Urinary excretion of N-acetyl-β-D-glucosaminidase (NAG), a lysosomal enzyme localized in the proximal tubular epithelial cells, has been reported to increase in subjects having renal tubular injury. In the present study, excreted amounts of β
2-microglobulin (β
2-mg), an established indicator of proximal tubular dysfunction, and NAG were determined in urine specimens from people living in cadmium (Cd)-polluted areas in Izuhara, Nagasaki prefecture (male, 136; female, 180) and in non-polluted areas in Ibaraki prefecture (male, 158; female, 140), and their usefulness as indicators of renal damage caused by environmental Cd exposure was compared. Subjects of each sex were divided into groups by every 10 years of age. In the non-polluted areas, urinary β
2-mg concentration was almost constant among all age groups, whereas NAG activity was elevated in age groups over 60 years old. Urinary β
2-mg concentration and NAG activity of female subjects in the Cd-polluted areas were higher than those in the non-polluted areas in age groups over 50 and 40 years old, respectively. In the polluted areas, number of subjects who excreted abnormally high amounts of urinary β
2-mg was sharply increased when urinary Cd exceeded a certain level, while urinary NAG activity was almost linearly elevated with increase in urinary Cd concentration. The incidence of abnormal values of urinary NAG activity in people living in the polluted areas was higher in age groups below 60 years old and was lower in age groups over 60 years old than that of urinary β
2-mg concentration. These results suggest that urinary NAG activity reflects renal effects of Cd in a more sensitive manner than urinary β
2-mg concentration at an earlier stage of renal damage, but that in a more advanced stage the renal damage is more markedly indicated by the increased level of β
2-mg concentration than that of NAG.
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