Impact of urine concentration adjustment method on associations between urine metals and estimated glomerular filtration rates (eGFR) in adolescents.
Impact of urine concentration adjustment method on associations between urine metals and estimated glomerular filtration rates (eGFR) in adolescents.
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DOI：
10.1016/j.envres.2014.04.013
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发表时间：
2014-07
影响因子：
8.3
通讯作者：
Guallar, Eliseo
中科院分区：
文献类型：
--
作者：
Weaver, Virginia M.;Vargas, Gonzalo Garcia;Silbergeld, Ellen K.;Rothenberg, Stephen J.;Fadrowski, Jeffrey J.;Rubio-Andrade, Marisela;Parsons, Patrick J.;Steuerwald, Amy J.;Navas-Acien, Ana;Guallar, Eliseo
最近在一系列人群中报道了尿毒物水平与肾小球滤过率(GFR)之间的正相关关系。对这些关联的解释与传统的肾毒性相反，目前还不确定。也观察到尿液浓度调节方法的相关性的变化。在一项对居住在铅冶炼厂附近的青少年的横断面研究中，采用多元线性回归方法研究了尿镉、铊和铀在基于血肌酐和胱抑素C的估计肾小球滤过率(EGFR)模型中的相关性。比较尿液浓度调节方法包括尿肌酐、尿渗透压和不调节。中位年龄13.9岁，血铅4.0μg/dL，尿镉0.2 2，0.2 7，尿铀0.0 4g/g肌酐。只有在用尿肌酐校正尿液浓度时，尿镉和铊才与血肌酸型表皮生长因子受体呈正相关(β系数=3.1mL/min/1.73m2；95%可信区间=1.4，每增加一倍尿镉4.8%)。在这些金属和以胱抑素C为基础的EGFR之间以及尿铀和以肌酐为基础的EGFR之间观察到较弱的正相关性，也仅与尿肌酐调节有关。有必要进行额外的研究，使用非基于肌酐的方法调整尿液浓度。
Positive associations between urine toxicant levels and measures of glomerular filtration rate (GFR) have been reported recently in a range of populations. The explanation for these associations, in a direction opposite that of traditional nephrotoxicity, is uncertain. Variation in associations by urine concentration adjustment approach has also been observed. Associations of urine cadmium, thallium and uranium in models of serum creatinine- and cystatin-C-based estimated GFR (eGFR) were examined using multiple linear regression in a cross-sectional study of adolescents residing near a lead smelter complex. Urine concentration adjustment approaches compared included urine creatinine, urine osmolality and no adjustment. Median age, blood lead and urine cadmium, thallium and uranium were 13.9 years, 4.0 μg/dL, 0.22, 0.27 and 0.04 g/g creatinine, respectively, in 512 adolescents. Urine cadmium and thallium were positively associated with serum creatinine-based eGFR only when urine creatinine was used to adjust for urine concentration (β coefficient=3.1 mL/min/1.73 m2; 95% confidence interval=1.4, 4.8 per each doubling of urine cadmium). Weaker positive associations, also only with urine creatinine adjustment, were observed between these metals and serum cystatin-C-based eGFR and between urine uranium and serum creatinine-based eGFR. Additional research using non-creatinine-based methods of adjustment for urine concentration is necessary.
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