Urinary proteins and enzymes as early indicators of renal dysfunction in chronic exposure to cadmium.
Urinary proteins and enzymes as early indicators of renal dysfunction in chronic exposure to cadmium.
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DOI：
10.1093/clinchem/39.5.757
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发表时间：
1993-05
影响因子：
9.3
通讯作者：
Klaus Jung;M. Pergande;H. Graubaum;L. M. Fels;Uirich Endl;Hilmar Stoke
中科院分区：
文献类型：
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作者：
Klaus Jung;M. Pergande;H. Graubaum;L. M. Fels;Uirich Endl;Hilmar Stoke
我们测试了各种尿分析物在早期检测镉诱导肾病的诊断灵敏度。我们调查了73名健康人（对照组1）和个人接触镉，无论是环境（n = 36，风险组2）或职业（n = 62，暴露组3）。所有数据均与对照组中心95%参考区间的限值相关。血清肌酐和核糖核酸酶值，肾小球滤过率的指标，在三组中没有差异。在接触者（第3组）中，近端肾小管指标（低M（r）蛋白溶菌酶、核糖核酸酶、视黄醇结合蛋白和α 1-微球蛋白）比肾小球指标（高M（r）蛋白转铁蛋白、IgG和白蛋白）更常升高。低M（r）蛋白和肾小管酶的排泄率发生了不同的变化。丙氨酸氨基肽酶、碱性磷酸酶和N-乙酰-β-D-氨基葡萄糖苷酶升高，即使在风险组2中也是如此。α 1-微球蛋白在镉排泄< 5 μ mol/mol肌酐的接触者中升高。第2组30%和第3组39%的α 1-微球蛋白和N-乙酰-β-D-氨基葡萄糖苷酶的联合测定结果超过相应的参考上限。我们建议对这两种分析物进行筛查，以在早期阶段检测镉诱导的肾功能不全。
We tested the diagnostic sensitivity of various urinary analytes for detecting cadmium-induced nephropathy at an early stage. We investigated 73 healthy persons (control group 1) and individuals exposed to cadmium, either environmentally (n = 36, risk group 2) or occupationally (n = 62, exposed group 3). All data were related to limits of the central 95% reference intervals of the control group. The serum creatinine and ribonuclease values, indicators of the glomerular filtration rate, were not different in the three groups. In the exposed persons (group 3), proximal tubular indicators (low-M(r) proteins lysozyme, ribonuclease, retinol-binding protein, and alpha 1-microglobulin) were more often increased than the glomerular indices (higher-M(r) proteins transferrin, IgG, and albumin). Both the low-M(r) proteins and tubular enzymes were differently altered in their excretion rates. Alanine aminopeptidase, alkaline phosphatase, and N-acetyl-beta-D-glucosaminidase increased even in the risk group 2. alpha 1-Microglobulin was increased in the exposed persons whose cadmium excretion was < 5 mumol/mol creatinine. The combined determination of alpha 1-microglobulin and N-acetyl-beta-D-glucosaminidase exceeded the corresponding upper reference limits in 30% of group 2 and 39% of group 3. We recommend screening for these two analytes to detect cadmium-induced renal dysfunction at an early stage.