Serum Aflatoxin B1-Lysine Adducts and Kidney Function Markers in NHANES 1999-2000: An Exploratory Cross-Sectional Analysis
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Abstract
Background: A foodborne mycotoxin, aflatoxin B1, is known to be hepatotoxic and hepatocarcinogenic. Experimental studies suggest renal toxicity due to oxidative stress and apoptosis, but human epidemiologic evidence is limited in humans.
Objective: In the context of NHANES 1999-2000, this study evaluated whether measurable serum aflatoxin B1-lysine adducts were related to markers of renal function among adults.
Methods: This 1999-2000 exploratory analysis of NHANES data investigates the relationship between aflatoxin B1 and kidney function, and other health and demographic factors. Study subjects consisted of adults aged 20 years or older with data on any variable pertaining to aflatoxin exposure. Detectable aflatoxin was defined in the laboratory comment code. The serum creatinine was standardized using the calibration equation for NHANES 1999–2000, estimated glomerular filtration rate was calculated using the CKD-EPI 2021 creatinine equation, and urine albumin-creatinine ratio was calculated from urine albumin–creatinine. The outcomes included creatinine, eGFR, blood urea nitrogen, natural-log UACR, albuminuria, lower eGFR, and any one-visit kidney abnormality. To estimate descriptive statistics from weighted data, we used non-parametric comparisons, weighted linear models with robust standard errors, exact tests for binary outcomes, and bootstrap median-difference intervals.
Results: In an analysis of 1,258 adults, only sixteen were found to have measurable serum aflatoxin B1-lysine, which pertains to a weighted detectable prevalence of 1.10%. The presence of detectable aflatoxin wasn’t related to any of these tests after adjusting for age, sex, race, and poverty income ratio. Estimates of the fully adjusted beta were -0.022 mg/dL for creatinine, -0.219 mL/min/1.73 m2 (eGFR), 0.293 mg/dL for BUN, and -0.486 log-UACR, all with p values >0.05. Aflatoxin detectability did not significantly differ by binary kidney outcomes.
Conclusion: In this adult U.S. sample, detectable serum aflatoxin B1-lysine was rare and not associated with markers of kidney dysfunction. The small size of the exposed group means that the findings are inconclusive rather than definitive evidence of no renal effect.
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