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THE EARLY DETECTION OF RENAL DYSFUNCTION IN THAI PEOPLE UPON HIGH CADMIUM EXPOSURE

TEEYAKASEM, WIMONRAT.1, NISHIJO, MUNEKO.2, SAWADDIWOOTHIPONG, WITTAYA.3, SATARUG, SOISUNGWAN.4, RUANGYUTTIKARN, WERAWAN.1

1 Division of Toxicology, Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
2 Department of Public Health, Kanazawa Medical University, Uchinada, Ishikawa, Japan
3 Mae Sot Hospital, Tak province, Thailand
4 National Research Center for Environmental Toxicology, Brisbane, Australia

        Recently, high levels of Cd contaminated in rice and soil in Amphur Mae Sot, Tak Province, Thailand were reported. Public concern goes to high exposure of inhabitants in this area to the high-dose of Cd through their long-term daily consumption of the rice. Therefore, urinary samples from 224 inhabitants (male=104 and female=114) living in the polluted area were investigated in order to find the biological marker for the early detection of renal dysfunction induced by high cadmium exposure. Qualitative urinalysis parameters; pH, protein, glucose, occult blood, urobilinogen and ketone body were measured by the urinary strip test at the sampling site. Quantitation of the levels of Cd was analyzed by atomic absorption spectrometry. N-acetyl-ß-D-glucosaminidase (NAG), albumin, ß2-microglobulin (ß2-MG), a1-microblobulin (a1-MG), total protein, glucose, lysozyme, and creatinine (Cr) were also quantitated. The results show that Cd concentrations in all subjects were classified into 3 levels; below 5 (n=54), 5-10 (n=77), and above 10 (n=84) µg/g Cr, with mean±S.D. of 3.95±0.96, 7.14±1.37 and 17.81±7.19 µg/g Cr, respectively. The three average urinary Cd levels were exceeded WHO maximum tolerable internal dose for the non-exposed population (2 µg/g Cr). Using Spearman’s correlation analysis, Chi square and ANOVA, ß2-MG, NAG, and a1-MG were positively correlated with urinary Cd levels in male and female subjects except urinary a1-MG and Cd in female. Therefore, ß2-MG, NAG, and a1-MG are the sensitive markers to detect renal dysfunction in the studied group. However, the NAG is a better marker for the early detection of renal dysfunction related to Cd exposure than other proteins.

ที่มา :
การประชุมวิชาการสมาคมพิษวิทยาแห่งประเทศไทย ประจำปี 2548 Food & Chemical Safety วันที่ 17-18 พฤศจิกายน 2548 โรงแรมแกรนด์ ทาวเวอร์อินน์ ถนนพระรามหก กรุงเทพฯ