{"title":"Association between exposure to arsenic, cadmium, and lead and chronic kidney disease: evidence from four practical statistical models.","authors":"Jiongli Huang, Jingying Mao, Huilin Liu, Zhongyou Li, Guiyun Liang, Dabiao Zhang, Junchao Yang, Wen Qin, Pingjing Wen, Yueming Jiang, Zhaoyu Mo","doi":"10.1007/s10653-024-02318-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Environmental exposure to arsenic (As), lead (Pb) and cadmium (Cd) may cause chronic kidney disease (CKD), with varying independent effects and unclear combined impact. This study aimed to evaluate these effects on CKD.</p><p><strong>Methods: </strong>1,398 individuals were included. Urine arsenic (UAs) was determined by atomic fluorescence method. Urinary cadmium (UCd) and blood lead (BPb) levels were determined by graphite-furnace atomic absorption spectrometry. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m<sup>2 </sup>or proteinuria. Generalized linear models (GLM), restricted cubic spline (RCS) models, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) models were employed to study the independent and combined effects of exposure to As, Pb and Cd on CKD risk.</p><p><strong>Results: </strong>Compared with non-CKD subjects, UAs, UCd, BPb, and creatinine adjusted urinary cadmium (UCdCr) were all significantly higher in CKD subjects. Compared with the lowest quartiles, the ORs (95%CIs) of CKD risk in the highest quartiles were 2.09 (1.16-3.74) for UAs, 2.84(1.56-5.18) for UCd, and 1.79 (1.05-3.06) for UCdCr, respectively. UAs, UCd, and UCdCr were all significantly positively associated with CKD risk in p-trend tests. RCS models revealed non-linear links between UAs, UCd, UCdCr and CKD risk, while a linear dose-response existed for BPb and CKD risk. The OR (95%CI) in WQS models were 1.72 (1.25-2.36) with UAs being the highest weighing metal(loid). BKMR models showed co-exposure mixture linked to higher CKD risk when the ln-transformed metal(loid)s above their 55th percentile. The ln-transformed UAs and UCdCr was significantly positively associated with CKD risk when the other two ln-transformed metals levels were all fixed at their different percentile levels. Synergism between Cd and Pb was also apparent.</p><p><strong>Conclusions: </strong>Single As, and Cd exposure were positively associated with an increased CKD risk. Co-exposure to As, Pb and Cd was positively associated with CKD risk, with As playing a dominant role.</p>","PeriodicalId":11759,"journal":{"name":"Environmental Geochemistry and Health","volume":"47 1","pages":"6"},"PeriodicalIF":3.2000,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Environmental Geochemistry and Health","FirstCategoryId":"93","ListUrlMain":"https://doi.org/10.1007/s10653-024-02318-3","RegionNum":3,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ENGINEERING, ENVIRONMENTAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Environmental exposure to arsenic (As), lead (Pb) and cadmium (Cd) may cause chronic kidney disease (CKD), with varying independent effects and unclear combined impact. This study aimed to evaluate these effects on CKD.
Methods: 1,398 individuals were included. Urine arsenic (UAs) was determined by atomic fluorescence method. Urinary cadmium (UCd) and blood lead (BPb) levels were determined by graphite-furnace atomic absorption spectrometry. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2 or proteinuria. Generalized linear models (GLM), restricted cubic spline (RCS) models, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) models were employed to study the independent and combined effects of exposure to As, Pb and Cd on CKD risk.
Results: Compared with non-CKD subjects, UAs, UCd, BPb, and creatinine adjusted urinary cadmium (UCdCr) were all significantly higher in CKD subjects. Compared with the lowest quartiles, the ORs (95%CIs) of CKD risk in the highest quartiles were 2.09 (1.16-3.74) for UAs, 2.84(1.56-5.18) for UCd, and 1.79 (1.05-3.06) for UCdCr, respectively. UAs, UCd, and UCdCr were all significantly positively associated with CKD risk in p-trend tests. RCS models revealed non-linear links between UAs, UCd, UCdCr and CKD risk, while a linear dose-response existed for BPb and CKD risk. The OR (95%CI) in WQS models were 1.72 (1.25-2.36) with UAs being the highest weighing metal(loid). BKMR models showed co-exposure mixture linked to higher CKD risk when the ln-transformed metal(loid)s above their 55th percentile. The ln-transformed UAs and UCdCr was significantly positively associated with CKD risk when the other two ln-transformed metals levels were all fixed at their different percentile levels. Synergism between Cd and Pb was also apparent.
Conclusions: Single As, and Cd exposure were positively associated with an increased CKD risk. Co-exposure to As, Pb and Cd was positively associated with CKD risk, with As playing a dominant role.
期刊介绍：
Environmental Geochemistry and Health publishes original research papers and review papers across the broad field of environmental geochemistry. Environmental geochemistry and health establishes and explains links between the natural or disturbed chemical composition of the earth’s surface and the health of plants, animals and people.
Beneficial elements regulate or promote enzymatic and hormonal activity whereas other elements may be toxic. Bedrock geochemistry controls the composition of soil and hence that of water and vegetation. Environmental issues, such as pollution, arising from the extraction and use of mineral resources, are discussed. The effects of contaminants introduced into the earth’s geochemical systems are examined. Geochemical surveys of soil, water and plants show how major and trace elements are distributed geographically. Associated epidemiological studies reveal the possibility of causal links between the natural or disturbed geochemical environment and disease. Experimental research illuminates the nature or consequences of natural or disturbed geochemical processes.
The journal particularly welcomes novel research linking environmental geochemistry and health issues on such topics as: heavy metals (including mercury), persistent organic pollutants (POPs), and mixed chemicals emitted through human activities, such as uncontrolled recycling of electronic-waste; waste recycling; surface-atmospheric interaction processes (natural and anthropogenic emissions, vertical transport, deposition, and physical-chemical interaction) of gases and aerosols; phytoremediation/restoration of contaminated sites; food contamination and safety; environmental effects of medicines; effects and toxicity of mixed pollutants; speciation of heavy metals/metalloids; effects of mining; disturbed geochemistry from human behavior, natural or man-made hazards; particle and nanoparticle toxicology; risk and the vulnerability of populations, etc.
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