PDF(Pubmed)
Abstract：
This study aimed to develop an environmental risk score (ERS) of multiple pollutants (MP) causing kidney damage (KD) in Korean residents near abandoned metal mines or smelters and evaluate the association between ERS and KD by a history of occupational chemical exposure (OCE). Exposure to MP, consisting of nine metals, four polycyclic aromatic hydrocarbons, and four volatile organic compounds, was measured as urinary metabolites. The study participants were recruited from the Forensic Research via Omics Markers (FROM) study (n = 256). Beta-2-microglobulin (β2-MG), N-acetyl-β-D-glucosaminidase (NAG), and estimated glomerular filtration rate (eGFR) were used as biomarkers of KD. Bayesian kernel machine regression (BKMR) was selected as the optimal ERS model with the best performance and stability of the predicted effect size among the elastic net, adaptive elastic net, weighted quantile sum regression, BKMR, Bayesian additive regression tree, and super learner model. Variable importance was estimated to evaluate the effects of metabolites on KD. When stratified with the history of OCE after adjusting for several confounding factors, the risks for KD were higher in the OCE group than those in the non-OCE group; the odds ratio (OR; 95% CI) for ERS in non-OCE and OCE groups were 2.97 (2.19, 4.02) and 6.43 (2.85, 14.5) for β2-MG, 1.37 (1.01, 1.86) and 4.16 (1.85, 9.39) for NAG, and 4.57 (3.37, 6.19) and 6.44 (2.85, 14.5) for eGFR, respectively. We found that the ERS stratified history of OCE was the most suitable for evaluating the association between MP and KD, and the risks were higher in the OCE group than those in the non-OCE group.
摘要：
这项研究旨在开发一种环境风险评分（ERS）的多种污染物（MP）引起的肾脏损害（KD）附近的韩国居民废弃的金属矿或冶炼厂，并通过职业化学暴露史（OCE）评估ERS和KD之间的关联。接触MP，由九种金属组成，四种多环芳烃，和四种挥发性有机化合物，被测量为尿代谢物。研究参与者通过组学标记（FROM）研究从法医研究中招募（n=256）。β-2-微球蛋白(β2-MG),N-乙酰-β-D-氨基葡萄糖苷酶(NAG),和估计的肾小球滤过率（eGFR）被用作KD的生物标志物。选择贝叶斯核机回归(BKMR)作为弹性网络中预测效应大小的性能和稳定性最好的ERS模型,自适应弹性网，加权分位数和回归，BKMR,贝叶斯加法回归树，和超级学习者模型。估计变量重要性以评估代谢物对KD的影响。在调整了几个混杂因素后，当与OCE的历史进行分层时，OCE组KD的风险高于非OCE组；非OCE和OCE组ERS的比值比（OR;95％CI）分别为2.97（2.19，4.02）和6.43（2.85，14.5）β2-MG，NAG的1.37（1.01，1.86）和4.16（1.85，9.39），eGFR为4.57（3.37，6.19）和6.44（2.85，14.5），分别。我们发现，OCE的ERS分层历史最适合评估MP和KD之间的关联，OCE组的风险高于非OCE组。
