PMID- 36828458 OWN - NLM STAT- MEDLINE DCOM- 20230228 LR - 20231118 IS - 2072-6651 (Electronic) IS - 2072-6651 (Linking) VI - 15 IP - 2 DP - 2023 Feb 10 TI - Combination Effect of Microcystins and Arsenic Exposures on CKD: A Case-Control Study in China. LID - 10.3390/toxins15020144 [doi] LID - 144 AB - Evidence has shown that exposure to environmental pollutants such as microcystins (MCs), arsenic (As), and cadmium (Cd) can lead to the occurrence and development of chronic kidney disease (CKD). There is a synergistic effect between MCs and Cd. However, the combined effect of MCs and As exposures on CKD remains unclear. In Hunan province, China, 135 controls and 135 CKD cases were enrolled in a case-control study. Serum MCs, plasma As and Cd concentrations were measured for all participants. We investigated the association between MCs/As and CKD risk using conditional logistic regression. The additive model explored the interaction effect, and the Bayesian kernel machine regression (BKMR) models investigated the combined effects of MCs, As, and Cd on CKD. The results showed that MCs and As were significantly associated with CKD risk. Participants in the highest MCs concentration had a 4,81-fold increased risk of CKD compared to those in the lowest quartile (95% confidence interval [CI]: 1,96 to 11,81). The highest quartile of As concentrations corresponded to an adjusted odds ratio of 3.40 (95% CI: 1.51, 7.65) relative to the lowest quartile. MCs/As and CKD risk exhibited significant dose-response correlations (all p for trend < 0.01). In addition, a positive interaction effect of MCs and As on CKD was also reported. The CKD risk due to interaction was 2.34 times (95% CI: 0.14, 4.54) relative to the CKD risk without interaction, and the attributable proportion of CKD due to interaction among individuals with both exposures was 56% (95% CI: 0.22, 0.91). In the BKMR, the combined effect of MCs, As, and Cd was positively associated with CKD. In conclusion, both MCs and As are independent risk factors for CKD, exerting a synergistic effect between them. Combined exposure to MCs, As, and Cd can increase the risk of CKD. FAU - Gao, Hong AU - Gao H AD - Nursing Department, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang 421001, China. AD - School of Nursing, University of South China, Hengyang 421001, China. FAU - Zhu, Na AU - Zhu N AD - Nursing Department, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang 421001, China. AD - School of Nursing, University of South China, Hengyang 421001, China. FAU - Deng, Shuxiang AU - Deng S AD - Department of Epidemiology and Health Statistics, The Key Laboratory of Typical Environmental Pollution and Health Hazards of Hunan Province, School of Basic Medicine, School of Public Health, Hengyang Medical School, University of South China, Hengyang 421001, China. FAU - Du, Can AU - Du C AD - Hunan Provincial Key Laboratory of Clinical Epidemiology, Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha 410000, China. FAU - Tang, Yan AU - Tang Y AD - Department of Epidemiology and Health Statistics, The Key Laboratory of Typical Environmental Pollution and Health Hazards of Hunan Province, School of Basic Medicine, School of Public Health, Hengyang Medical School, University of South China, Hengyang 421001, China. FAU - Tang, Peng AU - Tang P AD - Department of Epidemiology and Health Statistics, The Key Laboratory of Typical Environmental Pollution and Health Hazards of Hunan Province, School of Basic Medicine, School of Public Health, Hengyang Medical School, University of South China, Hengyang 421001, China. FAU - Xu, Shuaishuai AU - Xu S AD - Hunan Provincial Key Laboratory of Clinical Epidemiology, Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha 410000, China. FAU - Liu, Wenya AU - Liu W AD - Hunan Provincial Key Laboratory of Clinical Epidemiology, Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha 410000, China. FAU - Shen, Minxue AU - Shen M AUID- ORCID: 0000-0003-0441-9303 AD - Hunan Provincial Key Laboratory of Clinical Epidemiology, Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha 410000, China. FAU - Xiao, Xinhua AU - Xiao X AD - Department of Metabolism and Endocrinology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang 421001, China. FAU - Yang, Fei AU - Yang F AUID- ORCID: 0000-0001-5687-0556 AD - Department of Epidemiology and Health Statistics, The Key Laboratory of Typical Environmental Pollution and Health Hazards of Hunan Province, School of Basic Medicine, School of Public Health, Hengyang Medical School, University of South China, Hengyang 421001, China. AD - Department of Metabolism and Endocrinology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang 421001, China. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20230210 PL - Switzerland TA - Toxins (Basel) JT - Toxins JID - 101530765 RN - N712M78A8G (Arsenic) RN - 00BH33GNGH (Cadmium) RN - 0 (Microcystins) SB - IM MH - Humans MH - *Arsenic MH - Cadmium MH - Case-Control Studies MH - Microcystins MH - Bayes Theorem MH - Environmental Exposure MH - *Renal Insufficiency, Chronic/epidemiology MH - China PMC - PMC9964595 OTO - NOTNLM OT - arsenic OT - chronic kidney disease OT - microcystins OT - synergistic interaction COIS- The authors declare no conflict of interest. EDAT- 2023/02/25 06:00 MHDA- 2023/03/03 06:00 PMCR- 2023/02/10 CRDT- 2023/02/24 19:53 PHST- 2022/11/22 00:00 [received] PHST- 2023/01/22 00:00 [revised] PHST- 2023/01/25 00:00 [accepted] PHST- 2023/02/24 19:53 [entrez] PHST- 2023/02/25 06:00 [pubmed] PHST- 2023/03/03 06:00 [medline] PHST- 2023/02/10 00:00 [pmc-release] AID - toxins15020144 [pii] AID - toxins-15-00144 [pii] AID - 10.3390/toxins15020144 [doi] PST - epublish SO - Toxins (Basel). 2023 Feb 10;15(2):144. doi: 10.3390/toxins15020144.