[Environmental exposure to cadmium and effects on human health. Part 1. Renal tubular function in inhabitants of the cadmium-polluted Jinzu River basin in Toyama Prefecture--special reference to urinary beta 2 microglobulin].
[Environmental exposure to cadmium and effects on human health. Part 1. Renal tubular function in inhabitants of the cadmium-polluted Jinzu River basin in Toyama Prefecture--special reference to urinary beta 2 microglobulin].
复制标题
[环境中镉的暴露及其对人体健康的影响。
DOI：
10.1265/jjh.43.853
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发表时间：
1988
期刊：
影响因子：
--
通讯作者：
M. Kasuya
中科院分区：
文献类型：
--
作者：
K. Aoshima;K. Iwata;M. Kasuya
对金祖江流域87名55~71岁女性居民的肾功能进行了研究，包括肾小球蛋白2-微球蛋白(β2-m)清除(Cβ2-m/Ccr)、肌酐清除(Ccr)、单位体积肾小管磷酸盐最大重吸收率(β/Gfr)、尿酸清除(CuA/Ccr)、血气分析和肾糖尿。1)87例受试者尿β_2-m范围为0.50~137.7 mg/g肌酐，几何平均值为7.53 mg/g肌酐，均有升高。2)C-β2-m/Ccr值在0.2%~68.9%之间，几何均数为4.10%，均有升高。尿β2-m排泄量与Cβ2-m/Ccr呈高度正相关(r=0.986；p<；0.001)。85例受试者血清β2-m水平均未超过β2-m肾阈值4.5 mg/L，提示85例受试者尿β2-m升高表现为近曲小管β2-m重吸收障碍。3)Ccr为9.5~95.8ml/min，算术平均值为58.7ml/min。Ccr有随尿β2-m排泄量增加而降低的趋势(r=-0.419；p<；0.001)。4)TMP/GFR与尿β_2-m呈显著正相关(r=-0.508；p<；0.001)。TMP/GFR<2.5 mg/dl者27例(31.4%)。5)CuA/Ccr的几何平均值为27.6%(观测范围为13.8~90.6%)，所有数值均增大。尿β2-m水平与CuA/Ccr呈显著正相关(r=0.692；p<；0.001)。6)77例受检者尿β2-m水平与血碳酸氢盐浓度呈显著负相关(r=-0.560；p<；0.001)。7)尿糖与β_(2-m)呈高度正相关(r=0.775；p<；0.001)。8)这些结果表明，镉污染的金祖江流域居民存在多发性近端肾小管功能障碍。尿β2-m水平可较好地反映肾小管功能障碍的严重程度，尿β2-m水平与其他评价肾小管功能的指标具有良好的相关性。
Renal functiGns, such as β2-microglobulin (β2-m) clearance (Cβ2-m/Ccr), creatinine clearance (Ccr), the maximum tubuiar reabsorptive rate for phosphate per unit volume of GFR (TmP/GFR), uric acid clearance (Cua/Ccr), blood gas analysis and renal glucosuria, were studied in 87 female inhabitants (aged 55 to 71 years) of the cadmium-polluted Jinzu River basin. 1) The values for urinary β2-m in the 87 sublects ranged from 0.5 to 137.7mg/g creatinine with a geometric mean of 7.53mg/g creatinine; all values were increased. 2) The values for Cβ2-m/Ccr in these sublects ranged from 0.2 to 68.9% with a geometric mean of 4.10%; all values were increased. The correlation between urinary β2-m excretion and Cβ2-m/Ccr was highly significant (r=0.986; p<0.001). The values for serum β2-m in 85 subjects did not exceed 4.5mg/ liter, which is the level of the renal threshold of β2-m, so that the increased urinary levels ofβ2-m in the 85 subjects showed a disturbance of reabsorption of,β2-m at the proximal tubules. 3) The values for Ccr ranged from 9.5 to 95.8ml/min, with an arithmetric mean of 58.7ml/min. There was a tendency for Ccr to decrease as urinary excretion of β2-m increased (r=-0.419; p<0.001). 4) The correlation between TmP/GFR and urinary levels of β2-m was significant (r=-0.508;p< 0.001). The values for TmP/GFR in 27 subjects (31.4%) were below 2.5 mg/dl. 5) The geometric mean value for Cua/Ccr was 27.6% (observed range 13.8 to 90.6%); all values were increased. The correlation between Cua/Ccr and urinary levels ofβ2-m was significant (r=0.692; p< 0.001). 6) A significant negative correlation between the urinary level of β2-m and the bicarbonate concentration in blood in 77 subjects examined was found (r=-0.560; p<0.001). 7) Ahighly significant correlation between urinary glucose and β2-m was found (r=0.775; p<0.001). 8) These results indicate that the inhabitants of the cadmium-polluted Jinzu River basin had multiple proximal renal tubular dysfunction. The urinary levels of β2-m provide a good indicator of the severity of renal tubular dysfunction, showing good correlations between β2-m levels in urine and other indices for evaluating the renal tubular function.