, Fudan University, 2094 Xietu road, Shanghai, 200032, China
| | - Taiyi Jin
- Department of Occupational Medicine, School of Public Health, Shanghai Medical College Fudan University, 150 Dongan road, Shanghai, 200032, China
| | - Zhongqiu Wang
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, 150 Hanzhong road, Nanjing, 210029, China
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32
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Zhu XJ, Wang JJ, Mao JH, Shu Q, Du LZ. Relationships of Cadmium, Lead, and Mercury Levels With Albuminuria in US Adults: Results From the National Health and Nutrition Examination Survey Database, 2009-2012. Am J Epidemiol 2019; 188:1281-1287. [PMID: 30874715 DOI: 10.1093/aje/kwz070] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 03/06/2019] [Accepted: 03/07/2019] [Indexed: 12/17/2022] Open
Abstract
In this cross-sectional study, we evaluated associations between cadmium, lead, and mercury levels and the presence of albuminuria in US adults who participated in the National Health and Nutrition Examination Survey during the period 2009-2012. A total of 2,926 adults aged ≥20 years were included, representing a population-based sample of 18,264,307 persons. Data on blood and urinary levels of cadmium, lead, and mercury and urinary albumin concentration (albuminuria, measured as albumin:creatinine ratio (ACR) ≥30 mg/g) were obtained. Multivariate linear regression was used to analyze associations between log-transformed cadmium, lead, and mercury levels and the presence of albuminuria. Urinary ACR was significantly higher among participants with a blood cadmium level of 0.349-0.692 μg/L (quartile 3) than in those with a blood cadmium level less than or equal to 0.243 μg/L (quartile 1) (crude β = 0.15, 95% confidence interval (CI): 0.01, 0.28). Participants with a urinary cadmium level greater than or equal to 0.220 μg/L had a significantly higher ACR (0.220-0.403 μg/L (quartile 3): crude β = 0.12 (95% CI: 0.03, 0.21); ≥0.404 μg/L (quartile 4): crude β = 0.29 (95% CI: 0.18, 0.39)) than those with a urinary cadmium level less than or equal to 0.126 μg/L (quartile 1). In conclusion, only blood and urinary cadmium levels, not mercury or lead levels, were associated with albuminuria among adults in this population.
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Affiliation(s)
- Xiu-Juan Zhu
- Department of Nephrology, Children’s Hospital of Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, People’s Republic of China
| | - Jing-Jing Wang
- Department of Nephrology, Children’s Hospital of Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, People’s Republic of China
| | - Jian-Hua Mao
- Department of Nephrology, Children’s Hospital of Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, People’s Republic of China
| | - Qiang Shu
- Department of Thoracic and Cardiovascular Surgery, Children’s Hospital of Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, People’s Republic of China
| | - Li-Zhong Du
- Department of Neonatology, Children’s Hospital of Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, People’s Republic of China
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Tellez-Plaza M, Briongos-Figuero L, Pichler G, Dominguez-Lucas A, Simal-Blanco F, Mena-Martin FJ, Bellido-Casado J, Arzua-Mouronte D, Chaves FJ, Redon J, Martin-Escudero JC. Cohort profile: the Hortega Study for the evaluation of non-traditional risk factors of cardiometabolic and other chronic diseases in a general population from Spain. BMJ Open 2019; 9:e024073. [PMID: 31248913 PMCID: PMC6597740 DOI: 10.1136/bmjopen-2018-024073] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The Hortega Study is a prospective study, which investigates novel determinants of selected chronic conditions with an emphasis on cardiovascular health in a representative sample of a general population from Spain. PARTICIPANTS In 1997, a mailed survey was sent to a random selection of public health system beneficiaries assigned to the University Hospital Rio Hortega's catchment area in Valladolid (Spain) (n=11 423, phase I), followed by a pilot examination in 1999-2000 of 495 phase I participants (phase II). In 2001-2003, the examination of 1502 individuals constituted the Hortega Study baseline examination visit (phase III, mean age 48.7 years, 49% men, 17% with obesity, 27% current smokers). Follow-up of phase III participants (also termed Hortega Follow-up Study) was obtained as of 30 November 2015 through review of health records (9.5% of participants without follow-up information). FINDINGS TO DATE The Hortega Study integrates baseline information of traditional and non-traditional factors (metabolomic including lipidomic and oxidative stress metabolites, genetic variants and environmental factors, such as metals), with 14 years of follow-up for the assessment of mortality and incidence of chronic diseases. Preliminary analysis of time to event data shows that well-known cardiovascular risk factors are associated with cardiovascular incidence rates, which add robustness to our cohort. FUTURE PLANS In 2020, we will review updated health and mortality records of this ongoing cohort for a 5-year follow-up extension. We will also re-examine elder survivors to evaluate specific aspects of ageing and conduct geolocation to study additional environmental exposures. Stored biological specimens are available for analysis of new biomarkers. The Hortega Study will, thus, enable the identification of novel factors based on time to event data, potentially contributing to the prevention and control of chronic diseases in ageing populations.
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Affiliation(s)
- Maria Tellez-Plaza
- Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Madrid, Spain
- Area of Cardiometabolic and Renal Risk, Biomedical Research Institute Hospital Clinic de Valencia (INCLIVA), Valencia, Valencia, Spain
| | - Laisa Briongos-Figuero
- Department of Internal Medicine, Hospital Universitario Rio Hortega, Valladolid, Valladolid, Spain
| | - Gernot Pichler
- Area of Cardiometabolic and Renal Risk, Biomedical Research Institute Hospital Clinic de Valencia (INCLIVA), Valencia, Valencia, Spain
| | - Alejandro Dominguez-Lucas
- Area of Cardiometabolic and Renal Risk, Biomedical Research Institute Hospital Clinic de Valencia (INCLIVA), Valencia, Valencia, Spain
| | - Fernando Simal-Blanco
- Department of Internal Medicine, Hospital Universitario Rio Hortega, Valladolid, Valladolid, Spain
| | - Francisco J Mena-Martin
- Department of Internal Medicine, Hospital Universitario Rio Hortega, Valladolid, Valladolid, Spain
| | - Jesus Bellido-Casado
- Department of Internal Medicine, Hospital Universitario Rio Hortega, Valladolid, Valladolid, Spain
| | - Delfin Arzua-Mouronte
- Department of Internal Medicine, Hospital Universitario Rio Hortega, Valladolid, Valladolid, Spain
| | - Felipe Javier Chaves
- Genomic and Genetic Diagnosis Unit, INCLIVA, Valencia, Valencia, Spain
- CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), ISCIII, Madrid, Madrid, Spain
| | - Josep Redon
- Area of Cardiometabolic and Renal Risk, Biomedical Research Institute Hospital Clinic de Valencia (INCLIVA), Valencia, Valencia, Spain
- Deparment of Internal Medicine, Hospital Universitario Clinic de Valencia, Valencia, Valencia, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), ISCIII, Madrid, Madrid, Spain
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Moody EC, Coca SG, Sanders AP. Toxic Metals and Chronic Kidney Disease: a Systematic Review of Recent Literature. Curr Environ Health Rep 2019; 5:453-463. [PMID: 30338443 DOI: 10.1007/s40572-018-0212-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW Arsenic (As), cadmium (Cd), and lead (Pb) are ubiquitous toxicants with evidence of adverse kidney impacts at high exposure levels. There is less evidence whether environmental exposure to As, Cd, or Pb plays a role in development of chronic kidney disease (CKD). We conducted a systematic review to summarize the recent epidemiologic literature examining the relationship between As, Cd, or Pb with CKD. RECENT FINDINGS We included peer-reviewed studies published in English between January 2013 and April 2018 for As and Cd, and all dates prior to April 2018 for Pb. We imposed temporality requirements for both the definition of CKD (as per NKF-KDOQI guidelines) and environmental exposures prior to disease diagnosis. Our assessment included cohort, case-control or cross-sectional study designs that satisfied 5 inclusion criteria. We included a total of eight articles of which three, two, and four studies examined the effects of As, Cd, or Pb, respectively. Studies of As exposure consistently reported positive association with CKD incidence; studies of Pb exposure were mixed. We found little evidence of association between Cd exposure and CKD. Additional well-designed prospective cohort studies are needed and we present recommendations for future studies.
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Affiliation(s)
- Emily C Moody
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Steven G Coca
- Department of Nephrology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alison P Sanders
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,Departments of Pediatrics & Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA.
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Satarug S, Vesey DA, Nishijo M, Ruangyuttikarn W, Gobe GC. The inverse association of glomerular function and urinary β2-MG excretion and its implications for cadmium health risk assessment. ENVIRONMENTAL RESEARCH 2019; 173:40-47. [PMID: 30889420 DOI: 10.1016/j.envres.2019.03.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/28/2019] [Accepted: 03/10/2019] [Indexed: 05/22/2023]
Abstract
Urinary β2-microgroblin (β2-MG) excretion levels above 300 μg/g creatinine are used to indicate defective tubular reabsorption. Arguably, increased urinary β2-MG excretion could also reflect glomerular filtration rate decline. Thus, we investigated an association between urinary β2-MG and estimated glomerular filtration rate (eGFR). We studied 527 subjects, aged 30-87 years (mean 51.2), who lived in a rural area of Thailand polluted with cadmium (Cd). Of this cohort, 10.3% had urinary Cd levels <2 μg/g creatinine and 53.5% had urinary Cd levels ≥5 μg/g creatinine. Half (53.1%) of the participants had urinary β2-MG levels ≥ 300 μg/g creatinine, and 11.6% had low GFR, defined as eGFR <60 mL/min/1.73 m2. Lower eGFR values were associated with older age (β = -0.568, P < 0.001), higher urinary β2-MG (β = -0.170, P < 0.001), higher urinary Cd (β = -0.103, P = 0.005) and diabetes (β = 0.074, P = 0.032). An inverse association between eGFR and urinary β2-MG was evident in subjects with low GFR (β = -0.332, P = 0.033), but not in those with GFR >90 mL/min/1.73 m2 (β = -0.008, P = 0.896). These findings suggested Cd-induced nephron loss and reduced tubular reabsorption in low eGFR subjects. Urinary β2-MG levels <300 μg/g creatinine were associated with 4.66 (95% CI: 1.92, 11.32) fold increase in the POR for low GFR, compared with urinary β2-MG levels <100 μg/g creatinine. Findings in the present study cast doubt on a cut-off value for urinary β2-MG, while lending support to the notion that elevated urinary β2-MG excretion could indicate a fall of GFR.
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Affiliation(s)
- Soisungwan Satarug
- Kidney Disease Research Collaborative, The University of Queensland, Faculty of Medicine and Translational Research Institute, Brisbane, 4102, Australia.
| | - David A Vesey
- Kidney Disease Research Collaborative, The University of Queensland, Faculty of Medicine and Translational Research Institute, Brisbane, 4102, Australia; Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Brisbane, 4075, Australia
| | - Muneko Nishijo
- Department of Public Health, Kanazawa Medical University, Uchinada, Ishikawa, 920-0293, Japan
| | - Werawan Ruangyuttikarn
- Division of Toxicology, Department of Forensic Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Glenda C Gobe
- Kidney Disease Research Collaborative, The University of Queensland, Faculty of Medicine and Translational Research Institute, Brisbane, 4102, Australia; School of Biomedical Sciences, The University of Queensland, Brisbane, 4072, Australia; NHMRC Centre of Research Excellence for CKD, QLD, UQ Health Sciences, Royal Brisbane and Women's Hospital, Brisbane, 4029, Australia
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Wu W, Liu D, Jiang S, Zhang K, Zhou H, Lu Q. Polymorphisms in gene MMP-2 modify the association of cadmium exposure with hypertension risk. ENVIRONMENT INTERNATIONAL 2019; 124:441-447. [PMID: 30684802 DOI: 10.1016/j.envint.2019.01.041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/22/2018] [Accepted: 01/15/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Cadmium exposure has been inconsistently related with hypertension. However, epidemiologic data on the genetic susceptibility to the hypertensive effect of cadmium exposure are limited. OBJECTIVES We investigated whether the associations between cadmium exposure and hypertension risk differed by genetic polymorphisms in MMPs genes. METHODS The present study of 497 hypertension cases and 497 healthy controls was conducted in a Chinese population. Urinary cadmium levels were measured with inductively coupled plasma-mass spectrometer (ICP-MS). Multivariable logistic regression models were analyzed after controlling major confounders. RESULTS Within the multivariable logistic regression models, compared with the lowest tertile, the highest tertile of urinary cadmium had a 1.33-fold (95% CI: 1.01, 1.93) increased risk of hypertension. Carriers of rs243865 T allele and rs243866 A allele in MMP-2 were suggested to have increased risks of hypertension. The associations of urinary cadmium with hypertension risk were modified by rs14070 (P-value for interaction = 0.022) and rs7201 (P-value for interaction = 0.009) in gene MMP-2. Positively significant trends for increasing odds of hypertension with cadmium levels were observed among the wild types of rs14070 and rs7201, respectively. CONCLUSIONS Increasing urinary cadmium concentrations were positively associated with hypertension risk in a Chinese population, and the associations were modified by polymorphism of rs14070 and rs7201 in gene MMP-2.
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Affiliation(s)
- Weixiang Wu
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei 430030, China; Department of Clinical Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Dayang Liu
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei 430030, China
| | - Shunli Jiang
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei 430030, China
| | - Ke Zhang
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei 430030, China; Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, #1277 Jiefang Road, Wuhan, Hubei 430022, China
| | - Hao Zhou
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei 430030, China
| | - Qing Lu
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei 430030, China.
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Zang Y, Devleesschauwer B, Bolger PM, Goodman E, Gibb HJ. Global burden of late-stage chronic kidney disease resulting from dietary exposure to cadmium, 2015. ENVIRONMENTAL RESEARCH 2019; 169:72-78. [PMID: 30419431 DOI: 10.1016/j.envres.2018.10.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 10/03/2018] [Indexed: 06/09/2023]
Abstract
Chronic exposures to cadmium (Cd) are associated with reduced glomerular filtration rate (GFR), increasing the risk of chronic kidney disease (CKD). In support of the World Health Organization (WHO)'s initiative to estimate the global burden of foodborne diseases, a risk assessment was performed to estimate the Disability-Adjusted Life Years (DALYs) due to late-stage CKD associated with dietary exposures to cadmium. Using the distribution of population GFRs, the prevalence of CKD was calculated as the proportion of humans whose GFR fall in the ranges corresponding to Stage 4 or Stage 5 CKD. The increase in the CKD prevalence due to cadmium exposure was simulated based on a previously reported pharmacokinetic model describing the relationship between dietary cadmium intake and urinary cadmium (UCd), as well as a previously published dose-response relationship between UCd and GFR. Cadmium-related incidence rate, calculated as the change in the prevalence during a one-year period, were used to compute the mortality and DALY in all WHO regions. It is estimated that dietary cadmium would result in a median of 12,224 stage 4 and stage 5 new CKD cases per year worldwide, resulting in 2064 global deaths and 70,513 DALYs. These data translate into a median global burden of 1.0 DALY per 100,000 population, which account for 0.2% of the global DALYs of CKD. While these results suggest that the overall impact of dietary cadmium exposure on global CKD is low, they do indicate that reasonable efforts to reduce dietary exposure will result a positive public health impact. This would be particularly the case in areas with elevated levels of dietary cadmium.
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Affiliation(s)
- Yu Zang
- Center for Food Safety and Applied Nutrition, US Food and Drug Administration, 5001 Campus Drive, College Park, MD 20740, USA
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium; Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
| | | | - Emily Goodman
- George Washington University Milken Institute School of Public Health, Washington, D.C., USA
| | - Herman J Gibb
- George Washington University Milken Institute School of Public Health, Washington, D.C., USA; Gibb Epidemiology Consulting LLC, Arlington, VA, USA
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Satarug S, Boonprasert K, Gobe GC, Ruenweerayut R, Johnson DW, Na-Bangchang K, Vesey DA. Chronic exposure to cadmium is associated with a marked reduction in glomerular filtration rate. Clin Kidney J 2018; 12:468-475. [PMID: 31384436 PMCID: PMC6671389 DOI: 10.1093/ckj/sfy113] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Indexed: 01/09/2023] Open
Abstract
Background Urinary 20-hydroxyeicosatetraenoic acid (20-HETE) has been associated with hypertension in women with elevated urinary cadmium (Cd) excretion rates. The present study investigates the urinary Cd and 20-HETE levels in relation to the estimated glomerular filtration rate (eGFR) and albumin excretion in men and women. Methods A population-based, cross-sectional study, which included 225 women and 84 men aged 33–55 years, was conducted in a rural area known to be polluted with Cd. Results In all subjects, lower eGFR values were associated with higher urinary Cd excretion (P = 0.030), and tubulopathy markers N-acetyl-β-d-glucosaminidase (P < 0.001) and β2-microglobulin (β2-MG) (P < 0.001). On average, the hypertensive subjects with the highest quartile of urinary Cd had eGFR values of 12 and 17 mL/min/1.73 m2 lower than that in the hypertensive (P = 0.009) and normotensive subjects (P < 0.001) with the lowest quartile of urinary Cd, respectively. In men, urinary albumin was inversely associated with 20-HETE (β = −0.384, P < 0.001), while showing a moderately positive association with systolic blood pressure (SBP) (β = 0.302, P = 0.037). In women, urinary albumin was not associated with 20-HETE (P = 0.776), but was associated with tubulopathy, reflected by elevated urinary excretion of β2-MG (β = 0.231, P = 0.002). Conclusions Tubulopathy is a determinant of albumin excretion in women, while 20-HETE and SBP are determinants of urinary albumin excretion in men. Associations of chronic exposure to Cd with marked eGFR decline and renal tubular injury seen in both Cd-exposed men and women add to mounting research data that links Cd to the risk of developing chronic kidney disease.
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Affiliation(s)
- Soisungwan Satarug
- Centre for Kidney Disease Research, Faculty of Medicine, Translational Research Institute, University of Queensland, Brisbane, Australia
| | - Kanyarat Boonprasert
- Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand
| | - Glenda C Gobe
- Centre for Kidney Disease Research, Faculty of Medicine, Translational Research Institute, University of Queensland, Brisbane, Australia
| | | | - David W Johnson
- Centre for Kidney Disease Research, Faculty of Medicine, Translational Research Institute, University of Queensland, Brisbane, Australia.,Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
| | - Kesara Na-Bangchang
- Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand
| | - David A Vesey
- Centre for Kidney Disease Research, Faculty of Medicine, Translational Research Institute, University of Queensland, Brisbane, Australia.,Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
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39
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Jiménez-Córdova MI, Cárdenas-González M, Aguilar-Madrid G, Sanchez-Peña LC, Barrera-Hernández Á, Domínguez-Guerrero IA, González-Horta C, Barbier OC, Del Razo LM. Evaluation of kidney injury biomarkers in an adult Mexican population environmentally exposed to fluoride and low arsenic levels. Toxicol Appl Pharmacol 2018; 352:97-106. [DOI: 10.1016/j.taap.2018.05.027] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/11/2018] [Accepted: 05/21/2018] [Indexed: 01/06/2023]
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Al-Saleh I, Al-Rouqi R, Elkhatib R, Abduljabbar M, Al-Rajudi T. Risk assessment of environmental exposure to heavy metals in mothers and their respective infants. Int J Hyg Environ Health 2017; 220:1252-1278. [PMID: 28869188 DOI: 10.1016/j.ijheh.2017.07.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 07/26/2017] [Accepted: 07/31/2017] [Indexed: 12/17/2022]
Abstract
Exposure to heavy metals can cause renal injury, which has been well documented in occupational exposure. Studies of low exposure in the general population, however, are still scarce, particularly for vulnerable populations such as mothers and young children. This study evaluated exposure to heavy metals, and biomarkers of renal function and oxidative stress in 944 lactating mothers and their infants and investigated the role of the interaction between heavy metals and oxidative stress in altering renal function. Mother and infant urine samples were analyzed to measure mercury (Hg), cadmium (Cd), and lead (Pb) concentrations for determining body-burden exposure; N-acetyl-β-d-glucosaminidase (NAG), α1-microglobulin (α1-MG), albumin (ALB), and creatinine (Cr) concentrations for determining early renal injury; and 8-hydroxy-2-deoxyguanosine (8-OHdG) and malondialdehyde (MDA) concentrations for determining oxidative stress. The median concentrclearlyations in mothers presented as μg/g Cr (infants as μg/l) for Hg, Cd, and Pb were 0.695 (0.716), 0.322 (0.343), and 3.97 (5.306) respectively. The mothers and their infants had clearly been exposed to heavy metals and had levels higher than the reference values reported for the general populations of USA, Germany, and Canada. Multiple regression analyses clearly demonstrated associations between urinary heavy metals in quartiles and several renal and oxidative biomarkers in mothers and to a lesser extent their infants. ß coefficients for urinary excretions of MDA, 8-OHdG, ALB, α1-MG, NAG, and Cr in mothers were high in the highest quartile of Hg (1.183-51.29μg/g Cr or 1.732-106.95μg/l), Cd (0.565-765.776μg/g Cr or 0.785-1347.0μg/l), and Pb (6.606-83.937μg/g Cr or 9.459-80.826μg/l), except Pb was not associated with ALB. Infants in the highest Pb quartile (9.293-263.098μg/l) had the highest ß coefficients of urinary excretion of MDA, 8-OHdG, ALB, NAG, and Cr. Significant increasing trend in biomarkers across the quartiles of the three metals was seen in both mothers and infants (ptrend <0.001). A receiver operating characteristic analysis supported the predictive abilities of the four renal biomarkers in discriminating between low versus high metal quartiles. The interaction between heavy metals and oxidative stress contributed to the high excretions of renal biomarkers, but the mechanism remains unclear. These findings add to the limited evidence that low exposure to heavy metals in the general population is associated with alterations in renal function that could eventually progress to renal damage if exposure continues and that children are more susceptible due to the immaturity of their body organs.
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Affiliation(s)
- Iman Al-Saleh
- Environmental Health Program, Research Centre, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh 11211, Saudi Arabia.
| | - Reem Al-Rouqi
- Environmental Health Program, Research Centre, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh 11211, Saudi Arabia
| | - Rola Elkhatib
- Environmental Health Program, Research Centre, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh 11211, Saudi Arabia
| | - Mai Abduljabbar
- Environmental Health Program, Research Centre, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh 11211, Saudi Arabia
| | - Tahreer Al-Rajudi
- Environmental Health Program, Research Centre, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh 11211, Saudi Arabia
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41
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Kang GF, Wang YZ, Bai YF, Chen ZZ, Feng F. Surface plasmon resonance based competitive immunoassay for Cd2+. RSC Adv 2017. [DOI: 10.1039/c7ra07635e] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
In this study, a label-free, specific and sensitive surface plasmon resonance (SPR) based competitive immunoassay was used for detecting Cd2+ in water samples.
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Affiliation(s)
- Gai-Feng Kang
- School of Chemistry and Materials Science
- Shanxi Normal University
- Linfen 041004
- P. R. China
| | - Yu-Zhen Wang
- College of Chemistry and Environmental Engineering
- Shanxi Datong University
- Datong 037009
- P. R. China
| | - Yun-Feng Bai
- College of Chemistry and Environmental Engineering
- Shanxi Datong University
- Datong 037009
- P. R. China
| | - Ze-Zhong Chen
- College of Chemistry and Environmental Engineering
- Shanxi Datong University
- Datong 037009
- P. R. China
| | - Feng Feng
- School of Chemistry and Materials Science
- Shanxi Normal University
- Linfen 041004
- P. R. China
- College of Chemistry and Environmental Engineering
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