Biomarkers of renal effects in children and adults with low environmental exposure to heavy metals
Biomarkers of renal effects in children and adults with low environmental exposure to heavy metals
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DOI：
10.1080/15287390306384
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发表时间：
2003-05-09
影响因子：
2.6
通讯作者：
Mutti, A
中科院分区：
文献类型：
--
作者：
de Burbure, C;Buchet, JP;Mutti, A
长期接触铅、镉和汞等重金属对健康的影响被广泛记录在案，但关于环境中对这些金属的低暴露对肾脏的影响的数据很少，特别是在儿童中。这项研究的目的是评估生活在法国北部两家有色金属冶炼厂(Noyelle-Godault和Auby)周围以过去的重金属污染而闻名的环境中的儿童和成年人的肾脏参数，并将他们的结果与居住在邻近土壤未受污染的城市(总计：400名儿童，600名成年人，性别比=1)的年龄和性别匹配的对照组进行比较。通过测定尿总蛋白、白蛋白、转铁蛋白、β(2)-微球蛋白、视黄醇结合蛋白、刷状缘抗原和N-乙酰-β-D-氨基葡萄糖苷酶(NAG)排泄水平、血铅平均浓度(铅-B，儿童小于等于42.2微克/L，成人小于或等于71.3微克/L)和镉(镉，小于或等于0.52微克/L，成人小于或等于0.86微克/L)来评估肾功能的完整性。都相对较低，表明尽管土壤中的重金属含量相对较高(铅在100至1700 ppm之间，镉在0.7至233 ppm之间)，但从环境中对这些重金属的吸收较低。然而，生活在污染地区的男孩、女孩和妇女的PB-B水平显著增加，但男性没有。生活在污染地区的男孩、男性和女性的平均Cd-B水平也较高。对照组和接触组的尿汞浓度(HgU)相差不大。所研究的肾脏参数在对照组和接触组之间均无显著差异。通过逐步多元回归分析，分别检测铅、镉、汞、年龄、性别、体重指数(BMI)、尿肌酐水平和居住地等因素对儿童和成人肾脏参数的影响，包括一级金属相互作用项、吸烟习惯和饮酒情况。在整个儿童人群中，尿NAG活性(以体重指数和尿肌酐为标准)的排泄量与Cd-B水平之间唯一的正相关关系被发现，这表明即使是低镉负荷也可能对儿童的近端小管产生微妙的影响，尽管如果不增加暴露，有害后果不太可能发生。然而，即使在研究了重金属水平较高的较小亚类后也没有其他积极的发现，这些结果清楚地表明，即使土壤污染仍然很高，居住在目前遵守污染法规的有色金属冶炼厂周围对肾脏的影响也是最小的。
The health effects of chronic exposure to heavy metals such as lead, cadmium, and mercury are widely documented, yet few data exist about the renal impact of low environmental exposure to these metals, particularly in children. The aim of this study was to assess renal parameters in children and adults living in an environment known for its past heavy metal contamination around two nonferrous smelters in northern France (Noyelles-Godault and Auby) and to compare their results with age and gender-matched controls living in neighboring municipalities with unpolluted soil (total: 400 children, 600 adults, sex ratio = 1). The integrity of renal function was assessed by measuring the urinary excretion levels of total protein, albumin, transferrin, beta(2)-microglobulin, retinol-binding protein, brush border antigen, and the enzyme N-acetyl-beta-D-glucosaminidase (NAG), The mean blood concentrations of lead (Pb-B, children less than or equal to42.2 mug/L, adults less than or equal to71.3.mug/L) and of cadmium (Cd-B, children less than or equal to0.52 mug/L, adults less than or equal to0.86 mug/l.) were all relatively low, indicating a low uptake of these heavy metals from the environment despite relatively high levels in soil (between 100 and 1700 ppm for lead and 0.7 to 233 ppm for cadmium). Pb-B levels were, however, significantly increased in boys, girls, and women-but not men-living in the polluted area. Boys, men, and women living in the polluted area had also on average higher Cd-B levels. The concentrations of mercury in urine (Hg-U) were by contrast similar in control and exposed groups. None of the renal parameters studied showed a significant difference between control and exposed groups. The influence of heavy metals on renal parameters was further assessed by stepwise multiple regression, testing Pb-B, Cd-B, Hg-U, age, gender, body mass index (BMI), urinary creatinine levels, and area of residence as predictors in both children and adults, including first-order metal interaction terms, smoking habits, and alcohol consumption in adults. The only positive correlation was found between the urinary excretion of NAG activity (standardized for BMI and urinary creatinine) and Cd-B levels when taking the whole children population, indicating that even low cadmium burdens may produce subtle effects on the proximal tubule in children, although deleterious consequences are unlikely should exposure not increase. However, in the absence of other positive findings even after studying the smaller subgroups with higher levels of heavy metals, these results are clearly indicative of the minimal renal impact of living around nonferrous smelters that are currently complying with pollution regulations, even when soil contamination is still high.