沈阳市镉污染区居民尿镉及骨密度调查

目的通过检测脱离环境镉接触人群的尿镉及骨密度，探讨镉致肾损伤的远期效应与骨密度的关系。方法选择在镉污染区连续居住20年以上的居民为调查对象，应用GMY-1型单光子骨密度吸收仪，测量其桡骨远端骨密度（BMD）；用原子吸收分光光度法检测该人群的尿镉（UCd）水平。结果污染区居民的尿镉水平显著高于对照组（P〈0．05），并随着镉污染程度的增加而增高；BMD随着UCd水平的增加而下降，接触组与对照组差异有统计学意义（P〈0．05）。结论长期脱离镉污染环境后，体内镉仍处于一个较高水平，并影响骨代谢导致骨密度下降。     

环境镉接触人群中尿NAG和白蛋白的变化

调查居住在不同程度镉污染区的４９４名居民尿中ＮＡＧ、白蛋白和尿镉的变化，同时分析尿镉排泄与两指标的关系，结果发现：镉接触人群尿ＮＧＡ排泄显著升高，而尿白蛋白只在高接触组中有增高，可见镉肾损害主要在肾近曲小管，严重时可累及肾小球，尿镉排泄与尿ＮＡＧ排泄存在一定剂量－反应关系，提示尿ＮＡＧ活性测定可作为镉肾损害的早期监测指标。     

低浓度镉暴露对工人肾功能及体液中铁和锌水平的影响

[目的]探讨通过呼吸道职业性接触镉的情况下,工人体液中铁和锌的水平与镉肾毒作用间的相互关系。[方法]随机抽取镉接触工人103人和对照组人员36人,分别测定镉接触标志物[血镉（blood cadmium,BCd）和尿镉（urinary cadmium,UCd）]、镉肾毒性的效应标志物[尿β2-微球蛋白（urinary β2-microglobulin,Uβ2-MG）、尿白蛋白（urinary albumin,UALB）和尿N-乙酰-β-D-氨基葡萄糖苷酶（urinary N-acetyl-β-D-glucosaminidase,UNAG）]和反映铁状态的生物标志物[血红蛋白（Hb）、血清铁蛋白（serum ferritin,SF）和血清转铁蛋白受体（serum transferrin receptor,sTfR）],测定血锌和尿锌来反映体液中锌水平,并分析这些标志物间的相互关系。[结果]镉接触工人的血镉、尿镉均明显增高,尿β2-MG和UALB均高于对照组,尿NAG、β2-MG和UALB均随尿镉水平的增高而增高,存在剂量-效应关系,Hb含量和SF低于对照组,贫血患病率高于对照组。接触组血锌和尿锌含量与对照组的差异无统计学意义,但是尿锌与尿镉和血镉间均呈正相关关系,尿镉高的工人尿锌浓度高于尿镉低的工人。[结论]职业性镉接触能引起体内铁储存量下降和贫血患病率增高,在体内镉蓄积到一定程度时,会引起尿锌排泄增加。     

镉一镍电池厂人群尿镉的影响因素分析

目的分析镉-镍电池厂人群尿镉的影响因素。方法选择某镉-镍电池厂2226名员工分为直接接触和非直接接触人群,以无接触有毒害因素且体检未见异常的245人为对照组。对各组进行尿镉相关的分析。结果直接接触组尿镉较对照组高（P〈0．001）,非直接接触组尿镉与对照组比较差异无统计学意义（P〉0．05）;多因素逐步Logistic回归分析示：512龄、接触程度、性别、年龄与尿镉超标的发生相关（0R=1．367-10．552,P〈0．05）。结论工龄较长、直接接触氧化镉、女性、年龄较长者发生尿镉超标的危险性明显增加。     

血中铅,镉水平与其尿排泄关系的研究

报道了肌酐代谢无明显异常的17名职业性铅、镉接触者在自由饮水情况下血中铅、镉水平与其尿排泄的关系。结果表明,血中铅、镉浓度以及铅、镉、肌酐的尿排泄存在明显的个体差异。血铅浓度与24h尿铅排泄量呈明显正相关,血镉浓度与24h尿镉排泄量无明显相关,而与每天吸烟量明显相关。17人的132份尿样的尿流速与肌酐、镉排泄率呈显著正相关,但与尿铅排泄率无显著相关。本研究还表明,尿中肌酐排泄率与尿铅、镉排泄率之间也有显著的正相关性。     

人外周血淋巴细胞中金属硫蛋白基因表达作为镉接触的生物标志物

目的：本研究选择不同途径（职业和环境）接触镉的人群，观察外周血淋巴细胞（PBL0的金属硫蛋白（MT）表达水平改变，以探讨其作为镉接触指标的可能性。方法：以广西某锌品厂镉接触男工为接触组，分为硫酸车间组和电解车间组；选取当地29名男性商业人员为对照组。镉的摄入量按Cai等描述的方法，主要包括工作场所接触和环境摄入和吸烟摄入。测定血样和尿样中镉浓度用原子吸收分光光度法测定。MT基因表达水平测定：分离淋巴细胞，抽提RNA，进行RT－PCR。以β-肌动蛋白（actin)为内参照，按公式MT／actin计算MT基因表达水平。结果：电解车间组的基础和诱导的MT表达水平显著高于其他两组。随尿镉水平上升，MT基础表达和诱导表达都增高，其中MT基础表达和诱导表达在尿镉10μg/gCr以上组显著高于0－2μg/gCr组，MT诱导能力在各组间未见显著差异。随血镉水平上升，MT基础表达和诱导表达都增高，显示良好的剂量－反应关系。随镉摄入量增加，MT基础表达和诱导表达都增高，在摄入量最高组达显著性。MT诱导能力在组间未见显著差异。MT表达水平与血膈、尿膈以及其他指标的相关分析和逐步回归分析，可见MT基础和诱导表达与血镉水平显著相关，同时与尿镉也显著相关。MT诱导能力与各指标之间均无显著性。结论：MT基础表达和诱导表达随镉接触量增高呈现剂量－效应关系，初步提示其作为镉接触的生物标志物的可能性。     

职业性镉接触工人尿镉含量的影响因素

目的分析镉接触工人的尿镉含量的影响因素。方法选取无锡某电池厂的镉接触工人437名为接触组,另选取782名未接触镉的工人作为对照组,分析2组人群的尿镉含量水平,同时对此镍镉电池厂进行劳动卫生学调查。结果工作场所中镉及其化合物的短时间接触浓度范围为0．002～3．058mg／m3,超标率为87．5％。接触组尿镉含量（中位数1．4300μmol／mol肌酐）明显高于对照组（中位数0．7300μmol／mol肌酐）,高浓度接触组的尿镉含量（中位数1．7500μmol／mol肌酐）明显高于低浓度接触组（中位数1．2450μmol／mol肌酐）,高浓度接触组的尿镉异常率（6．40％）也明显高于低浓度接触组（2．14％）。对照组和接触组中女性尿镉含量明显高于男性;多元线性回归分析结果显示,车间空气中镉暴露水平、工龄和年龄与尿镉含量的相关系数依次为0．851、0．630和0．038。结论工作场所中镉及其化合物浓度超标、工龄的增加是尿镉含量升高的主要因素,降低工作场所空气中镉及其化合物的浓度至职业接触限值以下和减少接触时间是预防慢性镉中毒的关键。     

湘江流域土壤高镉地区人群肾损伤调查

目的调查湘江流域土壤高镉地区人群肾健康状况,探索尿镉水平与肾损伤生物标志物的关系。方法采用横断面研究,选择湘江流域某土壤高镉地区常住居民作为暴露组,土壤镉较低地区常住居民为对照组,通过问卷调查收集研究对象基本情况和重金属接触典型症状情况,采集尿液并检测尿中镉和NAG、β_2-MG水平。结果暴露组尿镉水平中位数为5.36μg/g Cr,高于对照组(2.66μg/g Cr)(P0.001),且暴露组尿镉水平随着年龄的增加呈升高趋势(P0.05)。人群肾损伤生物标志物检测结果显示暴露组尿NAG活力中位数为10.62 U/g Cr,高于对照组(8.11 U/g Cr)(P0.05),两组人群尿β_2-MG水平的差异无统计学意义(P0.05)。暴露组与对照组人群重金属接触典型症状发生率之间的差异无统计学意义(P0.05)。尿NAG和尿β_2-MG异常率随尿镉水平的升高而升高(P趋势0.05)。相关分析结果显示尿镉水平与尿NAG活力、尿β_2-MG水平及年龄之间均存在正相关关系(P0.05)。多重线性回归分析结果显示,尿镉水平的变化仅可显著影响尿NAG活力(B=0.466,P0.001);而尿β_2-MG水平的变化受到年龄的影响较大(B=0.008,P0.05)。结论长期环境土壤镉暴露将造成人群肾损伤,湘江流域土壤高镉地区人群肾肾功能损伤存在一定风险。     

人血浆抗金属硫蛋白抗体与镉致肾损伤易感性的关系

目的研究人血浆抗金属硫蛋白扰体（anit-MT Ab）与职业镉接触所致肾功能损伤的关系。方法选择某镉冶炼厂男性作业工人为研究对象，进行接触评定和效应评定，以尿镉（UCd）、血镉（BCd）和职业镉摄入（TTCd）为接触指标，尿β2-微球蛋白（Uβ2-MG）、尿N-乙酰-β-D-氨基葡萄糖苷酶（UNAG）、尿白蛋白（UALB）作为镉敛肾损伤的效应标志物。酶联免疫吸附法（EHSA）检测血浆中anti-MT Ab滴度。结果职业镉接触组中UCd（3．16μg／g Cr）、血镉（9．28βg/L）、Uβ2-MC（81．17βg/g Cr）、UALB（7．03mg／gCr）水平明显高于对照组，随着职业镉接触水平升高，Uβ2-MG、UNAG和UALB含帚和异常发生率明显升高。对照组与接触组间anti-MT Ab滴度的差异无统计学意义（P〉0．05）。anti-MT Ab滴度并不随接触剂晕增加而增加，与血镉、UCd和TIEd间无明显联系（P〉0．05）。拄接触组中anti-MT Ab与UNAG和Uβ2-MG呈正相关，相关系数分别为0．302和0．218（P〈0．05）。相同机体镉负荷下，anti-MT Ab高滴度人群较低滴度人群更易出现肾小管损伤，比值比为4．200。结论职业性镉接触与肾功能损害间存在剂量一反应关系，而与血浆anti-MT Ab间无明显关联。镉接触人群中血浆anti-MT Ab高水平者更容易出现肾脏损伤。     

基准剂量在镉接触人群骨效应研究中的应用

目的通过镉接触人群流行病学研究，估测环境镉接触引起人群骨质疏松的基准剂量。方法镉污染区居住的居民为接触组，非污染区居民为对照组。尿镉（UCd）、血镉（BCd）为接触生物标记物；代表骨质疏松的Z评分为效应生物标记物。结果污染区人群尿镉、血镉水平均明显高于对照地区（P〈0．05），且高污染医人群尿镉、血镉水平明显高于中污染区（P〈0．05）。与5μg/gCr组相比，各人群尿镉水平、血镉水平最高组的骨密度均明显降低，差异有统计学意义（P〈0．05）。人群随着体内镉接触水平的升高，骨质疏松的患病率均随之明显升高，有统计学意义（P〈0．05）并有线性关系（P〈0．05）。计算得到基准剂量（BMD），推出基准剂量的95％低限水平（BMDL）。镉所引起的骨质疏松指标的尿镉BMDL值高于镉致肾功能不全指标的BMDL值。结论高剂量镉能引起人群骨质疏松，但时间上晚于镉致肾功能不全的损害。基准剂量是一种值得应用的新方法。     

Significance of the excretion of urinary indicator proteins for a low level of occupational exposure to cadmium

Urinary cadmium (Cd), N-acetyl-beta-D-glucosaminidase (NAG), metallothionein (MT), beta 2-microglobulin (BMG), and blood cadmium were determined in 79 workers who had been employed at a Cd pigment factory in Japan. The workers who had been dealing with Cd pigment manufacturing processes were estimated to be exposed to cadmium pigment dust at a maximum concentration of 3.0 micrograms/m3/8 h for about 20 years. The urinary Cd level ranged from 0.2 to 9.7 micrograms/g creatinine with a geometric mean of 1.02 micrograms/g creatinine. Pearson's correlation coefficients between logarithm of urinary Cd and that of NAG, MT, and BMG in urine were 0.45, 0.62, and 0.05, respectively. The correlation coefficients between blood Cd and urinary NAG, MT, and BMG were 0.21, 0.40, and -0.074, respectively. When partial correlation coefficients were calculated to exclude the contribution of age factor, urinary Cd turned out to be significantly correlated with urinary MT (r = 0.55) and NAG (r = 0.52). The present results indicate that urinary Cd is more closely associated with urinary MT and NAG than with BMG, and suggest that MT and NAG could be good indicators of Cd absorption in a Cd-exposed population whose mean urinary Cd level is relatively low, or less than 10 micrograms/g creatinine.     

The association between renal dysfunction and osteopenia in environmental cadmium-exposed subjects

Two hundred and three cadmium (Cd)-exposed subjects with renal dysfunction and 80 non-exposed subjects were examined to reveal the relationship between Cd-induced renal dysfunction and osteopenia. As biological indicators of renal function, urinary beta 2-microglobulin (beta 2-mg), and serum creatinine, calcium, and phosphorus were selected. Cd in the urine and blood was also measured. The results indicated that significant differences exist between both sexes in Cd-exposed as well as nonexposed subjects. To evaluate the degree of osteopenia, a microdensitometrical (MD) method was used. The relationships between biological parameters and each index of the MD method were analyzed using multivariate analysis. Age, urinary beta 2-mg, and serum creatinine were significantly associated with indices of osteopenia in Cd-exposed men. In contrast, age showed the most significant association with MD indices in women of both groups. However, urinary beta 2-mg was significantly associated with MD indices only in Cd-exposed women. In Cd-exposed subjects, after the number of predictor variables was increased, urinary beta 2-mg was also strongly associated with osteopenia. These results suggest a causal relationship between renal dysfunction and osteopenia in Cd-exposed subjects.     

Effect of Chlorella intake on Cadmium metabolism in rats

This study was performed to investigate the effect of chlorella on cadmium (Cd) toxicity in Cd- administered rats. Sixty male Sprague-Dawley rats (14 week-old) were blocked into 6 groups. Cadmium chloride was given at levels of 0 or 325 mg (Cd: 0, 160 ppm), and chlorella powder at levels of 0, 3 and 5%. Cadmium was accumulated in blood and tissues (liver, kidney and small intestine) in the Cd-exposed groups, while the accumulation of Cd was decreased in the Cd-exposed chlorella groups. Fecal and urinary Cd excretions were remarkably increased in Cd-exposed chlorella groups. Thus, cadmium retention ratio and absorption rate were decreased in the Cd exposed chlorella groups. Urinary and serum creatinine, and creatinine clearance were not changed in experimental animals. In addition, metallothionein (MT) synthesis in tissues was increased by Cd administration. The Cd-exposed chlorella groups indicated lower MT concentration compared to the Cd-exposed groups. Moreover, glomerular filtration rate (GFR) was not changed by dietary chlorella and Cd administration. According to the results above, this study could suggest that Cd toxicity can be alleviated by increasing Cd excretion through feces. Therefore, when exposed to Cd, chlorella is an appropriate source which counteracts heavy metal poisoning, to decrease the damage of tissues by decreasing cadmium absorption.     

Serum levels of bone Gla-protein in inhabitants exposed to environmental cadmium

Serum levels of bone Gla-protein (BGP)--the vitamin K-dependent CA2(+)-binding protein--were evaluated in 76 cadmium (Cd)-exposed subjects with renal tubular dysfunction (32 men, 44 women) and 133 nonexposed subjects (53 men, 80 women). Serum BGP levels were higher in the Cd-exposed subjects than in nonexposed subjects. Significant correlations between BGP and each index measured by bone microdensitometry (MD), serum alkaline phosphatase activity, and Cd in blood and urine were found. For all of the Cd-exposed and nonexposed men and women, BGP showed a significant standard partial regression coefficient (multiple regression analysis) with the metacarpal index (MCI), which was one of the MD indicators. Bone Gla-protein also correlated significantly with urinary beta 2-microglobulin in the men and with serum creatinine in the women. Serum BGP values strongly reflect the degree of bone damage and also reflect, although less strongly, the degree of renal damage induced by exposure to Cd.     

接触低浓度镉对某锌粉厂工人健康的影响

目的 探讨低浓度镉接触对工人健康的影响.方法 以锌粉加工118名工人为接触组,该厂34名管理、行政、后勤、化验人员作为对照组,进行血铅、血镉、尿镉、尿β2-微球蛋白、尿肌酐、X线胸片、肺功能、纯音测听等职业健康检查.结果 工作场所空气中镉采6个点共12个样,浓度范围(STEL)为＜0.002～0.015 mg/m3均未超过职业接触限值.接触组血镉超标检出率为65.25％,一次尿镉超标检出率为38.14％,二次尿镉超标检出率为27.12％,2次尿镉超标均伴有尿β2-微球蛋白超标(检出率2.54％);对照组血镉超标检出率为26.47％,但尿镉无人超标;接触组尿镉超标检出率随工龄的增加有增高的趋势,吸烟可使血镉、尿镉超标检出率升高.结论 锌粉加工接触低浓度镉可引起职业性镉中毒,采取综合防护措施,可减少职业性镉中毒的发生,并建议降低镉的职业接触限值.     

Effects of exposure to cadmium on calcium metabolism: a population study.

The objective was to investigate the hypothesis that environmental exposure to cadmium may affect calcium metabolism in the population at large. The 1987 participants (965 men and 1022 women), from 20 to 80 years old, constituted a random sample of the population of four Belgian districts. The urinary excretion of cadmium, a measure of lifetime exposure, averaged 9.3 nmol/24 h in men (range 0.4-324 nmol/24 h) and 7.1 nmol/24 h (range 0.1-71 nmol/24 h) in women. Serum alkaline phosphatase activity and the urinary excretion of calcium correlated significantly and positively with urinary cadmium excretion in both men and women, and serum total calcium concentration negatively with urinary cadmium excretion in men only. The regression coefficients obtained after adjustment for significant covariates indicated that when urinary cadmium excretion increased twofold, serum alkaline phosphatase activity and urinary calcium excretion rose by 3-4% and 0.25 mmol/24 h respectively, whereas in men serum total calcium concentration fell by 6 mumol/l. After adjustment for significant covariates the relation between serum total calcium concentration and urinary cadmium excretion was not significant in women. The findings suggest that even at environmental exposure levels calcium metabolism is gradually affected, as cadmium accumulates in the body. The morbidity associated with this phenomenon in industrialised countries remains presently unknown and requires further investigation.     

Significance of the excretion of urinary indicator proteins for a low level of occupational exposure to cadmium

Summary Urinary cadmium (Cd), N-acetyl-β-D-glucosaminidase (NAG), metallothionein (MT), β₂-microglobulin (BMG), and blood cadmium were determined in 79 workers who had been employed at a Cd pigment factory in Japan. The workers who had been dealing with Cd pigment manufacturing processes were estimated to be exposed to cadmium pigment dust at a maximum concentration of 3.0 [μg/m³/8 h for about 20 years. The urinary Cd level ranged from 0.2 to 9.7 μg/g creatinine with a geometric mean of 1.02 μg/g creatinine. Pearson's correlation coefficients between logarithm of urinary Cd and that of NAG, MT, and BMG in urine were 0.45, 0.62, and 0.05, respectively. The correlation coefficients between blood Cd and urinary NAG, MT, and BMG were 0.21, 0.40, and −0.074, respectively. When partial correlation coefficients were calculated to exclude the contribution of age factor, urinary Cd turned out to be significantly correlated with urinary MT (r = 0.55) and NAG (r = 0.52). The present results indicate that urinary Cd is more closely associated with urinary MT and NAG than with BMG, and suggest that MT and NAG could be good indicators of Cd absorption in a Cd-exposed population whose mean urinary Cd level is relatively low, or less than 10 μg/g creatinine.     

镉接触工人体内血清性激素水平的变化

目的 探讨镉接触工人体内血清性激素水平的变化及其机制。方法 选取南方某冶炼厂镉接触工人及当地健康男性为调查对象,经空气采样测定各车间空气中镉的浓度,用原子吸收分光光度法测定尿镉,并经肌酐校正作为调查对象体内镉负荷的生物标记物;同时测定工人体内性激素水平,并进行镉接触的剂量－效应评定。结果 在控制年龄等混杂因素后,血清睾酮水平随镉接触水平的增高而呈升高趋势,其中尿镉为10．9－21．9μmol/mol肌酐及＞21．9μmol/mol肌酐组的睾酮水平分别为：13．00nmol／L和11．37nmol／L,与0．0－2．2μmol/mol肌酐组的9．31nmol／L比较,差异有显著性;电解车间及尿镉＞21．9μmol/mol肌酐组人的血清黄体生成素水平分别为4．11U／T和4．32U／L,显著同于对照组的2．52U／L和尿镉0．0－2．2μmol/mol肌酐组的2．64U／L。结论 镉接触能引起工人血清性激素水平的变化。     

Effects of exposure to cadmium on calcium metabolism: a population study

The objective was to investigate the hypothesis that environmental exposure to cadmium may affect calcium metabolism in the population at large. The 1987 participants (965 men and 1022 women), from 20 to 80 years old, constituted a random sample of the population of four Belgian districts. The urinary excretion of cadmium, a measure of lifetime exposure, averaged 9.3 nmol/24 h in men (range 0.4-324 nmol/24 h) and 7.1 nmol/24 h (range 0.1-71 nmol/24 h) in women. Serum alkaline phosphatase activity and the urinary excretion of calcium correlated significantly and positively with urinary cadmium excretion in both men and women, and serum total calcium concentration negatively with urinary cadmium excretion in men only. The regression coefficients obtained after adjustment for significant covariates indicated that when urinary cadmium excretion increased twofold, serum alkaline phosphatase activity and urinary calcium excretion rose by 3-4% and 0.25 mmol/24 h respectively, whereas in men serum total calcium concentration fell by 6 mumol/l. After adjustment for significant covariates the relation between serum total calcium concentration and urinary cadmium excretion was not significant in women. The findings suggest that even at environmental exposure levels calcium metabolism is gradually affected, as cadmium accumulates in the body. The morbidity associated with this phenomenon in industrialised countries remains presently unknown and requires further investigation.