Prenatal blood lead levels and reduced preadolescent glomerular filtration rate: Modification by body mass index
Autor: | Alison P. Sanders, Nia McRae, Robert O. Wright, Charlie Saylor, Mari Cruz Tolentino, Guadalupe Estrada-Gutierrez, Martha María Téllez-Rojo, Chitra Amarasiriwardena, Marcela Tamayo-Ortiz, Andrea A. Baccarelli, Chris Gennings, Ivan Pantic, Lisa M. Satlin, Jeffrey J. Fadrowski, Sandra Parra-Hernández |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Male
010504 meteorology & atmospheric sciences Adolescent Physiology Renal function Nephron 010501 environmental sciences Overweight Kidney Function Tests 01 natural sciences Article Body Mass Index chemistry.chemical_compound Kidney function Pregnancy eGFR Medicine Humans Prenatal GE1-350 Obesity Adverse effect Child 0105 earth and related environmental sciences General Environmental Science Creatinine biology business.industry medicine.disease Environmental sciences medicine.anatomical_structure chemistry Cystatin C Lead biology.protein Female medicine.symptom business Body mass index Glomerular Filtration Rate |
Zdroj: | Environment International, Vol 154, Iss, Pp 106414-(2021) Environ Int |
ISSN: | 0160-4120 |
Popis: | Background For the developing kidney, the prenatal period may represent a critical window of vulnerability to environmental insults resulting in permanent nephron loss. Given that the majority of nephron formation is complete in the 3rd trimester, we set out to test whether 1) prenatal lead exposure is associated with decreased preadolescent kidney function and 2) whether preadolescent obesity acts synergistically with early life lead exposure to reduce kidney function. Methods Our study included 453 mother–child pairs participating in the PROGRESS birth cohort. We assessed prenatal blood lead levels (BLLs) in samples collected in the 2nd and 3rd trimesters and at delivery, as well as tibial and patellar bone lead measures assessed one-month postpartum. Preadolescent estimated glomerular filtration rate (eGFR) was derived from serum levels of creatinine and/or cystatin C measured at age 8–12 years. We applied linear regression to assess the relationship between prenatal bone and BLL with preadolescent eGFR, and adjusted for covariates including age, sex, BMI z-score, indoor tobacco smoke exposure, and socioeconomic status. We also examined sex-specific associations and tested for effect modification by BMI status. Results We observed null associations between prenatal lead exposure and eGFR. However, in interaction analyses we found that among overweight children, there was an inverse association between BLL (assessed at 2nd and 3rd trimester and at delivery) and preadolescent eGFR. For example, among overweight participants, a one ln-unit increase in 2nd trimester BLL was associated with a 10.5 unit decrease in cystatin C-based eGFR (95% CI: −18.1, −2.8; p = 0.008). Regardless of lead exposure, we also observed null relationships between BMI z-score and eGFR overall, as well as among overweight participants. However, among participants with preadolescent obesity, we observed a significant 5.9-unit decrease in eGFR. We observed no evidence of sex-specific effects. Conclusions Our findings, if confirmed in other studies, suggest a complex interplay between the combined adverse effects of adiposity and perinatal lead exposure as they relate to adolescent kidney function. Future studies will assess kidney function and adiposity trajectories through adolescence to better understand environmental risk factors for kidney function decline. |
Databáze: | OpenAIRE |
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