Abstract
In the world, chronic kidney disease (CKD) has been recognized as one of the critical public health problems, and the prevalence is higher in the elderly people. However, there are few studies on the association between exposure to multiple serum metal levels and CKD. A case–control study, we established, for elderly people in Anhui Province, China, to explore the effects of different metals and analyze the effect of mixed exposure on CKD. In this study, 287 cases of CKD and 287 controls were selected in the elderly health physical examination project in Tongling City, Anhui Province. Questionnaire survey, physical examination, and blood collection were conducted. Graphite furnace atomic absorption spectrometry (GFAAS) and inductively coupled plasma optical emission spectrometry (ICP-OES) were used to measure the concentration of serum metals. After selecting by least absolute shrinkage and selection operator (LASSO), 5 metals were brought into the multi-metal model. After adjusting all potential covariates additionally, the concentrations of lead (Pb), cadmium (Cd), cobalt (Co), and manganese (Mn) were significantly associated with CKD risk, whereas Pb, Se, and Cd had significant non-linearity with CKD. Besides, patients with highest quartiles of cobalt (Co), lead (Pb), and manganese (Mn) were 1.64, 1.39, and 0.64 times more possible to have CKD, respectively, as compared with the lowest levels. In the Bayesian kernel machine regression (BKMR) model, cadmium (Cd) had a combined effect with lead (Pb) possibly. This study suggested that the CKD risk was associated with exposure of multiple metals in elderly people. The underlying mechanisms of serum metals and CKD need more experimental and prospective studies to elucidate.
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The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Acknowledgements
This study was supported by The Project for Top Disciplinary Talents of Majors in Universities of Anhui Province (gxbjZD09). Thanks to all the subjects that participated in this research. The final manuscript was read and approved by all the authors.
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This study was supported by The Project for Top Disciplinary Talents of Majors in Universities of Anhui Province (gxbjZD09).
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Wenlei Hu: study concept and design, acquisition of data, analysis and interpretation of the data, and drafting of the article. Guoao Li: acquisition of data, analysis and interpretation of data, and drafting of the article. Jialiu He: acquisition of the data, analysis and interpretation of the data. Huanhuan Zhao: acquisition of the data, critical review of manuscript. Hanshuang Zhang: acquisition of the data, critical review of the manuscript. Huan-huan Lu: analysis and interpretation of the data. Jian-jun Liu: analysis and interpretation of the data. Fen Huang: study concept and design, critical review of the manuscript, and funding acquisition. All the authors read and approved the final manuscript.
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Hu, W., Li, G., He, J. et al. Association of exposure to multiple serum metals with the risk of chronic kidney disease in the elderly: a population-based case–control study. Environ Sci Pollut Res 30, 17245–17256 (2023). https://doi.org/10.1007/s11356-022-23303-2
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DOI: https://doi.org/10.1007/s11356-022-23303-2