【摘要】 探索代谢综合征人群中重金属暴露与肾功能的相关性，为特定人群中慢性肾脏病的诊治提供新思路。基于2011—2018年美国健康与营养调查数据，纳入2 474名代谢综合征患者作为研究对象；探讨四种血液金属元素(包括镉、铅、硒、锰)对肾功能的影响。肾功能主要通过慢性肾病(CKD)、估计的肾小球滤过率(eGFR),尿微量白蛋白肌酐比(UACR)和尿酸(UA)评估。通过加权多因素Logistic回归模型及线性回归模型分析血液中金属元素水平与肾功能的关系。进一步按照年龄、性别、体质量指数(BMI)、是否患高血压、糖尿病及血脂异常进行亚组分析。研究发现血液中镉、铅水平与CKD的发生呈正相关，与eGFR呈现负相关。血硒与CKD的发生存在负向关联，而血锰与eGFR水平存在正相关(P<0.05)。而亚组分析结果显示，女性及老年代谢综合征患者对于金属暴露的效应更为敏感。代谢综合征人群中重金属暴露与肾功能存在关联，铅、镉暴露可能会导致肾功能受损，而硒、锰暴露则可能会起到一定的保护作用。更多还原

【Abstract】 This research delves into the relationship between heavy metal exposure and kidney function among individuals with metabolic syndrome, offering novel perspectives for diagnosing and treating chronic kidney diseases in targeted populations.Utilizing data from the U.S.National Health and Nutrition Examination Survey spanning 2011 to 2018,the study encompasses 2 474 subjects diagnosed with metabolic syndrome.It focuses on the influence of four key blood metal elements-cadmium, lead, selenium and manganese-on kidney function.Kidney function assessment primarily revolves around indicators such as chronic kidney disease(CKD),estimated glomerular filtration rate(eGFR),urine microalbumin-creatinine ratio(UACR),and uric acid(UA).The study employs weighted multifactorial logistic and linear regression models to dissect the interplay between blood metal concentrations and kidney functionality.Additionally, it conducts nuanced subgroup analyses, considering variables like age, gender, body mass index(BMI),and the presence of hypertension, diabetes, or dyslipidemia.Notably, the findings indicate a direct, positive correlation between blood levels of cadmium and lead and the onset of CKD,inversely affecting eGFR.Conversely, blood selenium is inversely associated with CKD development, while manganese shows a positive correlation with eGFR levels(P<0.05).The subgroup analysis underscores a heightened sensitivity to metal exposure effects in female and elderly metabolic syndrome patients.The study establishes a significant connection between heavy metal exposure and kidney function in metabolic syndrome populations.Notably, exposure to lead and cadmium may impair kidney function, whereas selenium and manganese exposure might confer protective benefits.更多还原