慢性肾脏病患者的双酚类化合物水平及其与肾功能的相关性  

Levels of bisphenols in patients with chronic kidney disease and their correlation with renal function

作　　者：刘婷彦 史媛媛 朱秋毓 庄峰[1] 卢建新[1] 丁峰[1] Liu Tingyan;Shi Yuanyuan;Zhu Qiuyu;Zhuang Feng;Lu Jianxin;Ding Feng(Division of Nephrology and Unit of Critical Nephrology,Shanghai Ninth People＇s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院肾脏科危重肾脏病研究室,200011

出　　处：《中华肾脏病杂志》2018年第9期654-660,共7页Chinese Journal of Nephrology

基　　金：国家自然科学基金（81270850、81470990）;上海市科委科技支撑项目（17441904200）;上海市浦东新区卫计委联合攻关项目（PW2015D-4）

摘　　要：目的检测双酚A、双酚B、双酚S、双酚F这4种双酚类化合物在肾功能不全患者中的水平及分析其与肾功能的相关性。方法依据肾脏病患者生存质量指南（KDIGO指南）进行慢性肾脏病（CKD）的诊断和分期。人选11例健康对照及63例CKD非透析患者，包括轻度肾损伤（CKD1、2期）组30例，中度肾损伤（CKD3期）组19例，重度肾损伤（CKD4、5期）组14例。高效液相色谱检测血清中双酚A、双酚B、双酚S、双酚F的浓度。采用Spearman相关分析评估双酚类化合物浓度与估算肾小球滤过率（eGFR）的相关性。采用二元多因素非条件Logistic回归分析评估4种双酚类化合物与CKD患者合并冠心病、糖尿病、高血压的相关性。结果（1）健康对照组中4种双酚类化合物均未检出；轻度肾损伤组未检出双酚A和双酚S，双酚B浓度为5．24（5．24，9．38）μg／L，双酚F为0．74（0．74，0．74）μg／L；中度肾损伤组未检出双酚S，双酚A浓度为2．79（1．01，4．53）μg／L，双酚B为5．24（5．24，5．24）μg／L，双酚F为0．74（0．74，0．74）μg／L；重度肾损伤组双酚A浓度为14．30（7．97，18．17）μg／L，双酚B为0μg／L，双酚S为23．73（23．73，136．59）μg/L，双酚F为0．74（0．74，1．42）μg／L。重度肾损伤组血清双酚A和双酚S水平均高于健康对照组、轻度肾损伤组及中度肾损伤组（均P〈0．05），4组研究对象间血清双酚B、双酚F差异均无统计学意义。（2）CKD患者中血清中双酚A、双酚S浓度与eGFR均呈负相关（分别r=-0．779，P〈0．001；r=0．546，P〈0．001）。（3）双酚A暴露与CKD患者合并糖尿病相关（OR=4．951，95％CI：1．603～15．294，P=0．005）；双酚S暴露与CKD患者合并高血压相关（OR=4．466，95％CI：1．575～12．666，P=0．005）。结论CKD患者血清中存在多种双酚类化合物，其中双酚A、双酚S水平较高，且与肾功能�Objective To observe the levels of four bisphenols （bisphenol A, B, S and F） and their correlation with renal function in chronic kidney disease （CKD） patients. Methods Patients with CKD were identified according to Kidney Disease： Improving Global Outcomes （KDIGO） criteria. Sixtythree CKD patients and eleven healthy controls were enrolled. CKD patients were further classified as mild renal injury group （CKD stage 1 and 2, n=30）, moderate renal injury group （CKD stage 3, n=19） and severe renal injury group （CKD stage 4 and 5, n=14）. The levels of four bisphenols in serum were determined by high performance liquid chromatography （HPLC）. The correlation between concentrations of four bisphenols and estimated glomerular filtration rate （eGFR） was assessed by Spearman＇s rank correlation analysis. The associations of four bisphenols with coronary heart disease, diabetes and hypertension in CKD patients were estimated by binary multivariate logistic regression. Results （1） Four bisphenols were not detected in serum of healthy control. In the mild renal injury group the bisphenol A and bisphenol S were not detected, and patients had 5.24 （5.24, 9.38） μg/L bisphenol B and 0.74 （0.74, 0.74） μg/L bisphenol F. In the moderate renal injury group bisphenol S was not detected, and patients had 2.79 （1.01, 4.53）μg/L bisphenol A, 5.24 （5.24, 5.24） μg/L bisphenol B and 0.74 （0.74, 0.74） μg/L bisphenol F. In severe renal injury group patients had 14.30 （7.97, 18.17）μg/L bisphenol A, 0μg/L bisphenol B, 23.73 （23.73, 136.59）μg/L bisphenol S and 0.74 （0.74, 1.42） μg/L bisphenol F. The levels of bisphenol A and bisphenol S in severe renal injury group were higher than those in the healthy control group, mild renal injury group and moderate renal injury group （all P 〈 0.05）. Bisphenol B and bisphenol F were not statistically different among four groups. （2） Bisphenol A and bisphenol S were negatively correlated with eGFR （r=-0.779, P 〈 0.001;

关 键 词：肾功能不全 慢性 LOGISTIC模型 环境污染 肾小球滤过率 双酚类化 合物 

分 类 号：R692[医药卫生—泌尿科学]