接触邻苯二甲酸盐会增加氧化应激、早期肾损伤和钙性尿路结石的风险：一项病例对照研究。

IF 6.2 2区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Ecotoxicology and Environmental Safety Pub Date : 2024-11-15 DOI:10.1016/j.ecoenv.2024.117322

Shih-Ting Huang , Tusty-Jiuan Hsieh , Yung-Chin Lee , Chia-Fang Wu , Yi-Chun Tsai , Chu-Chih Chen , Sih-Syuan Li , Jiun-Hung Geng , Yu-Ming Hsu , Che-Wei Chang , Yau-Hsuan Tsau , Shu-Pin Huang , Yung-Shun Juan , Wen-Jeng Wu , Ming-Tsang Wu , Chia-Chu Liu

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引用次数: 0

摘要

背景：邻苯二甲酸盐普遍存在于塑料和软化剂中，在我们的日常生活环境中无处不在。人们越来越关注邻苯二甲酸盐对肾脏健康的潜在影响，尤其是邻苯二甲酸盐诱发氧化应激的倾向。然而，人们对接触邻苯二甲酸盐与泌尿系统结石之间的关系仍然知之甚少。本研究旨在探讨邻苯二甲酸盐暴露、氧化应激和泌尿系统结石风险之间的关系：这项病例对照研究涉及 285 名确诊为钙性尿路结石的患者和 594 名健康对照者。参与者填写了结构化问卷，并提供了尿液样本，用于测量 10 种邻苯二甲酸酯代谢物、氧化应激生物标志物（丙二醛 [MDA]）和早期肾损伤生物标志物（N-乙酰-beta-D-葡糖苷酶 [NAG] 和白蛋白/肌酐比值 [ACR]）。在随后的分析中，我们采用了不同的类别：高分子量邻苯二甲酸酯代谢物总和（∑HMWm）、低分子量邻苯二甲酸酯代谢物总和（∑LMWm）以及邻苯二甲酸二-2-乙基己酯（DEHP）的日摄入量（DI_DEHP_5）：结果：与正常对照组相比，结石患者尿液中的氧化应激生物标志物（MDA）和早期肾损伤生物标志物（NAG 和 ACR）明显升高，在 10 种评估的邻苯二甲酸酯代谢物中，有 9 种的水平较高。在研究人群中，几乎所有的邻苯二甲酸酯代谢物都与尿液中的氧化应激生物标志物（MDA）和早期肾损伤生物标志物（NAG 和 ACR）呈显著正相关。逻辑回归进一步证实，在对混杂因素进行调整后，邻苯二甲酸盐（包括∑HMWm、∑LMWm和DI_DEHP_5）水平的升高与氧化应激、早期肾损伤和尿路结石风险的升高一致相关：我们的研究发现了邻苯二甲酸盐暴露与泌尿系结石风险之间的新关联，强调了邻苯二甲酸盐暴露会增加肾损伤的风险。考虑到邻苯二甲酸盐的广泛存在，监管措施和公共卫生干预对于减轻与邻苯二甲酸盐相关的肾毒性至关重要，而进一步的大规模纵向研究对于验证我们的初步发现和阐明其潜在机制也势在必行。

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Phthalate exposure increases oxidative stress, early renal injury, and the risk of calcium urolithiasis: A case-control study

Background

Phthalates, ubiquitous in plastics and softening agents, are pervasive in our daily environment. Growing concerns have emerged regarding their potential impact on renal health, particularly due to their propensity to induce oxidative stress. However, the relationship between phthalate exposure and urolithiasis remains poorly understood. This research seeks to explore the connection between phthalate exposure, oxidative stress, and the risk of urolithiasis.

Methods

A case-control study involving 285 patients diagnosed with calcium urolithiasis and 594 healthy controls was conducted. Participants completed structured questionnaires and provided urine samples for measuring 10 phthalate metabolites, biomarkers of oxidative stress (malondialdehyde [MDA]) and early renal injury (N-acetyl-beta-D-glucosaminidase [NAG] and albumin/creatinine ratio [ACR]). For subsequent analyses, we utilized distinct categories: the sum of high-molecular-weight phthalate metabolites (∑HMWm), the sum of low-molecular-weight phthalate metabolites (∑LMWm), and the daily intake of di-2-ethylhexyl phthalate (DEHP)(DI_DEHP_5).

Results

Stone patients exhibited significantly elevated urinary biomarkers of oxidative stress (MDA) and early renal injury (NAG and ACR), along with higher levels of 9 out of 10 assessed phthalate metabolites compared to normal controls. Within the study population, significant positive associations were found between almost all individual phthalate metabolites and urinary biomarkers of oxidative stress (MDA) as well as early renal injury (NAG and ACR). Logistic regression further confirmed that elevated phthalate levels, including ∑HMWm, ∑LMWm, and DI_DEHP_5, were uniformly associated with an increased risk of oxidative stress, early renal injury, and urolithiasis after adjusting for confounding factors.

Conclusions

Our study uncovers a novel association between phthalate exposure and the risk of urolithiasis, underscoring the heightened risk of kidney injury posed by such exposure. Considering the widespread presence of phthalates, regulatory measures and public health interventions are crucial to mitigate phthalate-related nephrotoxicity, while further large-scale longitudinal research is imperative to validate our initial findings and elucidate the underlying mechanisms.

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来源期刊

Ecotoxicology and Environmental Safety 环境科学-毒理学

CiteScore

12.10

自引率

5.90%

发文量

1234

审稿时长

88 days

期刊介绍： Ecotoxicology and Environmental Safety is a multi-disciplinary journal that focuses on understanding the exposure and effects of environmental contamination on organisms including human health. The scope of the journal covers three main themes. The topics within these themes, indicated below, include (but are not limited to) the following: Ecotoxicology、Environmental Chemistry、Environmental Safety etc.