Renal effects of dental amalgam in children: the New England children's amalgam trial.
Renal effects of dental amalgam in children: the New England children's amalgam trial.
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DOI：
10.1289/ehp.10504
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发表时间：
2008-03
影响因子：
10.4
通讯作者：
McKinlay S
中科院分区：
文献类型：
--
作者：
Barregard L;Trachtenberg F;McKinlay S
汞具有肾毒性，牙科汞合金是汞暴露的一个来源。6-10岁的儿童（n = 534），有两个或多个后牙龋齿，但没有以前的汞合金充填，被随机分配到两个治疗之一-汞合金或树脂复合材料（白色填充物）-用于龋齿治疗在5年的随访。主要结局是智商的变化，但重要的次要结局是对肾小球和肾小管肾功能标志物的影响：尿白蛋白排泄、α 1-微球蛋白（A1 M）、γ-谷氨酰转肽酶（γ-GT）和N-乙酰-β-d-氨基葡萄糖苷酶（NAG）。在试验过程中，这些标志物与尿汞和协变量一起测量了几次。我们使用重复测量分析来评估结果。治疗组之间肾脏生物标志物的平均水平没有显著差异，牙科汞合金数量对这些标志物也没有显著影响。然而，在3-5年，汞合金组儿童中微量白蛋白尿（MA）的患病率显著增加（调整后的比值比为1.8; 95%置信区间为1.1-2.9）。这些病例中的大多数可能是暂时性MA，但银汞合金组中有10名儿童在3年和5年都有MA，而复合组中有2名儿童（p = 0.04）。肾小管标志物（A1 M、γ-GT或NAG）高水平的发生率无差异。MA的增加可能是一个随机发现，但应进一步测试。这些结果并不支持最近在一项观察性研究中发现的低水平汞对儿童肾小管生物标志物的影响。
Mercury is nephrotoxic and dental amalgam is a source of mercury exposure. Children 6–10 years of age (n = 534) with two or more posterior teeth with caries but no prior amalgam restorations, were randomized to one of two treatments—amalgam or resin composite (white fillings)—used for caries treatment during 5 years of follow-up. The primary outcome was change in IQ, but important secondary outcomes were effects on markers of glomerular and tubular kidney function: urinary excretion of albumin, alpha-1-microglobulin (A1M), γ-glutamyl transpeptidase (γ-GT), and N-acetyl-β-d-glucosaminidase (NAG). These markers were measured on several occasions during the trial, together with urinary mercury and covariates. We evaluated the results using repeated-measures analyses. There were no significant differences between treatment groups in average levels of renal biomarkers, nor significant effects of number of dental amalgams on these markers. There was, however, a significantly increased prevalence of microalbuminuria (MA) among children in the amalgam group in years 3–5 (adjusted odds ratio 1.8; 95% confidence interval, 1.1–2.9). Most of these cases are likely to be temporary MA, but 10 children in the amalgam group had MA in both years 3 and 5, versus 2 children in the composite group (p = 0.04). There were no differences in the occurrence of high levels of renal tubular markers (A1M, γ-GT, or NAG). The increase in MA may be a random finding, but should be tested further. The results did not support recent findings in an observational study of an effect of low-level mercury on tubular biomarkers in children.
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影响因子：
120.7
作者：
DeRouen, TA;Martin, MD;Martins, IP
通讯作者：
Martins, IP
影响因子：
9.8
作者：
Barregard, Lars;Horvat, Milena;Eugensson, Marie Haeger
通讯作者：
Eugensson, Marie Haeger
影响因子：
8.3
作者：
Levy, M;Schwartz, S;Rouah, F
通讯作者：
Rouah, F
影响因子：
8
作者：
Hogg, RJ;Portman, RJ;Ingelfinger, J
通讯作者：
Ingelfinger, J
影响因子：
10.4
作者：
de Burbure C;Buchet JP;Leroyer A;Nisse C;Haguenoer JM;Mutti A;Smerhovsky Z;Cikrt M;Trzcinka-Ochocka M;Razniewska G;Jakubowski M;Bernard A
通讯作者：
Bernard A