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镉致肾损伤生物标志在长期环境暴露人群中应用的稳定性

Stability of cadmium-induced renal injury biomarkers in adult residents with long-term environmental cadmium exposure: a 13-month follow up survey

    摘要
  • 摘要:
      目的  探讨镉致肾损伤生物标志物在低环境暴露人群中应用的稳定性。
      方法  选择甘肃省某镉污染区在本地居住 ≥ 10年，年龄在40 ~ 69岁（生于1950 — 1979年）的63名居民以及与污染地区社会经济发展水平相似、自然环境优良、环境镉水平明显较低地区的17名居民作为观察对象，分别在2019年11月、2020年11月和2020年12月共收集3次静脉血和晨尿，测定血镉、尿镉、β2 – 微球蛋白（Uβ2-MG）、尿N – 乙酰 – β – D – 氨基葡萄糖苷酶（UNAG）、尿视黄醇结合蛋白（URBP）、尿金属硫蛋白（UMT）和尿白蛋白（UALB），并对数据进行重复测量设计资料的方差分析，χ2检验对一般情况进行比较。
      结果  污染地区与对照地区研究对象性别、年龄、吸烟和饮酒情况的构成差异均无统计学意义（P > 0.05）；时间因素对血镉、UALB、UMT和URBP的主效应均无统计学意义（均P > 0.05）；时间因素对尿镉、UNAG和Uβ2-MG的主效应均有统计学意义（均P < 0.001）。两两比较结果显示3个时间点血镉、UALB、UMT和URBP水平差异均无统计学意义（均P > 0.05）；第2次检测和第3次检测尿镉水平均明显高于第1次检测（均P < 0.001），第3次检测尿镉水平明显高于第2次检测（P < 0.01）；第2次检测UNAG水平明显高于第1次检测和第3次检测（均P < 0.001），第1次检测与第3次检测UNAG水平差异无统计学意义（P > 0.05）；第3次检测Uβ2-MG水平明显高于第1次检测和第2次检测（均P < 0.001），第1次检测与第2次检测Uβ2-MG水平差异无统计学意义（P > 0.05）。
      结论  血镉、UALB、UMT和URBP受时间因素影响小，稳定性好；尿镉、UNAG和Uβ2-MG受时间因素影响较大，稳定性较差。

     

    Abstract:
      Objective  To investigate the stability of cadmium-induced renal injury biomarkers in community adults with low environmental exposure.
      Methods  The participants of the survey were 80 permanent residents aged 40 – 69 years living in local areas at least 10 years (63 in an area with relatively heavy environmental cadmium pollution and 17 in an area with similar social and economic development to those of the contaminated area but with low environmental cadmium pollution) in Gansu province. Peripheral blood and morning urine samples of the participants were collected three times in November 2019, November 2020 and December 2020, for detections of blood cadmium, urinary cadmium, urinary β2-microglobulin (Uβ2-MG), urinary N-acetyl-β-D-glucosaminidase (UNAG), urinary retinol binding protein (URBP), urinary metallothionein (UMT) and urinary micro-albumin (UALB), respectively. Relevant information of the participants were collected simultaneously with questionnaire interviews. Descriptive statistics with variance analysis and Chi-square test were performed on the data collected.
      Results  The main effects of time on blood cadmium, UALB, UMT and URBP were not statistically significant (all P > 0.05). The main effects of time on urinary cadmium, UNAG and Uβ2-MG were statistically significant (all P < 0.001). Pairwise comparison showed that there were no significant differences in blood cadmium, UALB, UMT and URBP levels among detections at the three time points (all P > 0.05); but the levels of urinary cadmium in the second and third detection were significantly higher than that in the first detection (both P < 0.001); the level of urinary cadmium in the third detection was significantly higher than that in the second detection (P < 0.01); the UNAG level of the second detection was significantly higher than that of the first detection and the third detection (both P < 0.001). There was no significant difference in UNAG level between the first test and the third test (P > 0.05). The Uβ2-MG level in the third detection was significantly higher than that in the first and the second detection (both P < 0.001). There was no significant difference in Uβ2-MG level between the first and second detection (P > 0.05).
      Conclusion  Blood cadmium, UALB, UMT and URBP are less affected by time effect and of good stability; while urine cadmium, UNAG and Uβ2-MG are more affected by time effect and of poor stability.

     

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