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系統識別號 U0026-2508202018503700
論文名稱(中文) 嘉磷塞與重金屬共暴露對於慢性腎臟病之風險評估
論文名稱(英文) The risk assessment of co-exposure to glyphosate and heavy metals in chronic kidney disease
校院名稱 成功大學
系所名稱(中) 食品安全衛生暨風險管理研究所
系所名稱(英) Department of Food Safety / Hygiene and Risk Management
學年度 108
學期 2
出版年 109
研究生(中文) 許賀祺
研究生(英文) Ho-Chi Hsu
學號 SC6071043
學位類別 碩士
語文別 中文
論文頁數 133頁
口試委員 指導教授-陳秀玲
口試委員-李俊璋
口試委員-宋俊明
口試委員-張偉翔
中文關鍵字 嘉磷塞        慢性腎臟病  飲食習慣 
英文關鍵字 glyphosate  lead  arsenic  cadmium  chronic kidney disease  maternal dietary 
學科別分類
中文摘要 嘉磷塞(Glyphosate)為在世界各國使用量較高之除草劑,近年來有相關文獻指出人體對於嘉磷塞之暴露量有逐年上升之趨勢,並且有愈來愈多研究指出其對人體之健康傷害,短時間內大量暴露可能會造成急性腎損傷,而長期暴露則可能會有相關慢性疾病等危害,而氨甲基磷酸(aminomethylphosphonic acid, AMPA)為嘉磷塞之主要降解產物,目前對其毒性資料尚不明確。更有相關研究顯示嘉磷塞與重金屬之共同暴露對於慢性腎臟病(Chronic kidney disease, CKD)有協同效應,因此在逐年升高之暴露環境下,嘉磷塞對於人體相關疾病之風險是非常重要之議題。本研究目的欲探討嘉磷塞與重金屬之共同暴露對慢性腎臟病之影響。
本研究於成大醫院腎臟科招募56位慢性腎臟病患者作為病例組,而對照組則是採用台灣人體生物資料庫之100位腎功能健全受試者之檢體與問卷資料進行研究。利用血液與尿液檢體進行重金屬鉛(Lead)、砷(Arsenic)、鎘(Cadmium)、嘉磷塞、AMPA、腎絲球過濾率(estimated Glomerular Filtration Rate, eGFR)與肌酸酐(Creatinine)等生化指標之檢測,透過感應耦合電漿質譜儀(Inductively Coupled Plasma Mass Spectrometry, ICP-MS)分析血液與尿液中重金屬濃度,透過液相層析串聯質譜儀(Liquid Chromatography-tandem Mass Spectrometry, LC-MS/MS)分析尿液中之嘉磷塞與AMPA濃度,也針對慢性腎臟病患者進行飲食問卷調查,找出可能存在高風險之食品,最後以每日攝取量(Estimated Daily Intake, EDI)進行嘉磷塞暴露量之估算,以危害商數(Hazard quotient, HQ)進行風險描述。
本研究之嘉磷塞、AMPA、砷、鎘、肌酸酐以及eGFR於兩組別間皆觀察到顯著差異,且發現台灣之砷與鎘之暴露情形較其他亞洲國家與西方國家嚴重。嘉磷塞、AMPA、砷、鎘以及肌酸酐濃度皆觀察到有隨著CKD階段增加而上升之趨勢,而鉛則無此上升之趨勢。嘉磷塞與植物油與瓜果類呈現顯著正相關,與大漿果類呈現顯著負相關;AMPA與牛內臟呈現顯著正相關;鎘與咖啡、鹹蛋、優酪乳、起司片以及大漿果類呈現顯著負相關;砷與鉛於本研究中並無與任何食品類別呈現顯著正或負相關性;肌酸酐與咖啡、雞蛋、大漿果、小漿果類呈現顯著負相關;於CKD飲食原則中屬於高磷食品之茶類與碳酸飲料,於本研究中皆觀察到與eGFR或eGFR改變速度呈負相關性,代表此類食品於本研究中觀察到其使eGFR下降之趨勢,而市售碳酸飲料之相關性則接近統計顯著。風險評估之部分,發現病例組之嘉磷塞暴露情形較對照組嚴重,平均分別為0.006與0.001 mg/kg bw/day,而兩組別之危害商數平均分別為0.012與0.003,約為ADI之2.4%與0.6%,皆遠小於1,代表本研究之嘉磷塞暴露量對人體並無顯著性非致癌性風險。
英文摘要 The issue of risk of kidney disease caused by glyphosate is very important when the exposure of glyphosate is growing recently. The aim of this study is to evaluate the influence of co-exposure to glyphosate and heavy metals in chronic kidney disease. This research recruited 56 patients with chronic kidney disease as cases and recruited 100 healthier as controls. The current study analyzed the concentration of glyphosate, aminomethylphosphonic acid (AMPA), arsenic, lead and cadmium in urine or blood and further to compare the concentrations between case and control groups. The questionnaire interview for patients with CKD will find out whether dietary pattern that might with high risk. Finally, the estimated daily intake (EDI) was used to estimate the exposure of glyphosate, and the Hzard Quotient (HQ) was used to describe the risk of glyphosate. The result showed that the significant differences were observed in glyphosate, AMPA, arsenic, cadmium and creatinine between the two groups and those showed the increasing trend by the worse of CKD. Urine glyphosate level showed significant positive correlations with the consumption quantity of vegetable oils and melons; AMPA has a significant positive correlation with bovine offal. HQ of two groups were far less than 1, which meant that the exposure of glyphosate in this study has no significant non-carcinogenic risk to humans, but it’s not concsistent with the biomarker in CKD patients.
論文目次 目錄
摘要 II
Abstract IV
誌謝 VI
目錄 VIII
表目錄 X
圖目錄 XI
1. 緒論 13
1.1. 研究背景 13
1.2. 研究目的 14
2. 文獻回顧 16
2.1. 嘉磷塞簡介與全球使用狀況 16
2.2. 嘉磷塞毒性效應 20
2.4. 嘉磷塞之流行病學相關研究 24
2.3. 嘉磷塞於食品中之調查研究 30
2.5. 重金屬之毒性效應與流行病學研究 33
2.6. 慢性腎臟病之定義與檢驗 40
2.7. 台灣慢性腎臟病盛行率與血液透析狀況 43
2.8. 嘉磷塞與慢性腎臟病之相關性與國際現況 43
2.9. 嘉磷塞之健康風險分析研究 45
3. 研究材料與方法 48
3.1. 研究方法 48
3.2. 飲食問卷 50
3.3. 樣本收集 52
3.5. 血中鉛分析 52
3.6. 尿中砷、尿中鎘分析 55
3.7. 尿中嘉磷塞與AMPA分析 59
3.8. 腎功能之計算 70
3.9. 風險評估方法 71
4. 結果與討論 72
4.1. 基本人口特徵 72
4.2. 實驗數據結果 76
4.3. 飲食問卷結果 88
4.4. 嘉磷塞之風險評估 97
5. 結論 101
6. 研究限制與研究偏差 102
6.1. 研究偏差 102
6.2. 研究限制 103
7. 參考文獻 104
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