Low- and moderate- levels of arsenic exposure in young adulthood and incidence of chronic kidney disease: Findings from the CARDIA Trace Element Study.
Low- and moderate- levels of arsenic exposure in young adulthood and incidence of chronic kidney disease: Findings from the CARDIA Trace Element Study.
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DOI：
10.1016/j.jtemb.2020.126657
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发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
He K
中科院分区：
文献类型：
--
作者：
Yang K;Chen C;Brockman J;Shikany JM;He K
目前还不清楚砷是否会对肾脏产生不良的健康影响，在低和中等水平的暴露。我们前瞻性地研究了青年期测量的趾甲砷浓度与中年期慢性肾脏病（CKD）发病率的关系。在年轻人冠状动脉风险发展（CARDIA）研究中，共纳入了3，768名参与者（53%女性和48%黑人）。在CARDIA检查第2年，通过电感耦合等离子体质谱法评估趾甲剪下物中的砷浓度。如果估计的肾小球滤过率<60 mL/min/1.73 m2或白蛋白尿>30 mg/g，则确定为CKD事件。采用多变量校正的考克斯比例风险模型，对平均随访24年的趾甲砷水平与CKD发病率之间的关系进行了研究。在控制了潜在的混杂因素（包括人口统计学、社会经济学、生活方式因素、血压、血脂和血糖的临床测量以及病史）后，在脚趾甲中测量的砷暴露与CKD发病率无关（五分位数5与五分位数1：风险比= 1.04，95%置信区间= 0.78-1.40，趋势P = 0.38）。无效关联未被性别或种族改变。这项纵向研究并不支持低水平和中等水平的砷暴露与美国普通人群中CKD发病率升高相关的假设。需要进一步研究砷生物标志物的种类与肾毒性的关系。
It is unclear whether arsenic exerts adverse health effects on the kidney at low- and moderate- levels of exposure. We prospectively examined toenail arsenic concentrations measured during young adulthood in relation to incidence of chronic kidney disease (CKD) in midlife. A total of 3,768 participants (53% female and 48% blacks) in the Coronary Artery Risk Development in Young Adults (CARDIA) study were included. Arsenic concentration in toenail clippings was assessed by using inductively coupled plasma mass spectrometry at CARDIA exam year 2. Incident CKD was identified if having estimated glomerular filtration rate <60 mL/min per 1.73 m2 or albuminuria >30 mg/g. The association between toenail arsenic levels and CKD incidence over a mean of 24 years of follow-up was examined using multivariable-adjusted Cox proportional hazards models. After controlling for potential confounders, including demographics, socioeconomics, lifestyle factors, clinical measurements of blood pressure, lipids, and glucose, and medical history, arsenic exposure measured in toenails was not associated with CKD incidence (quintile 5 versus quintile 1: hazard ratio = 1.04, 95% confidence interval = 0.78–1.40, P for trend = 0.38). The null association was not modified by sex or race. This longitudinal study does not support the hypothesis that low- and moderate- levels of arsenic exposure are associated with elevated incidence of CKD in the US general population. Further studies are need to investigate species of arsenic biomarkers in relation to nephrotoxicity.
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