湘江流域土壤高镉地区人群肾损伤调查

Renal injury among population living in area polluted by cadmium in soil around Xiangjiang River basin

目的调查湘江流域土壤高镉地区人群肾健康状况,探索尿镉水平与肾损伤生物标志物的关系。方法采用横断面研究,选择湘江流域某土壤高镉地区常住居民作为暴露组,土壤镉较低地区常住居民为对照组,通过问卷调查收集研究对象基本情况和重金属接触典型症状情况,采集尿液并检测尿中镉和NAG、β2-MG水平。结果暴露组尿镉水平中位数为5.36μg/g Cr,高于对照组(2.66μg/g Cr)(P<0.001),且暴露组尿镉水平随着年龄的增加呈升高趋势(P<0.05)。人群肾损伤生物标志物检测结果显示暴露组尿NAG活力中位数为10.62 U/g Cr,高于对照组(8.11 U/g Cr)(P<0.05),两组人群尿β2-MG水平的差异无统计学意义(P>0.05)。暴露组与对照组人群重金属接触典型症状发生率之间的差异无统计学意义(P>0.05)。尿NAG和尿β2-MG异常率随尿镉水平的升高而升高(P趋势<0.05)。相关分析结果显示尿镉水平与尿NAG活力、尿β2-MG水平及年龄之间均存在正相关关系(P<0.05)。多重线性回归分析结果显示,尿镉水平的变化仅可显著影响尿NAG活力(B=0.466,P<0.001);而尿β2-MG水平的变化受到年龄的影响较大(B=0.008,P<0.05)。结论长期环境土壤镉暴露将造成人群肾损伤,湘江流域土壤高镉地区人群肾肾功能损伤存在一定风险。

Objective To investigate the renal function of population living in the area with high cadmium accumulating soil around the Xiangjiang River basin,and to explore the relationship between urinary cadmium level and biomarkers of renal injury.Methods A cross-sectional study was used to select residents living in the area around the the Xiangjiang River basin,where soil cadmium level was higher,as the exposure group,and residents living in the same city but with lower cadmium in soils as control group.Basic information and typical symptoms of subjects affected by heavy metal were collected based on questionnaire,and urine samples were collected for determination of the level of cadmium and early biomarkers of renal injury.Results The median level of urinary cadmium(5.36μg/g Cr)in the exposure group was higher than that(2.66μg/g Cr)of control group(P<0.001),and urinary cadmium levels of the exposure group increased with ages(P<0.05).The detection results of early biomarkers of renal injury showed that the activity of urinary NAG in the exposed group(10.62 U/g Cr)was higher than that(8.11 U/g Cr)of the control group(P<0.05),but there was no significant difference in urinaryβ2-MG among two groups(P>0.05).There was nosignificant difference in the incidence of typical symptoms induced by heavy metals between the expoure group and the control group(P>0.05).With the increase of urinary cadmium levels,the abnormal rates of urinary NAG andβ2-MG levels increased significantly(Ptrend<0.05).The correlation analysis results showed that the urinary cadmium had positive correlations with urinary NAG,β2-MG and age(P<0.05).The multiple regression analysis results showed that the change of urinary cadmium could significantly affect the activity of urinary NAG(P<0.001),while the levels of urinaryβ2-MG were mainly affected by age(P<0.05).Conclusion Long-term environmental cadmium exposure will lead to the occurrence of kidney injury,and there are certain risks for the renal health of population living in the area around the Xiangjiang River basin where soil cadmium level is higher.