李宇星, 郭建勇, 高媛媛, 康辉, 韩致超, 张祎凡, 刘如洁, 杨倩, 雷立健. 外周血端粒长度在环境铅暴露与肾小球滤过率关系中的中介作用[J]. 环境与职业医学, 2021, 38(12): 1327-1332. DOI: 10.13213/j.cnki.jeom.2021.21297
引用本文: 李宇星, 郭建勇, 高媛媛, 康辉, 韩致超, 张祎凡, 刘如洁, 杨倩, 雷立健. 外周血端粒长度在环境铅暴露与肾小球滤过率关系中的中介作用[J]. 环境与职业医学, 2021, 38(12): 1327-1332. DOI: 10.13213/j.cnki.jeom.2021.21297
LI Yuxing, GUO Jianyong, GAO Yuanyuan, KANG Hui, HAN Zhichao, ZHANG Yifan, LIU Rujie, YANG Qian, LEI Lijian. Mediating role of peripheral blood telomere length in relationship between environmental lead exposure and glomerular filtration rate[J]. Journal of Environmental and Occupational Medicine, 2021, 38(12): 1327-1332. DOI: 10.13213/j.cnki.jeom.2021.21297
Citation: LI Yuxing, GUO Jianyong, GAO Yuanyuan, KANG Hui, HAN Zhichao, ZHANG Yifan, LIU Rujie, YANG Qian, LEI Lijian. Mediating role of peripheral blood telomere length in relationship between environmental lead exposure and glomerular filtration rate[J]. Journal of Environmental and Occupational Medicine, 2021, 38(12): 1327-1332. DOI: 10.13213/j.cnki.jeom.2021.21297

外周血端粒长度在环境铅暴露与肾小球滤过率关系中的中介作用

Mediating role of peripheral blood telomere length in relationship between environmental lead exposure and glomerular filtration rate

  • 摘要: 背景

    环境铅暴露可对机体肾脏产生健康损伤并引发端粒磨损。然而铅、外周血端粒长度和肾小球滤过率(eGFR)间的关系尚不清晰。

    目的

    探讨尿铅水平与外周血端粒长度和肾功能指标eGFR的关联性,进一步探讨外周血端粒长度是否在尿铅水平与eGFR关系中发挥中介作用。

    方法

    采用病例-对照研究,选择某市的2个社区居民497人,其中对照组(eGFR≥80 mL·min−1)230人,eGFR异常组(eGFR<80 mL·min−1)267人。通过面对面问卷调查的方式,收集研究对象的基本信息与健康资料;采集研究对象空腹晨尿并检测尿铅和尿肌酐(UCr),采集空腹外周静脉血检测外周血白细胞中的端粒长度和血肌酐(SCr),采用公式估算eGFR。调整年龄、性别、受教育程度、家庭人均月收入、吸烟、饮酒因素后,通过中介作用分析尿铅水平、外周血端粒长度和肾功能指标eGFR三者间关系。

    结果

    eGFR异常组人群尿铅的总体水平MP25P75)为3.85(1.56,7.34)μg·g−1 (Cr校正),高于对照组1.57(0.60,3.62)μg·g−1 Cr(P<0.001);外周血端粒长度的总体水平MP25P75)为2.42(1.89,3.10)Kb,低于对照组2.69(2.09,3.64)Kb(P<0.001)。中介作用分析结果显示:全人群中,外周血端粒长度在尿铅水平和eGFR之间的中介效应大小为−0.276(95%CI:−0.708~−0.001),中介效应比例为3.35%;女性人群中,外周血端粒长度在尿铅水平和eGFR之间的中介效应大小为−0.484(95%CI:−1.160~−0.023),中介效应的比例为5.34%;男性人群中,尚未发现外周血端粒长度在尿铅和eGFR之间的中介作用。

    结论

    人群尿铅水平与肾功能指标eGFR和外周血端粒长度密切相关,外周血端粒长度在女性尿铅与eGFR关系中发挥中介作用。

     

    Abstract: Background

    Exposure to environmental lead can cause kidney damage and telomere wear. However, the relationship among lead, peripheral blood telomere length, and glomerular filtration rate (eGFR) are unclear.

    Objective

    This study is conducted to investigate the relationships of urinary lead level with peripheral blood telomere length and renal function index eGFR, and further explore whether peripheral blood telomere length plays an intermediary role in the relationship between urinary lead level and eGFR.

    Methods

    A case-control study was conducted to select 497 residents from two communities in a city, including 230 in the control group (eGFR≥80 mL·min−1) and 267 in the abnormal eGFR group (eGFR<80 mL·min−1). Basic information and health information of the subjects were collected through a face-to-face questionnaire survey. Fasting morning urine was collected, and urinary lead and urinary creatinine (UCr) were detected. Fasting peripheral venous blood was collected to detect telomere length and serum creatinine (SCr) in peripheral blood leukocytes. eGFR was estimated by the Levey formula. After further adjusting for age, gender, education level, family per capita monthly income, smoking, and drinking the relationship among urinary lead level, peripheral blood telomere length, and renal function index eGFR was evaluated by mediating effect analysis.

    Results

    The overall level of creatinine-adjusted urinary lead M (P25, P75) in the abnormal eGFR group was 3.85 (1.56, 7.34) μg·g−1 which was higher than that in the control group, 1.57 (0.60, 3.62) μg·g−1(P<0.001). In addition, the overall level of peripheral blood telomere length in the abnormal eGFR group was 2.42 (1.89, 3.10) Kb, lower than that in the control group, 2.69 (2.09, 3.64) Kb (P<0.001). The results of mediating effect analysis showed that the magnitude of mediating effect by peripheral blood telomere length was −0.276 (95%CI: −0.708-−0.001) and it contributed 3.35% to the relationship between urinary lead level and eGFR. In women, the magnitude of mediating effect by peripheral blood telomere length was −0.484 (95%CI: −1.160-−0.023) between urinary lead level and eGFR, and the proportion of the mediating effect was 5.34%. In men, no mediating role of peripheral blood telomere length was found between urinary lead and eGFR.

    Conclusion

    Urinary lead level is closely related to renal function index eGFR and telomere length in peripheral blood. Peripheral blood telomere length plays a mediating role in the relationship between female urinary lead and eGFR in women.

     

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