Urinary N-acetylglucosaminidase in People Environmentally Exposed to Cadmium Is Minimally Related to Cadmium-Induced Nephron Destruction

Exposure to even low levels of the environmental pollutant cadmium (Cd) increases the risk of kidney damage and malfunction. The body burden of Cd at which these outcomes occur is not, however, reliably defined. Here, multiple-regression and mediation analyses were applied to data from 737 non-diabe...

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Main Author: Soisungwan Satarug
Format: Article
Language:English
Published: MDPI AG 2024-10-01
Series:Toxics
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Online Access:https://www.mdpi.com/2305-6304/12/11/775
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author Soisungwan Satarug
author_facet Soisungwan Satarug
author_sort Soisungwan Satarug
collection DOAJ
description Exposure to even low levels of the environmental pollutant cadmium (Cd) increases the risk of kidney damage and malfunction. The body burden of Cd at which these outcomes occur is not, however, reliably defined. Here, multiple-regression and mediation analyses were applied to data from 737 non-diabetic Thai nationals, of which 9.1% had an estimated glomerular filtration rate (eGFR) ≤ 60 mL/min/1.73 m<sup>2</sup> (a low eGFR). The excretion of Cd (E<sub>Cd</sub>), and renal-effect biomarkers, namely β<sub>2</sub>-microglobulin (E<sub>β2M</sub>), albumin (E<sub>alb</sub>), and N-acetylglucosaminidase (E<sub>NAG</sub>), were normalized to creatinine clearance (C<sub>cr</sub>) as E<sub>Cd</sub>/C<sub>cr</sub> E<sub>β2M</sub>/C<sub>cr</sub>, E<sub>alb</sub>/C<sub>cr,</sub> and E<sub>NAG</sub>/C<sub>cr</sub>. After adjustment for potential confounders, the risks of having a low eGFR and albuminuria rose twofold per doubling E<sub>Cd</sub>/C<sub>cr</sub> rates and they both varied directly with the severity of β<sub>2</sub>-microglobulinuria. Doubling E<sub>Cd</sub>/C<sub>cr</sub> rates also increased the risk of having a severe tubular injury, evident from E<sub>NAG</sub>/C<sub>cr</sub> increments [POR = 4.80, <i>p</i> = 0.015]. E<sub>NAG</sub>/C<sub>cr</sub> was strongly associated with E<sub>Cd</sub>/C<sub>cr</sub> in both men (β = 0.447) and women (β = 0.394), while showing a moderate inverse association with eGFR only in women (β = −0.178). A moderate association of E<sub>NAG</sub>/C<sub>cr</sub> and E<sub>Cd</sub>/C<sub>cr</sub> was found in the low- (β = 0.287), and the high-Cd body burden groups (β = 0.145), but E<sub>NAG</sub>/C<sub>cr</sub> was inversely associated with eGFR only in the high-Cd body burden group (β = −0.223). These discrepancies together with mediation analysis suggest that Cd-induced nephron destruction, which reduces GFR and the tubular release of NAG by Cd, involves different mechanisms and kinetics.
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spelling doaj-art-e0b0e9868b8e4c4890c2fbf1404cd6942025-08-20T02:04:44ZengMDPI AGToxics2305-63042024-10-01121177510.3390/toxics12110775Urinary N-acetylglucosaminidase in People Environmentally Exposed to Cadmium Is Minimally Related to Cadmium-Induced Nephron DestructionSoisungwan Satarug0Centre for Kidney Disease Research, Translational Research Institute, Woolloongabba, Brisbane, QLD 4102, AustraliaExposure to even low levels of the environmental pollutant cadmium (Cd) increases the risk of kidney damage and malfunction. The body burden of Cd at which these outcomes occur is not, however, reliably defined. Here, multiple-regression and mediation analyses were applied to data from 737 non-diabetic Thai nationals, of which 9.1% had an estimated glomerular filtration rate (eGFR) ≤ 60 mL/min/1.73 m<sup>2</sup> (a low eGFR). The excretion of Cd (E<sub>Cd</sub>), and renal-effect biomarkers, namely β<sub>2</sub>-microglobulin (E<sub>β2M</sub>), albumin (E<sub>alb</sub>), and N-acetylglucosaminidase (E<sub>NAG</sub>), were normalized to creatinine clearance (C<sub>cr</sub>) as E<sub>Cd</sub>/C<sub>cr</sub> E<sub>β2M</sub>/C<sub>cr</sub>, E<sub>alb</sub>/C<sub>cr,</sub> and E<sub>NAG</sub>/C<sub>cr</sub>. After adjustment for potential confounders, the risks of having a low eGFR and albuminuria rose twofold per doubling E<sub>Cd</sub>/C<sub>cr</sub> rates and they both varied directly with the severity of β<sub>2</sub>-microglobulinuria. Doubling E<sub>Cd</sub>/C<sub>cr</sub> rates also increased the risk of having a severe tubular injury, evident from E<sub>NAG</sub>/C<sub>cr</sub> increments [POR = 4.80, <i>p</i> = 0.015]. E<sub>NAG</sub>/C<sub>cr</sub> was strongly associated with E<sub>Cd</sub>/C<sub>cr</sub> in both men (β = 0.447) and women (β = 0.394), while showing a moderate inverse association with eGFR only in women (β = −0.178). A moderate association of E<sub>NAG</sub>/C<sub>cr</sub> and E<sub>Cd</sub>/C<sub>cr</sub> was found in the low- (β = 0.287), and the high-Cd body burden groups (β = 0.145), but E<sub>NAG</sub>/C<sub>cr</sub> was inversely associated with eGFR only in the high-Cd body burden group (β = −0.223). These discrepancies together with mediation analysis suggest that Cd-induced nephron destruction, which reduces GFR and the tubular release of NAG by Cd, involves different mechanisms and kinetics.https://www.mdpi.com/2305-6304/12/11/775albuminuriacadmiumβ<sub>2</sub>-microglobulineGFRmediation analysisN-acetyl-β-D-glucosaminidase
spellingShingle Soisungwan Satarug
Urinary N-acetylglucosaminidase in People Environmentally Exposed to Cadmium Is Minimally Related to Cadmium-Induced Nephron Destruction
Toxics
albuminuria
cadmium
β<sub>2</sub>-microglobulin
eGFR
mediation analysis
N-acetyl-β-D-glucosaminidase
title Urinary N-acetylglucosaminidase in People Environmentally Exposed to Cadmium Is Minimally Related to Cadmium-Induced Nephron Destruction
title_full Urinary N-acetylglucosaminidase in People Environmentally Exposed to Cadmium Is Minimally Related to Cadmium-Induced Nephron Destruction
title_fullStr Urinary N-acetylglucosaminidase in People Environmentally Exposed to Cadmium Is Minimally Related to Cadmium-Induced Nephron Destruction
title_full_unstemmed Urinary N-acetylglucosaminidase in People Environmentally Exposed to Cadmium Is Minimally Related to Cadmium-Induced Nephron Destruction
title_short Urinary N-acetylglucosaminidase in People Environmentally Exposed to Cadmium Is Minimally Related to Cadmium-Induced Nephron Destruction
title_sort urinary n acetylglucosaminidase in people environmentally exposed to cadmium is minimally related to cadmium induced nephron destruction
topic albuminuria
cadmium
β<sub>2</sub>-microglobulin
eGFR
mediation analysis
N-acetyl-β-D-glucosaminidase
url https://www.mdpi.com/2305-6304/12/11/775
work_keys_str_mv AT soisungwansatarug urinarynacetylglucosaminidaseinpeopleenvironmentallyexposedtocadmiumisminimallyrelatedtocadmiuminducednephrondestruction