Association between urinary arsenic levels and kidney damage in US adults: NHANES 2007–2018

IF 3.6 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Journal of Trace Elements in Medicine and Biology Pub Date : 2024-11-07 DOI:10.1016/j.jtemb.2024.127559

Nishat Tasnim Hasan , Xiaohui Xu , Daikwon Han , Garett Sansom , Taehyun Roh

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Abstract

Background

Chronic arsenic exposure is known to be associated with various diseases by inducing multiple organ dysfunctions. Despite the high prevalence of kidney diseases in the US and globally, population-level research on the link between inorganic arsenic and kidney damage remains limited. In our study, we assessed the association between urinary arsenic levels and kidney damage among US adults using a multi-marker approach.

Methods

We analyzed data from the National Health and Nutrition Examination Survey (2007–2018). Multivariable logistic regression models were employed to estimate the odds ratios (ORs) for kidney damage based on total urinary arsenic levels and multiple kidney biomarkers, including albuminuria, low estimated glomerular filtration rate (eGFR), hyperuricemia, and elevated blood urea nitrogen (BUN), while adjusting for demographic, socioeconomic, and other risk factors. Total urinary arsenic levels were calculated by summing the levels of arsenous acid (As3), arsenic acid (As5), and their methylated metabolites, monomethylarsinic acid (MMA), and dimethylarsinic acid (DMA). Dimethylarsinic acid (DMA) was calibrated for arsenobetaine using a residual regression method to minimize the influence of seafood-related exposure.

Results

After adjusting for covariates, we observed 1.29-fold higher odds (95 % CI 1.01, 1.64) of kidney damage in the highest quartile of urinary arsenic compared to the lowest quartile. Specifically, the odds of albuminuria and hyperuricemia were 1.49-fold (95 % CI 1.09, 2.03) and 1.38-fold (95 % CI 1.01, 1.88) higher, respectively, in the highest quartile. Additionally, for every one-unit increase in the natural log of arsenic levels, significant associations were observed for overall kidney damage (OR 1.10, 95 % CI 1.01, 1.20), albuminuria (OR 1.15, 95 % CI 1.03, 1.29), and hyperuricemia (OR 1.12, 95 % CI 1.02, 1.24) when considering arsenic levels in drinking water as a continuous variable.

Conclusion

Our study concludes that higher urinary arsenic levels are positively associated with kidney damage. Further prospective studies are needed to confirm these findings.

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美国成年人尿砷水平与肾损伤之间的关系：Nhanes 2007-2018。

背景：众所周知，长期接触砷会诱发多种器官功能障碍，从而导致多种疾病。尽管肾脏疾病在美国和全球的发病率都很高，但有关无机砷与肾脏损伤之间关系的人群研究仍然有限。在我们的研究中，我们采用多指标方法评估了美国成年人尿砷水平与肾损伤之间的关联：我们分析了美国国家健康与营养调查（2007-2018 年）的数据。采用多变量逻辑回归模型，根据总尿砷水平和多种肾脏生物标志物（包括白蛋白尿、估计肾小球滤过率（eGFR）低、高尿酸血症和血尿素氮（BUN）升高）估算肾脏损伤的几率比（ORs），同时对人口、社会经济和其他风险因素进行调整。尿砷总含量的计算方法是将砷酸（As3）、砷酸（As5）及其甲基化代谢产物单甲基胂酸（MMA）和二甲基胂酸（DMA）的含量相加。采用残差回归法对二甲基胂酸（DMA）进行了砷甜菜碱校准，以尽量减少与海产品有关的暴露的影响：结果：在对协变量进行调整后，我们发现尿砷含量最高的四分位数与最低的四分位数相比，肾脏受损的几率高出 1.29 倍（95 % CI 1.01，1.64）。具体来说，最高四分位数人群出现白蛋白尿和高尿酸血症的几率分别高出 1.49 倍（95 % CI 1.09，2.03）和 1.38 倍（95 % CI 1.01，1.88）。此外，当将饮用水中的砷含量视为连续变量时，砷含量的自然对数每增加一个单位，整体肾脏损害（OR 1.10，95 % CI 1.01，1.20）、白蛋白尿（OR 1.15，95 % CI 1.03，1.29）和高尿酸血症（OR 1.12，95 % CI 1.02，1.24）就会出现显著的相关性：我们的研究得出结论，尿砷水平较高与肾损伤呈正相关。需要进一步的前瞻性研究来证实这些发现。

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来源期刊

Journal of Trace Elements in Medicine and Biology 医学-内分泌学与代谢

CiteScore

6.60

自引率

2.90%

发文量

202

审稿时长

85 days

期刊介绍： The journal provides the reader with a thorough description of theoretical and applied aspects of trace elements in medicine and biology and is devoted to the advancement of scientific knowledge about trace elements and trace element species. Trace elements play essential roles in the maintenance of physiological processes. During the last decades there has been a great deal of scientific investigation about the function and binding of trace elements. The Journal of Trace Elements in Medicine and Biology focuses on the description and dissemination of scientific results concerning the role of trace elements with respect to their mode of action in health and disease and nutritional importance. Progress in the knowledge of the biological role of trace elements depends, however, on advances in trace elements chemistry. Thus the Journal of Trace Elements in Medicine and Biology will include only those papers that base their results on proven analytical methods. Also, we only publish those articles in which the quality assurance regarding the execution of experiments and achievement of results is guaranteed.