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Impact of urine concentration adjustment method on associations between urine metals and estimated glomerular filtration rates (eGFR) in adolescents

机译:尿液浓度调节方法对青少年尿液金属与估计的肾小球滤过率(eGFR)之间关联的影响

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摘要

Positive associations between urine toxicant levels and measures of glomerular filtration rate (GFR) have been reported recently in a range of populations. The explanation for these associations, in a direction opposite that of traditional nephrotoxicity, is uncertain. Variation in associations by urine concentration adjustment approach has also been observed. Associations of urine cadmium, thallium and uranium in models of serum creatinine- and cystatin-C-based estimated GFR (eGFR) were examined using multiple linear regression in a cross-sectional study of adolescents residing near a lead smelter complex. Urine concentration adjustment approaches compared included urine creatinine, urine osmolality and no adjustment. Median age, blood lead and urine cadmium, thallium and uranium were 13.9 years, 4.0 μg/dL, 0.22, 0.27 and 0.04 g/g creatinine, respectively, in 512 adolescents. Urine cadmium and thallium were positively associated with serum creatinine-based eGFR only when urine creatinine was used to adjust for urine concentration (β coefficient=3.1 mL/min/1.73 m~2; 95% confidence interval = 1.4, 4.8 per each doubling of urine cadmium). Weaker positive associations, also only with urine creatinine adjustment, were observed between these metals and serum cystatin-C-based eGFR and between urine uranium and serum creatinine-based eGFR. Additional research using non-creatinine-based methods of adjustment for urine concentration is necessary.
机译:最近,在许多人群中,尿毒物水平与肾小球滤过率(GFR)指标之间呈正相关。对于这些关联的解释,与传统的肾毒性相反,尚不确定。还已经观察到通过尿液浓度调节方法的关联变化。基于多元线性回归的横断面研究研究了铅冶炼厂附近青少年的尿液中镉,th和铀的关联,这些模型基于血清肌酐和半胱氨酸蛋白酶抑制剂C估算的GFR(eGFR)。比较的尿液浓度调节方法包括尿肌酐,尿渗透压和无调节。 512名青少年的中位年龄,血铅和尿镉,th和铀分别为13.9岁,4.0μg/ dL,0.22、0.27和0.04 g / g肌酐。仅当使用尿肌酐调节尿液浓度时,尿镉和th才与基于血清肌酐的eGFR呈正相关(β系数= 3.1 mL / min / 1.73 m〜2; 95%置信区间= 1.4、4.8,每增加一倍)尿镉)。在这些金属与血清半胱氨酸蛋白酶抑制剂C基的eGFR之间以及尿液铀与血清肌酐基的eGFR之间观察到较弱的正相关,也仅与尿肌酐调节相关。使用基于非肌酸酐的方法来调节尿液浓度的其他研究是必要的。

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  • 来源
    《Environmental research》 |2014年第7期|226-232|共7页
  • 作者单位

    Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA,Johns Hopkins University School of Medicine, Baltimore, MD, USA,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA,Division of Occupational & Environmental Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe St., Rm. 7041, Baltimore, MD 21205, USA;

    Faculty of Medicine, University of Juarez of Durango State, Durango, Mexico,Secretaria de Salud del Estado de Coahuila, Coahuila, Mexico;

    Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA;

    Instituto Nacional de Salud Publica, Centro de Investigacion en Salud Poblacional, Cuernavaca, Morelos, Mexico;

    Johns Hopkins University School of Medicine, Baltimore, MD, USA,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA;

    Faculty of Medicine, University of Juarez of Durango State, Durango, Mexico;

    Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, Albany, NY, USA,Department of Environmental Health Sciences, School of Public Health, University at Albany, Albany, NY, USA;

    Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, Albany, NY, USA;

    Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA;

    Johns Hopkins University School of Medicine, Baltimore, MD, USA,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

    Cadmium; Creatinine; Osmolality; Uranium; Urine concentration;

    机译:镉;肌酐;渗透压铀;尿液浓度;

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