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Wu M, Hou W, Qin R, Wang G, Sun D, Geng Y, Du Y. Comparative mathematical modeling of causal association between metal exposure and development of chronic kidney disease. Front Endocrinol (Lausanne) 2024; 15:1362085. [PMID: 38752174 PMCID: PMC11094205 DOI: 10.3389/fendo.2024.1362085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
Background Previous studies have identified several genetic and environmental risk factors for chronic kidney disease (CKD). However, little is known about the relationship between serum metals and CKD risk. Methods We investigated associations between serum metals levels and CKD risk among 100 medical examiners and 443 CKD patients in the medical center of the First Hospital Affiliated to China Medical University. Serum metal concentrations were measured using inductively coupled plasma mass spectrometry (ICP-MS). We analyzed factors influencing CKD, including abnormalities in Creatine and Cystatin C, using univariate and multiple analysis such as Lasso and Logistic regression. Metal levels among CKD patients at different stages were also explored. The study utilized machine learning and Bayesian Kernel Machine Regression (BKMR) to assess associations and predict CKD risk based on serum metals. A chained mediation model was applied to investigate how interventions with different heavy metals influence renal function indicators (creatinine and cystatin C) and their impact on diagnosing and treating renal impairment. Results Serum potassium (K), sodium (Na), and calcium (Ca) showed positive trends with CKD, while selenium (Se) and molybdenum (Mo) showed negative trends. Metal mixtures had a significant negative effect on CKD when concentrations were all from 30th to 45th percentiles compared to the median, but the opposite was observed for the 55th to 60th percentiles. For example, a change in serum K concentration from the 25th to the 75th percentile was associated with a significant increase in CKD risk of 5.15(1.77,8.53), 13.62(8.91,18.33) and 31.81(14.03,49.58) when other metals were fixed at the 25th, 50th and 75th percentiles, respectively. Conclusions Cumulative metal exposures, especially double-exposure to serum K and Se may impact CKD risk. Machine learning methods validated the external relevance of the metal factors. Our study highlights the importance of employing diverse methodologies to evaluate health effects of metal mixtures.
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Affiliation(s)
- Miaoling Wu
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang, China
| | - Weiming Hou
- Department of Medical Engineering, Air Force Medical Center, PLA, Beijing, China
| | - Ruonan Qin
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang, China
| | - Gang Wang
- Experimental and Teaching Center, School of Public Health, China Medical University, Shenyang, China
| | - Da Sun
- Department of Nephrology, The First Hospital of China Medical University, Shenyang, China
| | - Ye Geng
- Blood Purification Center, The First Hospital of China Medical University, Shenyang, China
| | - Yinke Du
- Department of Nephrology, The First Hospital of China Medical University, Shenyang, China
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Haruna I, Obeng-Gyasi E. Association of Combined Per- and Polyfluoroalkyl Substances and Metals with Chronic Kidney Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:468. [PMID: 38673379 PMCID: PMC11050583 DOI: 10.3390/ijerph21040468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/04/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024]
Abstract
Background: Exposure to environmental pollutants such as metals and Per- and Polyfluoroalkyl Substances (PFAS) has become common and increasingly associated with a decrease in the estimated Glomerular Filtration Rate (eGFR), which is a marker often used to measure chronic kidney disease (CKD). However, there are limited studies involving the use of both eGFR and the urine albumin creatinine ratio (uACR), which are more comprehensive markers to determine the presence of CKD and the complexity of pollutant exposures and response interactions, especially for combined metals and PFAS, which has not been comprehensively elucidated. Objective: This study aims to assess the individual and combined effects of perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), Cadmium (Cd), Mercury (Hg), and Lead (Pb) exposure on CKD using data from the National Health and Nutritional Examination Survey (NHANES) 2017-2018. Methods: We employed the use of bivariate logistic regression and Bayesian Kernel Machine Regression (BKMR) in our analysis of the data. Results: Logistic regression results revealed a positive association between PFOA and CKD. Our BKMR analysis revealed a non-linear and bi-phasic relationship between the metal exposures and CKD. In our univariate exposure-response function plot, Cd and Hg exhibited a U and N-shaped interaction, which indicated a non-linear and non-additive relationship with both low and high exposures associated with CKD. In addition, the bivariate exposure-response function between two exposures in a mixture revealed that Cd had a U-shaped relationship with CKD at different quantiles of Pb, Hg, PFOA, and PFOS, indicating that both low and high levels of Cd is associated with CKD, implying a non-linear and complex biological interaction. Hg's interaction plot demonstrated a N-shaped association across all quantiles of Cd, with the 75th quantile of Pb and the 50th and 75th quantiles of PFOA and PFOS. Furthermore, the PIP results underscored Cd's consistent association with CKD (PIP = 1.000) followed by Hg's (PIP = 0.9984), then PFOA and PFOS with a closely related PIP of 0.7880 and 0.7604, respectively, and finally Pb (PIP = 0.6940), contributing the least among the five environmental pollutants on CKD, though significant. Conclusions: Our findings revealed that exposure to environmental pollutants, particularly Hg and Cd, are associated with CKD. These findings highlight the need for public health interventions and strategies to mitigate the cumulative effect of PFAS and metal exposure and elucidate the significance of utilizing advanced statistical methods and tools to understand the impact of environmental pollutants on human health. Further research is needed to understand the mechanistic pathways of PFAS and metal-induced kidney injury and CKD, and longitudinal studies are required to ascertain the long-term impact of these environmental exposures.
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Affiliation(s)
- Issah Haruna
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA
- Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA
| | - Emmanuel Obeng-Gyasi
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA
- Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA
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Liu S, Zhang L, Luo N, Wang M, Tang C, Jing J, Chen H, Hu Q, Tan L, Ma X, Zou Y. Metal mixture exposure and the risk for immunoglobulin A nephropathy: Evidence from weighted quantile sum regression. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:87783-87792. [PMID: 37434053 DOI: 10.1007/s11356-023-28706-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 07/05/2023] [Indexed: 07/13/2023]
Abstract
Immunoglobulin A nephropathy (IgAN) is the most common type of glomerulonephritis in adults worldwide. Environmental metal exposure has been reported to be involved in the pathogenic mechanisms of kidney diseases, yet no further epidemiological study has been conducted to assess the effects of metal mixture exposure on IgAN risk. In this study, we conducted a matched case‒control design with three controls for each patient to investigate the association between metal mixture exposure and IgAN risk. A total of 160 IgAN patients and 480 healthy controls were matched for age and sex. Plasma levels of arsenic, lead, chromium, manganese, cobalt, copper, zinc, and vanadium were measured using inductively coupled plasma mass spectrometry. We used a conditional logistic regression model to assess the association between individual metals and IgAN risk, and a weighted quantile sum (WQS) regression model to analyze the effects of metal mixtures on IgAN risk. Restricted cubic splines were used to evaluate overall associations between plasma metal concentrations and estimated glomerular filtration rate (eGFR) levels. We observed that except for Cu, all the metals analyzed were nonlinearly associated with decreased eGFR, and higher concentrations of arsenic and lead were associated with elevated IgAN risk in both single-metal [3.29 (1.94, 5.57), 6.10 (3.39, 11.0), respectively] and multiple-metal [3.04 (1.66, 5.57), 4.70 (2.47, 8.97), respectively] models. Elevated manganese [1.76 (1.09, 2.83)] levels were associated with increased IgAN risk in the single-metal model. Copper was inversely related to IgAN risk in both single-metal [0.392 (0.238, 0.645)] and multiple-metal [0.357 (0.200, 0.638)] models. The WQS indices in both positive [2.04 (1.68, 2.47)] and negative [0.717 (0.603, 0.852)] directions were associated with IgAN risk. Lead, arsenic, and vanadium contributed significant weights (0.594, 0.195, and 0.191, respectively) in the positive direction; copper, cobalt, and chromium carried significant weights (0.538, 0.253, and 0.209, respectively). In conclusion, metal exposure was related to IgAN risk. Lead, arsenic, and copper were all significantly weighted factors of IgAN development, which may require further investigation.
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Affiliation(s)
- Shaohui Liu
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, 530021, China
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, 530021, China
- Guangxi Key Laboratory of Environment and Health Research, Guangxi Medical University, Nanning, 530021, China
| | - Li'e Zhang
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, 530021, China
- Guangxi Key Laboratory of Environment and Health Research, Guangxi Medical University, Nanning, 530021, China
- Department of Occupational and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Na Luo
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, 530021, China
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, 530021, China
- Guangxi Key Laboratory of Environment and Health Research, Guangxi Medical University, Nanning, 530021, China
- Department of Clinical Nutriology, The First Affiliated Hospital of Shaoyang University, Shaoyang, 422000, China
| | - Mingjun Wang
- Department of Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
| | - Chuanqiao Tang
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, 530021, China
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, 530021, China
- Guangxi Key Laboratory of Environment and Health Research, Guangxi Medical University, Nanning, 530021, China
| | - Jiajun Jing
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, 530021, China
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, 530021, China
- Guangxi Key Laboratory of Environment and Health Research, Guangxi Medical University, Nanning, 530021, China
| | - Hao Chen
- Department of Occupational and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Qiuhua Hu
- Department of Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
| | - Lina Tan
- Department of Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
| | - Xiaoli Ma
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, 530021, China
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, 530021, China
- Guangxi Key Laboratory of Environment and Health Research, Guangxi Medical University, Nanning, 530021, China
| | - Yunfeng Zou
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, 530021, China.
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, 530021, China.
- Guangxi Key Laboratory of Environment and Health Research, Guangxi Medical University, Nanning, 530021, China.
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Wu J, Xu J, Zhao M, Li K, Yin G, Ge X, Zhao S, Liu X, Wei L, Xu Q. Threshold effect of urinary chromium on kidney function biomarkers: Evidence from a repeated-measures study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 262:115139. [PMID: 37327523 DOI: 10.1016/j.ecoenv.2023.115139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/07/2023] [Accepted: 06/11/2023] [Indexed: 06/18/2023]
Abstract
Chronic kidney disease (CKD) is a public health concern worldwide, and chromium exposure may be a risk factor due to its potential nephrotoxicity. However, research on the association between chromium exposure and kidney function especially the potential threshold effect of chromium exposure is limited. A repeated-measures study involving 183 adults (641 observations) was conducted from 2017 to 2021 in Jinzhou, China. Urinary albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) were measured as kidney function biomarkers. Generalized mixed models and two-piecewise linear spline mixed models were used to assess the dose-response relationship and potential threshold effect of chromium on kidney function, respectively. Temporal analysis was conducted by the latent process mixed model to depict the longitudinal change of kidney function over age. Urinary chromium was associated with CKD (odds ratio [OR] = 1.29; 95 % confidence interval [CI], 6.41, 14.06) and UACR (Percent change = 10.16 %; 95 % CI, 6.41 %, 14.06 %), and we did not find significant association between urinary chromium and eGFR (Percent change = 0.06 %; 95 % CI, -0.80 %, 0.95 %). The threshold analyses suggested the existence of threshold effects of urinary chromium, with inflection points at 2.74 μg/L for UACR and 3.95 μg/L for eGFR. Furthermore, we found that chromium exposure exhibited stronger kidney damage over age. Our study provided evidence for the threshold effects of chromium exposure on kidney function biomarkers and the heightened nephrotoxicity of chromium in older adults. More attention should be paid to the supervision of chromium exposure concentrations for preventing kidney damage, especially in older adults.
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Affiliation(s)
- Jingtao Wu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Jing Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China
| | - Meiduo Zhao
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Kai Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Guohuan Yin
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Xiaoyu Ge
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Shuanzheng Zhao
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Xiaolin Liu
- Department of Epidemiology and Biostatistics, Jinzhou Medical University, Jinzhou 121001, Liaoning Province, China
| | - Lanping Wei
- Jinzhou Central Hospital, Jinzhou 121001, Liaoning Province, China
| | - Qun Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China.
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5
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Choi JY, Kim SY, Kim T, Lee C, Kim S, Chung HM. Ambient air pollution and the risk of neurological diseases in residential areas near multi-purposed industrial complexes of korea: A population-based cohort study. ENVIRONMENTAL RESEARCH 2023; 219:115058. [PMID: 36521536 DOI: 10.1016/j.envres.2022.115058] [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: 05/09/2022] [Revised: 11/25/2022] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Abstract
Emerging evidence suggest that long-term exposure to air pollution may induce adverse effects on the central nervous system. However, no study explored the associations in large industrial complex (IC) areas which are one of the major contributors to air pollution. Therefore, we aimed to investigate the pollution status and the association between residential proximity and incidence of neurological diseases near two major ICs characterized as multi-purposed ICs in Korea. A retrospective cohort of residents near the ICs was constructed using Korea's health insurance data and monitored from 2008 to 2019. Emission amounts of the ICs and the air pollution status in the nearby (exposed) and remote (control) area were evaluated using data from national regulatory networks, and hazard ratios (HRs) and 95% confidence intervals (CIs) for neurological diseases of the exposed group compared to the control group were calculated using Cox proportional regression models. Overall, the complexes emitted large amounts of VOCs, CO, NOx, and PM10, and annual levels of ambient PM (2.5, 10), gaseous substances (NO2, SO2), VOCs and PAHs were higher in the exposed area compared to the control and/or the national average. The risk of inflammatory disease of the CNS (G00-09) and extrapyramidal and movement disorders (G20-26) were higher in the exposed area with a HR (95% CI) of 1.36 (1.10-1.68) and 1.33 (1.27-1.39) respectively. Among the subclasses, other extrapyramidal and movement disorders (G25) and epilepsy (G40) were associated with higher risks in the exposed area (HR (95%CI): 1.11 (1.04-1.18), 1.08 (1.00-1.16)) after adjusting for potential confounders. These results suggest that people living near ICs are more likely to be exposed to higher air pollution levels and have higher risks of developing several neurological disorders. However, further epidemiological studies in these industrial areas supplemented with other indicators of environmental exposure and control of other diverse factors are warranted.
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Affiliation(s)
- Ji Yoon Choi
- Environmental Health Research Division, Environmental Health Research Department, National Institute of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon, 22689, Republic of Korea
| | - Sung Yeon Kim
- Environmental Health Research Division, Environmental Health Research Department, National Institute of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon, 22689, Republic of Korea.
| | - Taekyu Kim
- Environmental Health Research Division, Environmental Health Research Department, National Institute of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon, 22689, Republic of Korea
| | - Chulwoo Lee
- Environmental Health Research Division, Environmental Health Research Department, National Institute of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon, 22689, Republic of Korea
| | - Suejin Kim
- Environmental Health Research Division, Environmental Health Research Department, National Institute of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon, 22689, Republic of Korea
| | - Hyen-Mi Chung
- Environmental Health Research Division, Environmental Health Research Department, National Institute of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon, 22689, Republic of Korea
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6
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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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7
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Tian X, Shan X, Ma L, Zhang C, Wang M, Zheng J, Lei R, He L, Yan J, Li X, Bai Y, Hu K, Li S, Niu J, Luo B. Mixed heavy metals exposure affects the renal function mediated by 8-OHG: A cross-sectional study in rural residents of China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 317:120727. [PMID: 36427825 DOI: 10.1016/j.envpol.2022.120727] [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: 07/01/2022] [Revised: 11/07/2022] [Accepted: 11/21/2022] [Indexed: 06/16/2023]
Abstract
Heavy metals are important risk factors for kidney, but their co-exposure effect on kidney and related mechanism remain unclear. This study evaluated the relationship between heavy metals and renal function, and the feasible mediation effect of oxidative stress. Based on the Dongdagou-Xinglong cohort, participants were recruited and their information were collected through questionnaires and physical examinations. The urine concentration of heavy metals like Cobalt, Nickel, Molybdenum, Cadmium, Antimony, Copper, Zinc, Mercury, Lead, Manganese, and renal injury biomarkers like β2-microglobulin, β-N-Acetylglucosaminidase, retinol-binding protein, 8-hydroxyguanine (8-OHG) were measured and corrected by creatinine. Linear regression was conducted to analyze the relationship between metals and renal biomarkers. Bayesian kernel machine regression, weighted quantile sum and quantile-based g-computation were applied to analyze the association between metal mixtures and renal biomarkers. Finally, the mediating effect of 8-OHG was analyzed through the mediation model. We found that these metals were positively related with renal biomarkers, where copper showed the strongest relationship. The co-exposure models showed that renal biomarkers increased with the concentration of mixtures, particularly for cadmium, copper, mercury, manganese. In addition, the proportion of 8-OHG in mediating effect of metals on renal function ranged from 2.6% to 86.9%. Accordingly, the renal function damage is positively associated with metals, and 8-OHG may play an important mediating role.
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Affiliation(s)
- Xiaoyu Tian
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Xiaobing Shan
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Li Ma
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Chenyang Zhang
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Mei Wang
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Jie Zheng
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Ruoyi Lei
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Li He
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Jun Yan
- The First School of Clinical Medical, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Xun Li
- The First School of Clinical Medical, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Yanjun Bai
- Silong Township Health Center in Baiyin City, Baiyin, Gansu, 730910, China
| | - Keqin Hu
- Mapo Township Health Center in Lanzhou City, Lanzhou, Gansu, 730115, China
| | - Sheng Li
- Public Health Department, The First People's Hospital of Lanzhou City, Lanzhou, Gansu, 730050, China
| | - Jingping Niu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, China.
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Su F, Zeeshan M, Xiong LH, Lv JY, Wu Y, Tang XJ, Zhou Y, Ou YQ, Huang WZ, Feng WR, Zeng XW, Dong GH. Co-exposure to perfluoroalkyl acids and heavy metals mixtures associated with impaired kidney function in adults: A community-based population study in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 839:156299. [PMID: 35643130 DOI: 10.1016/j.scitotenv.2022.156299] [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: 03/26/2022] [Revised: 05/19/2022] [Accepted: 05/24/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Previous studies have separately linked either perfluoroalkyl acid (PFAA) or heavy metal exposure with kidney dysfunction. However, the relationships of co-exposure to PFAAs and heavy metals with kidney function are still unclear. OBJECTIVES To explore the associations between exposure to PFAAs and heavy metals mixtures and kidney function in adults. METHODS We conducted a cross-sectional community-based population study in Guangzhou, China, enrolling 1312 adults from November 2018 to August 2019. We quantified 13 PFAAs in serum and 14 heavy metals in plasma. We chose estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD) as outcomes of interest. Distributed lag non-linear models (DLNMs) were used to check nonlinearity of individual pollutant with kidney function. Joint associations of pollutant mixtures on kidney function were assessed by Bayesian Kernel Machine Regression (BKMR) models. We further explored modification effects of gender. RESULTS Most individual PFAA and heavy metal were associated with declined kidney function in single-pollutant models. We also observed significant dose-response relationships of pollutant mixtures with reduced eGFR levels and increased odds of CKD in BKMR models. Perfluoroheptanesulfonic acid (PFHpS), arsenic (As) and strontium (Sr) were the predominant contributors among pollutant mixtures. A change in log PFHpS, As and Sr concentrations from the 25th to the 75th percentile were associated with a decrease in eGFR of -5.42 (95% confidence interval (CI): -6.86, -3.98), -2.14 (95% CI: -3.70, -0.58) and -1.87 (95% CI: -3.03, -0.72) mL/min/1.73 m2, respectively, when other pollutants were at their median values. In addition, the observed associations were more obvious in females. CONCLUSIONS We provided new evidence that co-exposure to PFAAs and heavy metals mixtures was associated with reduced kidney function in adults and PFHpS, As and Sr appeared to be the major contributors. Further studies are warranted to confirm our findings and elucidate the underlying mechanisms.
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Affiliation(s)
- Fan Su
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Mohammed Zeeshan
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Li-Hua Xiong
- Department of Environmental Health, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Jia-Yun Lv
- Department of Environmental Health, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Yan Wu
- Department of Environmental Health, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Xiao-Jiang Tang
- Guangzhou JES+US Pharmaceutical Technology Co., Ltd., Guangzhou 510530, China
| | - Yang Zhou
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Yan-Qiu Ou
- Department of Epidemiology, Guangdong Cardiovascular Institute, WHO Collaborating Center for Research and Training in Cardiovascular Diseases, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Wen-Zhong Huang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Wen-Ru Feng
- Department of Environmental Health, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
| | - Xiao-Wen Zeng
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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Chin WS, Pan SC, Huang CC, Chen YC, Hsu CY, Lin P, Chen PC, Guo YL. Proximity to petrochemical industrial parks and risk of chronic glomerulonephritis. ENVIRONMENTAL RESEARCH 2022; 208:112700. [PMID: 35016869 DOI: 10.1016/j.envres.2022.112700] [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: 10/25/2021] [Revised: 12/13/2021] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
This study determined whether individuals residing near petrochemical industrial parks (PIPs) have a higher risk of chronic glomerulonephritis (CGN). We performed population-based 1:4 case-control study by using Taiwan's National Health Insurance Research Database from 2000 to 2016. The subjects were aged 20-65 years, residing in western Taiwan, and did not have a history of any renal or urinary system disease in 2000. The case cohort included those who had at least three outpatient visits or one hospitalization between 2001 and 2016 with codes for CGN as per International Classification of Diseases (ICD)-Ninth and Tenth Revisions. Controls were randomly sampled age-, sex-, and urbanization-matched individuals without renal and urinary system diseases. Petrochemical exposure was evaluated by the distance to the nearest PIP of the residential township, and petrochemical exposure probability was examined considering the monthly prevailing wind direction. Conditional logistic regression was used to determine the association between petrochemical exposure and CGN risk. A total of 320,935 subjects were included in the final analysis (64,187 cases and 256,748 controls). After adjustment for potential confounders, living in townships within a 3-km radius of PIPs was associated with a higher risk of CGN (adjusted odds ratio [aOR] = 1.32, 95% confidence interval [CI] = 1.28-1.37). Compared with townships more than 20 km away from PIPs, those within 10 km of PIPs were associated with significantly increased risks of CGN in a dose-dependent manner. When prevailing wind was considered, townships with high exposure probability were associated with a significantly increased risk of CGN. We found that those residing near PIPs or with high petrochemical exposure probability had a higher risk of CGN. These findings highlight the need for monitoring environmental nephrotoxic substances and the renal health of residents living near PIPs.
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Affiliation(s)
- Wei-Shan Chin
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shih-Chun Pan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Ching-Chun Huang
- Environmental and Occupational Medicine, College of Medicine, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Cheng Chen
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Chin-Yu Hsu
- Department of Safety, Health and Environmental Engineering, Ming Chi University of Technology, New Taipei City, Taiwan; Center for Environmental Sustainability and Human Health, Ming Chi University of Technology, New Taipei City, Taiwan
| | - Pinpin Lin
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Pau-Chung Chen
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taiwan
| | - Yue Leon Guo
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Environmental and Occupational Medicine, College of Medicine, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan; Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taiwan.
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Okoye OC, Carnegie E, Mora L. Air Pollution and Chronic Kidney Disease Risk in Oil and Gas- Situated Communities: A Systematic Review and Meta-Analysis. Int J Public Health 2022; 67:1604522. [PMID: 35479765 PMCID: PMC9035494 DOI: 10.3389/ijph.2022.1604522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 03/15/2022] [Indexed: 11/24/2022] Open
Abstract
Objective: This systematic review and meta-analysis aimed at synthesising epidemiological data on the association between long-term air pollution and kidney-related outcomes in oil and natural gas (ONG) situated communities. Methods: We synthesised studies using the PRISMA 2020 guideline. We searched databases including Medline, Cochrane Library, CIHANL, CAB Abstracts, Greenlife, African Journal Online, Google Scholar and Web of Science, from inception to April 2021. Heterogeneity across studies and publication bias were assessed. Results: Twenty-five studies were systematically reviewed but only 14 were included in the meta-analysis and categorised based on the outcome studied. Residents of exposed communities have increased risk for Chronic Kidney Disease (CKD) (OR = 1.70, 95% CI 1.44–2.01), lower eGFR (OR = 0.55, 95% CI 0.48–0.67) and higher serum creatinine (OR = 1.39, 95% CI 1.06–1.82) compared to less exposed or unexposed populations. The risks for hypertension and kidney cancer between the two populations were not significantly different. Conclusion: We report an increased risk for CKD and kidney dysfunction in populations residing near petrochemical plants, although from a limited number of studies. The scientific community needs to explore this environment and non-communicable disease relationship, particularly in vulnerable populations.
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Affiliation(s)
- Ogochukwu Chinedum Okoye
- Department of Internal Medicine, Delta State University, Abraka, Nigeria
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, United Kingdom
- *Correspondence: Ogochukwu Chinedum Okoye,
| | - Elaine Carnegie
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Luca Mora
- Urban Innovation, Business School, Edinburgh Napier University, Edinburgh, United Kingdom
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Zhou TT, Hu B, Meng XL, Sun L, Li HB, Xu PR, Cheng BJ, Sheng J, Tao FB, Yang LS, Wu QS. The associations between urinary metals and metal mixtures and kidney function in Chinese community-dwelling older adults with diabetes mellitus. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 226:112829. [PMID: 34592520 DOI: 10.1016/j.ecoenv.2021.112829] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/11/2021] [Accepted: 09/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Previous studies have found associations between single toxic metals, such as arsenic and cadmium, and kidney function in adults with diabetes. However, studies with regards to other metals and metal mixtures are still limited. OBJECTIVE Our study aimed to investigate the associations between urinary concentrations of 5 selected metals and metal mixtures and kidney function using a sample of older adults with diabetes mellitus in Chinese communities. METHODS In a sample of older adults (n = 5186), 592 eligible subjects were included in this study. Urinary concentrations of 5 metals, i.e., arsenic (As), cadmium (Cd), vanadium (V), cobalt (Co), and thallium (Tl), were measured by inductively coupled plasma mass spectrometer (ICP-MS). Estimated glomerular filtration rate (eGFR) was calculated and dichotomized into indicator of chronic kidney disease (CKD). Logistic analysis and Bayesian kernel machine regression (BKMR) were used to explore the associations between single metals and metal mixtures and CKD, respectively. RESULTS Urinary levels of As and V were positively correlated with CKD (OR=2.37, 95% CI: 1.31-4.30 for As; OR=2.24, 95% CI: 1.25-4.03 for V), when compared the 4th quartile with the 1st quartile. After adjustment for potential confounders, the significant association between As and CKD still existed (OR=2.73, 95% CI: 1.23-6.07). BKMR analyses showed strong linear positive associations between As and V and CKD. Higher urinary levels of the mixture were significantly associated with higher odds of CKD in a dose-response pattern. As and V showed the highest posterior inclusion probabilities. CONCLUSION Urine As and V were positively associated with CKD in older adults with diabetes mellitus, separately and in a mixture. The metals mixture showed a linear dose-response association with the odds of CKD. The analyses of mixtures, rather than of single metals, may provide a real-world perspective on the relationship between metals and kidney function.
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Affiliation(s)
- Ting-Ting Zhou
- School of Public Health, Department of Hygiene Inspection and Quarantine, Anhui Medical University, Hefei, Anhui 230032, China
| | - Bing Hu
- Fuyang Center for Disease Control and Prevention, Fuyang, Anhui 236069, China
| | - Xiang-Long Meng
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei, Anhui 230032, China
| | - Liang Sun
- Fuyang Center for Disease Control and Prevention, Fuyang, Anhui 236069, China
| | - Huai-Biao Li
- Fuyang Center for Disease Control and Prevention, Fuyang, Anhui 236069, China
| | - Pei-Ru Xu
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei, Anhui 230032, China
| | - Bei-Jing Cheng
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei, Anhui 230032, China
| | - Jie Sheng
- School of Public Health, Experimental Center for Public Health, Anhui Medical University, Hefei, Anhui 230032, China
| | - Fang-Biao Tao
- School of Health Services Management, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, Anhui 230032, China
| | - Lin-Sheng Yang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei, Anhui 230032, China.
| | - Qing-Si Wu
- School of Public Health, Department of Hygiene Inspection and Quarantine, Anhui Medical University, Hefei, Anhui 230032, China; Department of Clinical Laboratory, The Second People's Hospital of Hefei, Hefei, Anhui 230011, China.
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