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Liang KH, Colombijn JMT, Verhaar MC, Ghannoum M, Timmermans EJ, Vernooij RWM. The general external exposome and the development or progression of chronic kidney disease: A systematic review and meta-analyses. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 358:124509. [PMID: 38968981 DOI: 10.1016/j.envpol.2024.124509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 06/07/2024] [Accepted: 07/03/2024] [Indexed: 07/07/2024]
Abstract
The impact of environmental risk factors on chronic kidney disease (CKD) remains unclear. This systematic review aims to provide an overview of the literature on the association between the general external exposome and CKD development or progression. We searched MEDLINE and EMBASE for case-control or cohort studies, that investigated the association of the general external exposome with a change in eGFR or albuminuria, diagnosis or progression of CKD, or CKD-related mortality. The risk of bias of included studies was assessed using the Newcastle-Ottawa Scale. Summary effect estimates were calculated using random-effects meta-analyses. Most of the 66 included studies focused on air pollution (n = 33), e.g. particulate matter (PM) and nitric oxides (NOx), and heavy metals (n = 21) e.g. lead and cadmium. Few studies investigated chemicals (n = 7) or built environmental factors (n = 5). No articles on other environment factors such as noise, food supply, or urbanization were found. PM2.5 exposure was associated with an increased CKD and end-stage kidney disease incidence, but not with CKD-related mortality. There was mixed evidence regarding the association of NO2 and PM10 on CKD incidence. Exposure to heavy metals might be associated with an increased risk of adverse kidney outcomes, however, evidence was inconsistent. Studies on effects of chemicals or built environment on kidney outcomes were inconclusive. In conclusion, prolonged exposure to PM2.5 is associated with an increased risk of CKD incidence and progression to kidney failure. Current studies predominantly investigate the exposure to air pollution and heavy metals, whereas chemicals and the built environment remains understudied. Substantial heterogeneity and mixed evidence were found across studies. Therefore, long-term high-quality studies are needed to elucidate the impact of exposure to chemicals or other (built) environmental factors and CKD.
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Affiliation(s)
- Kate H Liang
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - Julia M T Colombijn
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Marianne C Verhaar
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Marc Ghannoum
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands; National Poison Information Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Erik J Timmermans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Robin W M Vernooij
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
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Xie C, Yang S, Li Y, Zhang M, Xu Q, Wan Z, Song L, Lv Y, Luo D, Li Q, Wang Y, Chen H, Mei S. Associations of exposure to organochlorine pesticides and polychlorinated biphenyls with chronic kidney disease among adults: the modifying effects of lifestyle. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:45192-45203. [PMID: 38961018 DOI: 10.1007/s11356-024-34201-0] [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: 01/25/2024] [Accepted: 06/27/2024] [Indexed: 07/05/2024]
Abstract
Exposure to organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) has been reported to be associated with renal impairment and chronic kidney disease (CKD). Nevertheless, the research results thus far have exhibited inconsistency, and the effect of lifestyle on their association is not clear. In this study, we assessed the correlation between serum OCPs/PCBs and CKD and renal function indicators including estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR) among 1721 Chinese adults. In order to further investigate the potential impact of lifestyle, we conducted joint associations of lifestyle and OCPs/PCBs on CKD. We found a negative correlation between p,p'-DDE and eGFR, while logistic regression results showed a positive correlation between PCB-153 and CKD (OR, 1.92; 95% CI, 1.21, 3.06). Quantile g-computation regression analyses showed that the association between co-exposure to OCPs/PCBs and CKD was not significant, but p,p'-DDE and PCB-153 were the main contributors to the negative and positive co-exposure effects of eGFR and CKD, respectively, which is consistent with the regression results. Participants with both relatively high PCB-153 exposure and an unhealthy lifestyle had the highest risk of CKD, in the joint association analysis. The observed associations were generally supported by the FAS-eGFR method. Our research findings suggest that exposure to OCPs/PCBs may be associated with decreased eGFR and increased prevalence of CKD in humans, and a healthy lifestyle can to some extent alleviate the adverse association between PCB-153 exposure and CKD.
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Affiliation(s)
- Chang Xie
- 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, 430030, Hubei, China
| | - Sijie Yang
- 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, 430030, Hubei, China
| | - Yaping Li
- 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, 430030, 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, #13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Qitong Xu
- 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, 430030, Hubei, China
| | - Zhengce Wan
- 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
| | - Yongman Lv
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Dan Luo
- Analytical Application Center, Shimadzu (China) Co., LTD., Wuhan Branch, No 96 Linjiang Avenue, Wuhan, 430060, China
| | - Qiang Li
- Analytical Application Center, Shimadzu (China) Co., LTD., Wuhan Branch, No 96 Linjiang Avenue, Wuhan, 430060, 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
| | - Hui Chen
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Surong Mei
- 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, 430030, Hubei, China.
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Lv J, Guo L, Gu Y, Xu Y, Xue Q, Yang X, Wang QN, Meng XM, Xu DX, Pan XF, Xu S, Huang Y. National temporal trend for organophosphate pesticide DDT exposure and associations with chronic kidney disease using age-adapted eGFR model. ENVIRONMENT INTERNATIONAL 2022; 169:107499. [PMID: 36087379 DOI: 10.1016/j.envint.2022.107499] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/04/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
Whilst certain environmental organochlorine pesticide exposure may still pose significant burden, the associations between dichloro-diphenyl-trichloroethane (DDT) and chronic kidney disease (CKD) remain disputable notwithstanding the potentially inaccurate disease definition between age groups. National DDT exposure burden atlas was depicted from 92,061 participants by measuring their serum concentrations of DDT congeners and major metabolite in the US from 1999 to 2016. Temporal analyses of these toxicant exposure suggested that although serum DDT concentrations exhibited recent decline, the detection rates remain up to 99.8% every year, posing great concern for exposure risk. A total of 3,039 US adults were further included from these participants demonstrating the weighted CKD prevalence of 40.2% using the new age-adapted CKD-EPI40 model compared to 28.0% using the current CKD-EPI method. After adjustment for covariates, logistic regression model results showed individual metabolites and total DDT burden were positively, yet monotonically, associated with risk of CKD incidence (P-trend for all < 0.05), particularly among adults 40 years of age and older. Much heightened renal disease risk was also observed with high DDT exposure (OR, 1.55; 95 % CI, 1.11-2.15) in those who were hypertensive (P for heterogeneity < 0.001) but not with diabetes. The current high DDT exposure risk combined with elevated probability for CKD incidence call for health concerns and management for the environmentally persistent pollutants.
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Affiliation(s)
- Jia Lv
- Department of Toxicology, School of Public Health, Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, China
| | - Lijuan Guo
- Department of Toxicology, School of Public Health, Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, China
| | - Yue Gu
- Department of Nephrology, Henan Provincial Clinical Research Center for Kidney Disease, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Ying Xu
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Qingping Xue
- Department of Epidemiology and Biostatistics, Public School, Chengdu Medical College, Chengdu, China
| | - Xue Yang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Qu-Nan Wang
- Department of Toxicology, School of Public Health, Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, China
| | - Xiao-Ming Meng
- School of Pharmacy, Anhui Medical University, The Key Laboratory of Anti-Inflammatory of Immune Medicines, Ministry of Education, Hefei, China
| | - De-Xiang Xu
- Department of Toxicology, School of Public Health, Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, China
| | - Xiong-Fei Pan
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Wenjiang Institute of Women's and Children's Health, Wenjiang Maternal and Child Health Hospital, Chengdu, China.
| | - Shen Xu
- Department of Urology, Second Affiliated Hospital, Anhui Medical University, Hefei, China
| | - Yichao Huang
- Department of Toxicology, School of Public Health, Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, China.
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Li M, Wang R, Su C, Li J, Wu Z. Temporal Trends of Exposure to Organochlorine Pesticides in the United States: A Population Study from 2005 to 2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073862. [PMID: 35409545 PMCID: PMC8997618 DOI: 10.3390/ijerph19073862] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 02/04/2023]
Abstract
The current study aimed to investigate temporal trends of serum organochlorine pesticide (OCP) concentrations in the general United States population, approximately 30 years after the prohibition of OCP usage, by using National Health and Nutrition Examination Survey data. The least square geometric means and percent change in OCP concentrations were calculated by a survey weighted multiple linear regression model. Over 2005–2016, OCP concentrations showed significant downward temporal trends. Females had substantially higher concentrations of β-Hexachlorocyclohexane (β-HCH), p,p′-DDE and p,p′-DDT, but lower concentrations of Hexachlorobenzene (HCB) and trans-nonachlor. In addition, females had a more rapid decrease in p,p′-DDT levels over time than males. The overall OCP concentrations increased with age, and the two oldest age groups (aged 40–59 and 60+ years) had substantially lower rates of decrease than the younger age groups (aged 12–39 years). Concentrations and declines in OCPs (except for trans-nonachlor) were higher in Mexican Americans than both non-Hispanic Whites and non-Hispanic Blacks. There is a particular need for the ongoing monitoring of these banned chemicals, and measures should be taken to mitigate the exposure of vulnerable populations, including adults aged over 60, Mexican Americans, females for β-HCH, p,p′-DDE and p,p′-DDT, and males for HCB and trans-nonachlor.
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Affiliation(s)
- Mengmeng Li
- Department of Biostatistics, School of Public Health, Key Laboratory of Public Health Safety and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China;
| | - Rui Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (R.W.); (C.S.)
| | - Chang Su
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (R.W.); (C.S.)
| | - Jianwen Li
- China National Center for Food Safety Risk Assessment, Beijing 100022, China
- Correspondence: (J.L.); (Z.W.)
| | - Zhenyu Wu
- Department of Biostatistics, School of Public Health, Key Laboratory of Public Health Safety and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China;
- Correspondence: (J.L.); (Z.W.)
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Jolly AM, Thomas J. Chronic kidney disease of unknown etiology in India: a comparative study with Mesoamerican and Sri Lankan nephropathy. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:15303-15317. [PMID: 34984612 DOI: 10.1007/s11356-021-16548-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 09/11/2021] [Indexed: 06/14/2023]
Abstract
Chronic kidney disease of unknown etiology [CKDu] is a condition characterized by decline in kidney function and is not associated with diabetic nephropathy or hypertensive nephropathy. In this review, we have done a detailed literature analysis on CKDu in India, and then had a comparison with that of Mesoamerica and Sri Lanka. In India, CKDu became the second most common type of CKD after diabetic nephropathy. Silica was seen in the groundwater of both India and Sri Lanka, whereas in Mesoamerica silica exposure through particulate matter was seen among CKDu communities. DDE is a common agrochemical seen in both India and Sri Lanka. The risk factors vary from region to region and it is important to categorize CKDu population based on the risk factors to avoid misinterpretation of the condition as non-CKDu category and to evade further complications. More studies have to be conducted to reveal the detailed pathophysiological mechanisms and its relation with irrational exploitation of environmental resources.
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Affiliation(s)
- Aleeta Maria Jolly
- Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Ponekkara, Kerala, India
| | - Jaya Thomas
- Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Ponekkara, Kerala, India.
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Urinary concentrations of neonicotinoid insecticides were related to renal tubular dysfunction and neuropsychological complaints in Dry-zone of Sri Lanka. Sci Rep 2021; 11:22484. [PMID: 34795341 PMCID: PMC8602289 DOI: 10.1038/s41598-021-01732-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 11/03/2021] [Indexed: 12/04/2022] Open
Abstract
Neonicotinoids are systemic insecticides used since the 1990’s , that possess renal tubular toxicity. We conducted a field-based descriptive study in the North Central Dry-zone of Sri Lanka, where chronic kidney disease (CKD) of unknown etiology has been increasing since the 1990’s. To elucidate the relationship between renal tubular dysfunctions and urinary neonicotinoids concentrations, we collected spot urine samples from15 CKD patients, 15 family members, and 62 neighbors in 2015, analyzed two renal tubular biomarkers, Cystatin-C and L-FABP, quantified seven neonicotinoids and a metabolite N-desmethyl-acetamiprid by LC–MS/MS; and we investigated their symptoms using a questionnaire. Cystatin-C and L-FABP had a positive correlation (p < 0.001). N-Desmethyl-acetamiprid was detected in 92.4% of the urine samples, followed by dinotefuran (17.4%), thiamethoxam (17.4%), clothianidin (9.8%), thiacloprid and imidacloprid. Dinotefuran and thiacloprid have never been registered in Sri Lanka. In High Cystatin-C group (> 70 μg/gCre, n = 7), higher urinary concentration of dinotefuran (p = 0.009), and in Zero Cystatin-C group (< LOQ, n = 7), higher N-desmethyl-acetamiprid (p = 0.013), dinotefuran (p = 0.049), and thiacloprid (p = 0.035), and more complaints of chest pains, stomachache, skin eruption and diarrhea (p < 0.05) were found than in Normal Cystatin-C group (n = 78). Urinary neonicotinoids may be one of the potential risk factors for renal tubular dysfunction in this area.
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Redmon JH, Levine KE, Lebov J, Harrington J, Kondash AJ. A comparative review: Chronic Kidney Disease of unknown etiology (CKDu) research conducted in Latin America versus Asia. ENVIRONMENTAL RESEARCH 2021; 192:110270. [PMID: 33035557 DOI: 10.1016/j.envres.2020.110270] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/19/2020] [Accepted: 09/19/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION The incidence of chronic kidney disease of unknown or uncertain etiology (CKDu) is recognized as a global non-communicable health crisis. The goal of this work is to compare the types of research studies in Latin America and Asia, two regions with increasing CKDu incidence. METHODS A comparative literature review was conducted to evaluate the CKDu research design for peer-reviewed articles published from 2015 to 2019. Full texts were reviewed to identify study location, study type, study design, risk factors evaluated, and if applicable, sample type and number. RESULTS In Asia and Latin America, 82 and 65 articles were identified in total, respectively, with 55 field studies in Asia versus 34 in Latin America. In Asia, research was focused on drinking water (34), heavy metals (20), and agrochemical product usage (19) as potential risk factors. In Latin America, research focused mostly on heat stress/dehydration (36) and agrochemical product usage (18) as potential CKDu risk factors. Biological samples were collected more frequently than environmental samples, especially in Latin America. DISCUSSION Research to pinpoint the risk factors associated with CKDu to date is not standardized and typically limited in geographical scope. The emphasis of CKDu research varies by geographic region, with a greater priority placed on water quality and chemical exposure in Asia, versus dehydration and heat stress in Latin America. Using a harmonized approach to CKDu research would yield improved understanding of the risk factors associated with CKDu and how they compare across affected regions.
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Affiliation(s)
| | | | - Jill Lebov
- RTI International, Research Triangle Park, NC, USA
| | | | - A J Kondash
- RTI International, Research Triangle Park, NC, USA
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Jayasinghe S, Zhu YG. Chronic kidney disease of unknown etiology (CKDu): Using a system dynamics model to conceptualize the multiple environmental causative pathways of the epidemic. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 705:135766. [PMID: 31841920 DOI: 10.1016/j.scitotenv.2019.135766] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 11/24/2019] [Accepted: 11/24/2019] [Indexed: 06/10/2023]
Abstract
A chronic kidney disease of unknown etiology is devastating agricultural communities of Sri Lanka, Central America, areas of India, and Egypt. Researchers are yet to agree on its etio-pathogenesis despite many cross-sectional, case-control and cohort studies done in these countries. These approaches are broadly based on a reductionist approach. We propose a complementary paradigm based on complexity science to deepen our understanding of the disease. Complexity science views a population as system that has several dynamically interacting and inter-dependent sub-systems and is 'open' to the 'outer' environment. Health outcomes or epidemics are viewed as 'emergent' properties of the population. Using available literature from Sri Lanka, the paper presents a system dynamics model incorporating exposures from pesticides and heavy metals, drinking hard water with high levels of fluoride, poverty, low birth weight, micronutrient deficiencies and heat stress. This approach can be used to model the epidemic, understand the impacts of different factors, predict potential populations at risk, and formulate multi-pronged prevention strategies that target leverage points of the system.
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Affiliation(s)
- Saroj Jayasinghe
- Department of Clinical Medicine, University of Colombo, Colombo, Sri Lanka.
| | - Yong-Guan Zhu
- Environmental Soil Science and Biogeochemistry, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen, China
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Mengozzi A, Carli F, Biancalana E, Della Latta V, Seghieri M, Gastaldelli A, Solini A. Phthalates Exposure as Determinant of Albuminuria in Subjects With Type 2 Diabetes: A Cross-Sectional Study. J Clin Endocrinol Metab 2019; 104:1491-1499. [PMID: 30462244 DOI: 10.1210/jc.2018-01797] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 11/14/2018] [Indexed: 11/19/2022]
Abstract
CONTEXT Recent epidemiological observations have reported an association among phthalates exposure and insulin resistance, obesity, and diabetes but have not related exposure to these environmental pollutants with microvascular complications of diabetes. OBJECTIVE To explore the relationship between phthalates and renal function in subjects with diabetes. DESIGN Cross-sectional, case-only study. Concentrations of three urinary metabolites of di-2-ethylhexylphthalate were quantified in a spot morning urine sample, normalized for creatinine urinary excretion, and related to clinical parameters and phenotype, adjusting for confounders. PATIENTS Two hundred and nine patients with diabetes consecutively referred to our clinic. MAIN OUTCOME MEASURES Relationship between phthalates and renal function [evaluated with estimated glomerular filtration rate (eGFR) and albuminuria]. RESULTS Creatinine-adjusted urinary concentrations of mono-2-ethylhexyl phthalate (MEHP), mono-2-ethyl-5-oxohexyl phthalate (MEOHP), and mono-2-ethyl-5-hydroxyhexyl phthalate were 7.53 µg/g (range, 4.84 to 12.60), 3.04 µg/g (range, 1.03 to 5.14), and 10.70 µg/g (7.02 to 17.40), respectively. Age, sex, body mass index, diabetes duration, smoking, blood pressure, glycated Hb, and eGFR did not influence their levels. Exposure to MEHP and MEOHP was greater in individuals with microalbuminuria/macroalbuminuria (MEHP, P = 0.0173; MEOHP, P = 0.0306). The fourth vs first quartile showed a greater risk of albuminuria (MEHP: OR, 4.83; 95% CI, 1.45 to 16.06; P = 0.0297; MEOHP: OR, 3.29; 95% CI, 1.08 to 10.04); P = 0.0352). MEOHP was greater (P = 0.034) in subjects with cardiovascular events; MEHP showed a positive trend (P = 0.061). CONCLUSION Our findings have revealed an association between exposure to di-2-ethylhexylphthalate metabolites and the degree of albuminuria in subjects with diabetes; the lack of a relationship with eGFR suggests their urinary levels are independent of renal function.
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Affiliation(s)
- Alessandro Mengozzi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Fabrizia Carli
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Edoardo Biancalana
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Marta Seghieri
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Amalia Gastaldelli
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Anna Solini
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
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Addition of Carbonaceous Material to Aquatic Sediments for Sorption of Lindane and p,p’-Dichlorodiphenyldichloroethylene. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9091722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Isomers of hexachlorocyclohexanes (HCHs) and metabolites of dichlorodiphenyltrichloroethanes (DDTs) are still frequently detected worldwide in considerable amounts, even decades after their prohibition. Carbonaceous materials (CMs) have been shown to significantly reduce risks of propagation to humans by binding the hydrophobic organochlorine pesticides (OCPs) present in aquatic sediments. In the present study, black carbons extracted from natural sediments, and artificially produced black carbons, including black carbons by burning rice straw at 450 and 850 °C, and a commercial activated carbon were compared to investigate the factors affecting the sorption of γ-HCH (lindane) and p,p’-dichlorodiphenyldichloroethylene (p,p’-DDE) on CMs. The results indicated that when the proportion of CMs to total organic carbon (ƒCM/ƒOC) was greater than 0.35, CMs played a leading role in the sorption of lindane and p,p’-DDE by the sediments. The sorption contribution rate of CMs could reach up to 64.7%. When the ratio of ƒCM/ƒOC was less than 0.10, CMs played a minor role in the sorption. In addition, the nonlinearity of the sorption isotherms was strengthened with the increasing the proportion of CMs to total organic carbon. Our findings show that ƒCM/ƒOC value is a principal parameter for assessing the sorption capacity of sediments added by CMs for OCPs.
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Wimalawansa SJ. There is no evidence that organochlorine pesticides, such as DDT, cause chronic kidney disease of unknown etiology. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 649:1636-1637. [PMID: 30243793 DOI: 10.1016/j.scitotenv.2018.09.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 09/08/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Sunil J Wimalawansa
- Cardio-Metabolic and Endocrine Institute, Darmody Avenue, North Brunswick, N.J. 08902, U.S.A.
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