TY - JOUR
T1 - Associations of blood lead, cadmium, and mercury with estimated glomerular filtration rate in the Korean general population
T2 - Analysis of 2008-2010 Korean National Health and Nutrition Examination Survey data
AU - Kim, Yangho
AU - Lee, Byung Kook
N1 - Funding Information:
To assess levels of heavy metals in whole blood, 3-mL blood samples were drawn into standard commercial evacuated tubes containing sodium heparin (Vacutainer). Blood lead and cadmium were measured by graphite-furnace atomic absorption spectrometry with Zeeman background correction (Perkin Elmer AAnalyst 600, Perkin Elmer, Turku, Finland). Levels of blood mercury were measured using a gold–amalgam collection method with a DMA-80 (Milestone, Bergamo, Italy). All blood metal analyses were carried out by Neodin Medical Institute, a laboratory certified by the Korean Ministry of Health and Welfare. For an internal quality assurance and control program, commercial reference materials were used (Lyphochek Whole Blood Metals Control, Bio-Rad, Hercules, CA, USA). The coefficients of variation were within 0.95%–4.82%, 2.65%–6.50%, and 1.59%–4.86% for blood cadmium, lead, and mercury, respectively in four reference samples. As part of external quality assurance and control, the institute passed both the German External Quality Assessment Scheme, operated by Friedrich-Alexander University, and the Quality Assurance Program, operated by the Korea Occupational Safety and Health Agency. The institute was also certified by the Ministry of Employment and Labor as a designated laboratory for the analysis of specific chemicals, including heavy metals and certain organic chemicals. The method detection limits for blood cadmium, lead, and mercury in the present study were 0.056 μg/L, 0.12 μg/dL, and 0.158 μg/L, respectively. No sample for blood cadmium, lead, or mercury was the below detection limits. 2.4
PY - 2012/10
Y1 - 2012/10
N2 - Introduction: The objective of this study was to evaluate associations between blood lead, cadmium, and mercury levels with estimated glomerular filtration rate in a general population of South Korean adults. Methods: This was a cross-sectional study based on data obtained in the Korean National Health and Nutrition Examination Survey (KNHANES) (2008-2010). The final analytical sample consisted of 5924 participants. Estimated glomerular filtration rate (eGFR) was calculated using the MDRD Study equation as an indicator of glomerular function. Results: In multiple linear regression analysis of log2-transformed blood lead as a continuous variable on eGFR, after adjusting for covariates including cadmium and mercury, the difference in eGFR levels associated with doubling of blood lead were -2.624. mL/min per 1.73. m 2 (95% CI: -3.803 to -1.445). In multiple linear regression analysis using quartiles of blood lead as the independent variable, the difference in eGFR levels comparing participants in the highest versus the lowest quartiles of blood lead was -3.835. mL/min per 1.73. m 2 (95% CI: -5.730 to -1.939). In a multiple linear regression analysis using blood cadmium and mercury, as continuous or categorical variables, as independent variables, neither metal was a significant predictor of eGFR. Odds ratios (ORs) and 95% CI values for reduced eGFR calculated for log2-transformed blood metals and quartiles of the three metals showed similar trends after adjustment for covariates. Discussion: In this large, representative sample of South Korean adults, elevated blood lead level was consistently associated with lower eGFR levels and with the prevalence of reduced eGFR even in blood lead levels below 10 μg/dL.In conclusion, elevated blood lead level was associated with lower eGFR in a Korean general population, supporting the role of lead as a risk factor for chronic kidney disease.
AB - Introduction: The objective of this study was to evaluate associations between blood lead, cadmium, and mercury levels with estimated glomerular filtration rate in a general population of South Korean adults. Methods: This was a cross-sectional study based on data obtained in the Korean National Health and Nutrition Examination Survey (KNHANES) (2008-2010). The final analytical sample consisted of 5924 participants. Estimated glomerular filtration rate (eGFR) was calculated using the MDRD Study equation as an indicator of glomerular function. Results: In multiple linear regression analysis of log2-transformed blood lead as a continuous variable on eGFR, after adjusting for covariates including cadmium and mercury, the difference in eGFR levels associated with doubling of blood lead were -2.624. mL/min per 1.73. m 2 (95% CI: -3.803 to -1.445). In multiple linear regression analysis using quartiles of blood lead as the independent variable, the difference in eGFR levels comparing participants in the highest versus the lowest quartiles of blood lead was -3.835. mL/min per 1.73. m 2 (95% CI: -5.730 to -1.939). In a multiple linear regression analysis using blood cadmium and mercury, as continuous or categorical variables, as independent variables, neither metal was a significant predictor of eGFR. Odds ratios (ORs) and 95% CI values for reduced eGFR calculated for log2-transformed blood metals and quartiles of the three metals showed similar trends after adjustment for covariates. Discussion: In this large, representative sample of South Korean adults, elevated blood lead level was consistently associated with lower eGFR levels and with the prevalence of reduced eGFR even in blood lead levels below 10 μg/dL.In conclusion, elevated blood lead level was associated with lower eGFR in a Korean general population, supporting the role of lead as a risk factor for chronic kidney disease.
KW - Cadmium
KW - Glomerular filtration rate
KW - Kidney
KW - Korean National Health and Nutrition Examination Survey
KW - Lead
KW - Mercury
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U2 - 10.1016/j.envres.2012.06.003
DO - 10.1016/j.envres.2012.06.003
M3 - Article
C2 - 22749111
AN - SCOPUS:84866017344
VL - 118
SP - 124
EP - 129
JO - Environmental Research
JF - Environmental Research
SN - 0013-9351
ER -