Association Between Metal Exposure And Decline Of Renal Function In Elderly Population In Tongling Area

Objective The rapid development of industrial civilization and social economy have made the environmental pollution of metals an important issue of concern to human societyMetals in the environment can be absorbed by the human body through different ways,which may cause lots of diseases,especially the elderly,who are more likely to develop various chronic diseases due to the exposure of metals.Therefore,this study is based on the community elderly population in Tongling area to explore the association between human metals exposure and the decline of renal function.MethodsThis study was conducted in Yi’an District,Tongling City,Anhui Province from April2019 to August 2019.A total of 2,655 permanent residents over 60 years old were surveyed.We conducted questionnaire surveys,physical examinations,and blood collection.Use inductively coupled plasma emission spectrometer to measure the content of 12 metals in serum(Arsenic,As;Cobalt,Co;Chromium,Cr;Copper,Cu;Iron,Fe;Mercury,Hg;Magnesium,Mg;Manganese,Mn;Molybdenum,Mo;Lead,Pb;Selenium,Se;Zinc,Zn),using atomic absorption spectrophotometry to determine the serum cadmium content(Cadmium,Cd).Statistical analysis uses linear regression to explore the association between metals levels and glomerular filtration rate,uses binary logistic regression model to explore the impact of metal element levels on the risk of renal function decline,and uses Bayesian kernel machine regression model to explore mixed effects of several metal elements with joint effects.ResultsAfter excluding the participates with missing information and missing specimens,a total of 2470 samples were obtained,including 1164 males,with an average age of72.09±6.06 years old,accounting for 47.1% of the total participates;1306 females,with an average age of 71.93±5.67 years old,accounting for the total participates52.9%.The median concentration of serum metals Co,Mn,Fe in the case group was significantly lower than that of the normal group,while the case group had significantly higher Cr and Mo contents than the normal group.The results of linear regression analysis showed that the concentrations of Pb,Zn,and Cr were negatively correlated with glomerular filtration rate,and the regression coefficients were-0.56,-0.93 and-1.28,respectively;there is a positive correlation between the concentration of Mn and glomerular filtration rate,and the regression coefficient is 0.68.Logistic regression analysis showed that Fe in the high exposure levels of the single metal model reduced the risk of renal function decline,and the corresponding OR and95%CI was 0.60(0.39～0.91).The highest concentration of Cr will increase the risk of renal function decline,the corresponding OR and 95%CI is 1.71(1.15～2.57),the highest quantile Mo will also increase the risk of renal function decline,OR and95%CI is 1.82(1.24～2.67).Using LASSO regression to screen out six metals,namely Pb,Se,Fe,Zn,Mg,Mo,these six metals are included in the polymetallic model,the high exposure levels of Fe is shown as a protective factor for the decline of renal function,OR and 95%CI is 0.45(0.29～0.72),and the highest quintile of Mo will increase the risk of renal function decline,and the corresponding OR and 95%CI is 1.72(1.15～2.28).ConclusionThis study found that the exposure level of Pb,Zn,and Cr showed a negative correlation with glomerular filtration rate,while the exposure level of Mn showed a positive correlation with glomerular filtration rate.Fe may be a protective factor for the decline of renal function,and Cr and Mo can significantly increase the risk of the decline of renal function.The combined effect between the various metal elements is not significant.