Abstract
PurposeThis cross-sectional study aimed to assess the effect of environmental cadmium (Cd) exposure and essential metal imbalance on renal tubular damage and oxidative stress in 979 adults living in a Cd-polluted area near an abandoned copper (Cu) refinery.MethodsWe analyzed urinary Cd concentrations, renal tubular damage and oxidative stress markers, such as beta-2 microglobulin (β2-MG) and N-acetyl-β-d-glucosaminidase (NAG) activity and urine malondialdehyde (MDA) levels. The serum copper-to-zinc ratio (CZR) was used as an essential metal imbalance indicator. We divided the subjects into two Cd exposure groups based on the reference level of urinary Cd for renal dysfunction (2 μg/g creatinine).ResultsThe geometric mean concentration of urinary Cd in all subjects was 2.25 μg/g creatinine. In both low and high Cd exposure groups, urinary Cd levels were positively correlated with urinary NAG activity, but not with serum CZR. After multivariate adjustment, serum CZR was strongly associated with urinary β2-MG levels in the low Cd exposure group (β = 1.360, P = 0.019) and was significantly associated with urinary MDA levels, regardless of Cd exposure level. In addition, the risk of renal tubular damage was significantly associated with urinary Cd level, particularly in the lowest or highest CZR tertile groups.ConclusionsEssential metal imbalance may be a determinant of oxidative stress and renal tubular damage in a chronically Cd-exposed population, and proper zinc supplementation will be effective in preventing adverse health effects due to Cd exposure.
Highlights
Cadmium (Cd) is widely distributed in the environment and is a major environmental pollutant that threatens human health
The present study evaluated whether an imbalance in the levels of Zn and Cu is associated with renal tubular damage or oxidative stress in a population living in a Cd-polluted area
Serum copper-to-zinc ratio (CZR) was found to be a determinant of oxidative stress and was significantly associated with microscopic damage to the proximal tubules in the low and chronically Cd-exposed population
Summary
Cadmium (Cd) is widely distributed in the environment and is a major environmental pollutant that threatens human health. The gastrointestinal absorption of Cd is affected by the nutritional status of individuals, such as the body levels of iron (Fe) and zinc (Zn) (EFSA 2009; Ryu et al 2004), and Cd interacts metabolically with some essential metals such. International Archives of Occupational and Environmental Health (2020) 93:337–344 as Zn, copper (Cu), Fe, and calcium (Ca) (Goyer 1997). Those metal ions and Cd are competitively transported by common transporters [i.e., divalent metal transporter 1, Zrt Irt-related protein 8 (ZIP8), and ZIP14] (Jenkitkasemwong et al 2012; Vesey 2010) and tightly bound to metallothionein (MT) in the systemic circulation. The concentration of essential metals is affected by the concentration of Cd in the body
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