Yinxia Lin1, Jiansheng Cai1,2, Qiumei Liu1, Xiaoting Mo1, Min Xu1, Junling Zhang1, Shuzhen Liu1, Chunmei Wei1, Yanfei Wei1, Shenxiang Huang1, Tingyu Mai3, Dechan Tan3, Huaxiang Lu1, Tingyu Luo3, Ruoyu Gou3, Zhiyong Zhang4,5,6, Jian Qin7. 1. Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, Nanning, 530021, China. 2. Key Laboratory of Tumor Immunology and Microenvironmental Regulation, Guilin Medical University, Guangxi Zhuang Autonomous Region, Guilin, 541004, China. 3. School of Public Health, Guilin Medical University, 20 Lequn Road, Guangxi Zhuang Autonomous Region, Guilin, 541004, China. 4. Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, Nanning, 530021, China. rpazz@163.com. 5. School of Public Health, Guilin Medical University, 20 Lequn Road, Guangxi Zhuang Autonomous Region, Guilin, 541004, China. rpazz@163.com. 6. Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, Guilin Medical University, Guilin, China. rpazz@163.com. 7. Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, Nanning, 530021, China. qinjian@gxmu.edu.cn.
Abstract
BACKGROUND: Extensive studies have revealed the link between heavy metals and CKD. Compared to single meta-elements, mixture of metals reflect real-life metals exposure scenarios and are of interest. However, the mechanism of action of metal mixture on renal function is unclear. METHODS: This study aimed to explore the potential relationship between urinary arsenic (As), cadmium (Cd), lead (Pb), manganese (Mn), and chromium (Cr) contents with estimated glomerular filtration rate (eGFR) levels in 2775 participants. The levels of metals in urine were determined by inductively coupled plasma-mass spectrometry. We used linear regression models and the Bayesian kernel machine regression (BKMR) to evaluate the association between metals and eGFR levels. RESULTS: In linear regression analysis, urinary As (β = 2.723, 95%CI: 0.29, 5.157) and Pb (β = 3.081, 95%CI: 1.725, 4.438) were positively associated with eGFR in the total population. In the BKMR model, a mixture of the five metals had a positive joint effect on eGFR levels, while Pb (PIP = 0.996) contributed the most to eGFR levels. Pb was positively associated with eGFR levels in the total participants and women. As was positively correlated with eGFR levels in women. Pb and eGFR levels were positively correlated when the other metals were set at 25th, 50th, and 75th percentiles. CONCLUSIONS: To the best of our knowledge, all five metals mixed exposure was positively associated with eGFR. Pb showed more important effects than the other four metals in the mixture, especially in women.
BACKGROUND: Extensive studies have revealed the link between heavy metals and CKD. Compared to single meta-elements, mixture of metals reflect real-life metals exposure scenarios and are of interest. However, the mechanism of action of metal mixture on renal function is unclear. METHODS: This study aimed to explore the potential relationship between urinary arsenic (As), cadmium (Cd), lead (Pb), manganese (Mn), and chromium (Cr) contents with estimated glomerular filtration rate (eGFR) levels in 2775 participants. The levels of metals in urine were determined by inductively coupled plasma-mass spectrometry. We used linear regression models and the Bayesian kernel machine regression (BKMR) to evaluate the association between metals and eGFR levels. RESULTS: In linear regression analysis, urinary As (β = 2.723, 95%CI: 0.29, 5.157) and Pb (β = 3.081, 95%CI: 1.725, 4.438) were positively associated with eGFR in the total population. In the BKMR model, a mixture of the five metals had a positive joint effect on eGFR levels, while Pb (PIP = 0.996) contributed the most to eGFR levels. Pb was positively associated with eGFR levels in the total participants and women. As was positively correlated with eGFR levels in women. Pb and eGFR levels were positively correlated when the other metals were set at 25th, 50th, and 75th percentiles. CONCLUSIONS: To the best of our knowledge, all five metals mixed exposure was positively associated with eGFR. Pb showed more important effects than the other four metals in the mixture, especially in women.