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The association between urinary metals/metalloids and chronic kidney disease among general adults in Wuhan, China.

ABSTRACT: The relation between exposure to single metal/metalloid and the risk of chronic kidney disease (CKD) remains unclear. We aimed to determine the single and mixed associations of 21 heavy metals/metalloids exposure and the risk of CKD. We performed a cross-sectional study that recruited 4055 participants. Multivariate logistic regression, linear regression and weighted quantile sum (WQS) regression were conducted to explore the possible effects of single and mixed metals/metalloids exposure on the risk of CKD, the risk of albuminuria and changes in the estimated glomerular filtration rate (eGFR). In single-metal models, Cu, Fe, and Zn were positively associated with increased risks of CKD (P-trend < 0.05). Compared to the lowest level, the highest quartiles of Cu (OR = 2.94; 95% CI: 1.70, 5.11; P-trend < 0.05), Fe (OR = 2.39; 95% CI: 1.42, 4.02; P-trend < 0.05), and Zn (OR = 2.35; 95% CI: 1.31, 4.24; P-trend < 0.05) were associated with an increased risk of CKD. After multi-metal adjustment, the association with the risk of CKD remained robust for Cu (P < 0.05). Weighted quantile sum regression revealed a positive association between mixed metals/metalloids and the risk of CKD, and the association was largely driven by Cu (43.7%). Specifically, the mixture of urinary metals/metalloids was positively associated with the risk of albuminuria and negatively associated with eGFR.

SUBMITTER: Huang Y

PROVIDER: S-EPMC10504376 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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The association between urinary metals/metalloids and chronic kidney disease among general adults in Wuhan, China.

Huang Yuchai Y Wan Zhengce Z Zhang Mingye M Hu Liu L Song Lulu L Wang Youjie Y Lv Yongman Y Wang Le L

Scientific reports 20230915 1

The relation between exposure to single metal/metalloid and the risk of chronic kidney disease (CKD) remains unclear. We aimed to determine the single and mixed associations of 21 heavy metals/metalloids exposure and the risk of CKD. We performed a cross-sectional study that recruited 4055 participants. Multivariate logistic regression, linear regression and weighted quantile sum (WQS) regression were conducted to explore the possible effects of single and mixed metals/metalloids exposure on the ...[more]

PMID: 37714886

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Project description:BackgroundWhile current epidemiological studies have documented associations between environmental metals and renal dysfunction, the majority have concentrated on plasma metal levels. The relationship between urinary metal exposure and chronic kidney disease (CKD) remains contentious, particularly within specific demographic groups.MethodsThis cross-sectional study included 2919 rural Chinese adults recruited between 2018 and 2019. Urine metals were measured by ICP-MS. Least absolute shrinkage and selection operator (LASSO) regression was employed to identify metals significantly associated with CKD. Then, we used binary logistic regression, along with restricted cubic spline (RCS) models, to assess the individual exposure effects of specific metals on CKD. Quantile g-computation, weighted quantile sum regression, and Bayesian kernel machine regression (BKMR) models were applied to evaluate combined effects of metal exposures on CKD. Gender-stratified analyses were also conducted to explore these associations.ResultsLASSO identified seven metals (V, Cu, Rb, Sr, Ba, W, Pb) with significant impacts on CKD. In single-metal models, Cu and W exhibited a positive correlation with CKD, whereas V, Rb, Sr, Ba, and Pb showed significant negative correlations (all p < 0.05). RCS analysis revealed nonlinear associations between V, Cu, Ba, Pb, and CKD (all p-nonlinear < 0.05). In the multi-metal model, quantile-based g-computation demonstrated a collective negative association with CKD risk for the seven mixed urinary metal exposures (OR (95% CI) = -0.430 (-0.656, -0.204); p < 0.001), with V, Rb, Sr, Ba, and Pb contributing to this effect. The WQS model analysis further confirmed this joint negative association (OR (95% CI): -0.885 (-1.083, -0.899); p < 0.001), with V as the main contributor. BKMR model analysis indicated an overall negative impact of the metal mixture on CKD risk. Interactions may exist between V and Cu, as well as Cu and Sr and Pb. The female subgroup in the BKMR model demonstrated consistency with the overall association.ConclusionsOur study findings demonstrate a negative association between the urinary metal mixture and CKD risk, particularly notable in females. Joint exposure to multiple urinary metals may involve synergistic or antagonistic interactions influencing renal function. Further research is needed to validate these observations and elucidate underlying mechanisms.

Project description:BackgroundMetal(loid)s have been associated to adverse birth outcomes in experimental and epidemiological studies, but the underlying mechanism(s) are not well understood. Endocrine disruption may be a mechanism by which the metal(loid)s impact birth outcomes.MethodsPregnant women were recruited through the Puerto Rico Testsite for Exploring Contamination Threats (PROTECT). Urine, blood, demographic and pregnancy-related data were collected at recruitment and subsequent visits. Sixteen metal(loid)s were analyzed in urine and blood samples, while nine maternal hormones (corticotropin-releasing hormone (CRH), sex-hormone binding globulin (SHBG), estriol (E3), progesterone, testosterone, thyroid-stimulating hormone (TSH), total triiodothyronine (T3), total thyroxine (T4), and free thyroxine (fT4)) were measured in serum samples from 815 singleton pregnancies. Linear mixed models with random intercepts were used to examine associations between metal(loid)s in blood and urine with hormone concentrations.ResultsArsenic blood concentrations were significantly associated with increased levels in CRH (%Δ: 23.0, 95%CI: 8.4-39.6) and decreased levels in testosterone (%Δ: -16.3, 95%CI: -26.2--5.1). Cobalt, manganese, and lead blood concentrations were associated with small increases in SHBG (%Δ range: 3.3-4.2), E3 (%Δ range: 3.9-8.7) and progesterone (%Δ range: 4.1-6.3) levels, respectively. Nickel blood concentration was inversely associated with testosterone levels (%Δ -13.3, 95%CI: -18.7--7.6). Significant interactions were detected for the association between nickel and study visit in relation to CRH (p < 0.02) and testosterone levels (p < 0.01).ConclusionOur analysis suggests that metal(loid)s may act as endocrine disruptors by altering prenatal hormone levels. This disruption may depend on specific windows of exposure during pregnancy. Additionally, some essential metal(loid)s such as managense and cobalt may be contributors to adverse maternal and fetal outcomes. The study of metal(loid)s as endocrine disruptors is in the early stages of epidemiological research and future studies are needed to further investigate these associations.

Dataset Information

The association between urinary metals/metalloids and chronic kidney disease among general adults in Wuhan, China.

Publications

The association between urinary metals/metalloids and chronic kidney disease among general adults in Wuhan, China.

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