Blood lead level and kidney function in US adolescents: The Third National Health and Nutrition Examination Survey.
Blood lead level and kidney function in US adolescents: The Third National Health and Nutrition Examination Survey.
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DOI：
10.1001/archinternmed.2009.417
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发表时间：
2010-01-11
影响因子：
--
通讯作者：
Furth, Susan L.
中科院分区：
文献类型：
--
作者：
Fadrowski, Jeffrey J.;Navas-Acien, Ana;Tellez-Plaza, Maria;Guallar, Eliseo;Weaver, Virginia M.;Furth, Susan L.
慢性、高水平的铅暴露是肾脏疾病的已知风险因素。目前低水平环境铅暴露的影响不太为人所知，特别是在儿童中，他们通常没有高血压和糖尿病等肾脏疾病风险因素。因此，在这项研究中，我们调查了具有代表性的美国青少年样本中铅暴露与肾功能之间的关系。研究对象包括769名12-20岁的青少年，他们在1988-1994年间进行的第三次全国健康与营养调查中进行了全血铅和血清胱抑素C的测定。血铅水平和肾功能水平(肾小球滤过率[GFR])之间的相关性由基于胱抑素C和基于肌酐的估计方程确定。全血铅水平中位数为1.5ming/dL(换算为微摩尔每升，乘以0.0483)，半胱氨酸氨基转移酶C估计的肾小球滤过率中位数为112.9毫升/分钟/1.73m2。与第一个四分位数(<；1≥g/dL)相比，铅水平处于最高四分位数(≥3.0μg/dL)的受试者的估计肾小球滤过率(95%可信区间，−0.7%至−12.6mL/分钟/1.73m2)低6.6mL/分钟/1.73m2。血铅水平增加一倍与估计肾小球滤过率降低2.9mL/min/1.73m2相关(95%可信区间，−为0.7%至−5.0mL/min/1.73m2)。铅水平也与较低的以肌酐为基础的GFR水平相关，但这种相关性弱于以胱抑素C为基础的GFR，并且没有统计学意义。在具有代表性的美国青少年样本中，血铅水平在低于疾病控制和预防中心指定的关注水平(10μg/dL)的范围内较高，与较低的估计GFR有关。这一发现有助于提供越来越多的流行病学证据，表明低水平环境铅暴露的不利影响。
Chronic, high-level lead exposure is a known risk factor for kidney disease. The effect of current low-level environmental lead exposure is less well known, particularly among children, a population generally free from kidney disease risk factors such as hypertension and diabetes mellitus. Therefore, in this study, we investigated the association between lead exposure and kidney function in a representative sample of US adolescents. Participants included 769 adolescents aged 12 to 20 years for whom whole blood lead and serum cystatin C were measured in the Third National Health and Nutrition Examination Survey, conducted from 1988–1994. The association between blood lead level and level of kidney function (glomerular filtration rate [GFR]), determined by cystatin C–based and creatinine-based estimating equations, was examined. Median whole blood lead level was 1.5 μg/dL (to convert to micromoles per liter, multiply by 0.0483), and median cystatin C–estimated GFR was 112.9 mL/min/1.73 m2. Participants with lead levels in the highest quartile (≥3.0 μg/dL) had 6.6 mL/min/1.73 m2–lower estimated GFR (95% confidence interval, −0.7 to −12.6 mL/min/1.73 m2) compared with those in the first quartile (<1 μg/dL). A doubling of blood lead level was associated with a 2.9 mL/min/1.73 m2–lower estimated GFR (95% confidence interval, −0.7 to −5.0 mL/min/1.73 m2). Lead levels were also associated with lower creatinine-based estimated GFR levels, but the association was weaker than with cystatin C–based GFR and not statistically significant. Higher blood lead levels in a range below the current Centers for Disease Control and Prevention–designated level of concern (10 μg/dL) were associated with lower estimated GFRs in a representative sample of US adolescents. This finding contributes to the increasing epidemiologic evidence indicating an adverse effect of low-level environmental lead exposure.
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DOI：
10.2215/cjn.00840208
发表时间：
2008-11-01
影响因子：
9.8
作者：
Groesbeck, Darcy;Koettgen, Anna;Furth, Susan
通讯作者：
Furth, Susan
DOI：
10.1001/archpedi.1991.02160060099029
发表时间：
1991-06-01
影响因子：
--
作者：
HU, H
通讯作者：
HU, H
影响因子：
13.2
作者：
Koettgen, Anna;Selvin, Elizabeth;Coresh, Josef
通讯作者：
Coresh, Josef
影响因子：
6.1
作者：
Fels, LM;Wunsch, M;Stolte, H
通讯作者：
Stolte, H
影响因子：
7.3
作者：
INGLIS, JA;HENDERSON, DA;EMMERSON, BT
通讯作者：
EMMERSON, BT