Cadmium and lead in blood in relation to low bone mineral density and tubular proteinuria
Cadmium and lead in blood in relation to low bone mineral density and tubular proteinuria
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DOI：
10.1289/ehp.02110699
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发表时间：
2002-07-01
影响因子：
10.4
通讯作者：
Elinder, CG
中科院分区：
文献类型：
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作者：
Alfvén, T;Järup, L;Elinder, CG
长期接触镉可能导致肾脏和骨骼损伤。尿镉通常用作体内镉负荷的剂量估计。然而，尿中镉水平的升高不仅反映了高水平的镉剂量，而且还反映了肾功能障碍。在这项研究中，我们使用血镉作为剂量估计。此外，我们还分析了血铅。我们检查了479名男性和542名女性，年龄在16-81岁之间，他们在环境或职业中暴露于镉和铅。我们使用尿蛋白α 1-微球蛋白作为肾小管性蛋白尿的标志物，并使用双能X射线吸收法测量前臂骨密度。血镉和肾小管性蛋白尿之间的关系很强，即使我们排除了职业暴露的参与者。血镉水平最高的亚组发生肾小管性蛋白尿的风险是血镉水平最低的亚组的4倍。在老年组（年龄> 60岁）中，血镉水平最高的亚组的低骨密度风险（z评分< -1）几乎是血镉水平最低组的3倍。我们没有发现铅有类似的关联。所观察到的影响可能是由于过去较高的镉暴露造成的。这项研究加强了以前的证据表明，镉暴露可能会影响骨密度和肾功能。
Long-term exposure to cadmium may cause kidney and bone damage. Urinary cadmium is commonly used as the dose estimate for the body burden of cadmium. However, elevated levels of cadmium in the urine may reflect not only high levels of cadmium dose but also renal dysfunction. In this study we used blood cadmium as the dose estimate. In addition, we analyzed blood lead. We examined 479 men and 542 women, ages 16-81 years, who were environmentally or occupationally exposed to cadmium and lead. We used urinary protein alpha(1)-microglobulin as a marker for tubular proteinuria and measured forearm bone mineral density using dual-energy Xray absorptiometry, The relationship between blood cadmium and tubular proteinuria was strong, even when we excluded occupationally exposed participants. The subgroup with the highest blood cadmium levels had a 4-fold risk of tubular proteinuria compared to the subgroup with the lowest blood cadmium levels. In the older age group (age > 60), the risk of low bone mineral density (z-score < -1) for the subgroup with the highest blood cadmium levels was almost 3-fold compared to the group with lowest blood cadmium levels. We found no similar associations for lead. The observed effects may be caused by higher cadmium exposure in the past. This study strengthens previous evidence that cadmium exposure may affect both bone mineral density and kidney function.