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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 羅宇軒 | zh_TW |
| dc.contributor.advisor | Yu-Syuan Luo | en |
| dc.contributor.author | 林歆穎 | zh_TW |
| dc.contributor.author | Hsin-Ying Lin | en |
| dc.date.accessioned | 2026-08-28T16:12:57Z | - |
| dc.date.available | 2026-08-29 | - |
| dc.date.copyright | 2026-08-28 | - |
| dc.date.issued | 2026 | - |
| dc.date.submitted | 2026-08-13 18:31:12 | - |
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Mycotoxin Biomarkers of Exposure: A Comprehensive Review. Comprehensive Reviews in Food Science and Food Safety, 17(5), 1127–1155. https://doi.org/https://doi.org/10.1111/1541-4337.12367 Wafa, E. W., Yahya, R. S., Sobh, M. A., Eraky, I., El-Baz, M., El-Gayar, H. A., Betbeder, A. M., & Creppy, E. E. (1998). Human ochratoxicosis and nephropathy in Egypt: A preliminary study. Human & Experimental Toxicology, 17(2), 124–129. https://doi.org/10.1177/096032719801700207 Wang, X., Liang, J., Cao, P., Zhou, S., Wu, A., Gao, P., Xu, H., Liu, Z., & Gong, Y. (2019). Biomonitoring Study of Deoxynivalenol Exposure in Chinese Inhabitants. Int J Environ Res Public Health, 16(12). https://doi.org/10.3390/ijerph16122169 Warensjö Lemming, E., Montano Montes, A., Schmidt, J., Cramer, B., Humpf, H.-U., Moraeus, L., & Olsen, M. (2020). Mycotoxins in blood and urine of Swedish adolescents—possible associations to food intake and other background characteristics. Mycotoxin Research, 36(2), 193–206. https://doi.org/10.1007/s12550-019-00381-9 Wishart, D. S., Guo, A., Oler, E., Wang, F., Anjum, A., Peters, H., Dizon, R., Sayeeda, Z., Tian, S., Lee, Brian L., Berjanskii, M., Mah, R., Yamamoto, M., Jovel, J., Torres-Calzada, C., Hiebert-Giesbrecht, M., Lui, Vicki W., Varshavi, D., Varshavi, D.,…Gautam, V. (2022). HMDB 5.0: the Human Metabolome Database for 2022. Nucleic Acids Research, 50(D1), D622–D631. https://doi.org/10.1093/nar/gkab1062 Yu, F.-Y., Liao, Y.-C., Chang, C.-H., & Liu, B.-H. (2006). Citrinin induces apoptosis in HL-60 cells via activation of the mitochondrial pathway. Toxicology Letters, 161(2), 143–151. https://doi.org/https://doi.org/10.1016/j.toxlet.2005.08.009 Zhao, Q., Zhang, S., Feng, W., Zhou, A., Shi, L., & Zhang, J. (2024). Deoxynivalenol-mediated kidney injury via endoplasmic reticulum stress in mice. Ecotoxicology and Environmental Safety, 286, 117243. https://doi.org/https://doi.org/10.1016/j.ecoenv.2024.117243 Zhu, B., Qi, F., Wu, J., Yin, G., Hua, J., Zhang, Q., & Qin, L. (2019). Red Yeast Rice: A Systematic Review of the Traditional Uses, Chemistry, Pharmacology, and Quality Control of an Important Chinese Folk Medicine [Systematic Review]. Frontiers in Pharmacology, Volume 10 - 2019. https://doi.org/10.3389/fphar.2019.01449 陳亭羽. (2024). 利用代謝體學揭示農民尿液代謝模式與熱危害暴露之間的相關性 國立臺灣大學]. 臺灣博碩士論文知識加值系統. 台北市. https://hdl.handle.net/11296/9asda8 劉姿含. (2025). 利用極致液相層析-三段四極柱串聯式質譜儀同時分析人體尿液中的 10 種黴菌毒素之方法開發 國立臺灣大學]. 臺灣博碩士論文知識加值系統. 台北市. https://hdl.handle.net/11296/zj4k49 衛生福利部. (2024). 113年度全民健康保險醫療統計年報. 衛生福利部. Retrieved May 03, 2026 from https://dep.mohw.gov.tw/DOS/lp-5103-113-xCat-y113.html | - |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/104538 | - |
| dc.description.abstract | 慢性腎臟病在臺灣具有高盛行率，除傳統風險因子外，環境暴露也扮演重要角色。氣候變遷加劇了農作物遭受真菌污染的風險，使具有腎毒性之黴菌毒素暴露成為重要的公共衛生議題。然而，國內目前缺乏多重黴菌毒素的生物偵測數據，國際上亦缺乏其與人類早期腎臟損傷指標連結的流行病學證據。本研究以臺灣農業社區居民為研究對象，於2022至2025年間招募195位農業社區居民，利用極致液相層析串聯質譜儀 (UPLC-MS/MS) 分析尿液中9種目標黴菌毒素濃度 (AFB1, CIT, DON, FB1, OTA, ZEN, AOH, NIV, STER)，並以肌酸酐進行稀釋校正，探討單一及多重黴菌毒素暴露與早期腎損傷指標微量白蛋白與尿液肌酸酐比值 (Albumin to creatinine ratio, ACR) 與N-乙醯-β-D-氨基葡萄糖苷酶與尿液肌酸酐比值 (N-acetyl-β-D-glucosaminidase to creatinine ratio, NAGCr) 以及基於肌酸酐估算之腎絲球過濾率 (Estimated glomerular filtration rate based on creatinine, eGFRCr) 與基於血清胱蛋白估算之腎絲球過濾率 (Estimated glomerular filtration rate based on cystatin C, eGFRCys) 之統計關聯與潛在生物學機制。研究結果顯示，受試族群之黴菌毒素總檢出率高達82%，以脫氧雪腐鐮刀菌烯醇 (DON) 與橘黴素 (CIT) 為主要黴菌毒素，檢出率分別為56%與44%，且有58.7%的檢出者呈現多種毒素共同檢出的現象。多元線性迴歸模型分析發現，在校正年齡、性別、糖尿病、高血壓病史、中藥及非類固醇消炎止痛藥服用習慣後，尿液CIT濃度與反應腎絲球屏障受損之ACR (β = 0.154, p = 0.038) 及反應近曲小管早期損傷之NAGCr (β = 0.170, p = 0.002) 皆呈顯著正相關。貝葉斯核機器迴歸 (Bayesian kernel machine regression, BKMR) 模型進一步發現當混合暴露於多重黴菌毒素時，受試者體內預測之NAGCr變化量隨毒素濃度增加而顯著上升，且後驗納入機率排序證實CIT在混合暴露所致之早期腎損傷中扮演最關鍵的主導角色。本橫斷性研究證實尿液中黴菌毒素與早期腎臟損傷具有潛在關聯性，在氣候變遷加劇真菌污染風險的趨勢下，本研究所建立之尿液中黴菌毒素濃度數據與初步關聯性分析結果，可作為未來評估農業社區腎臟健康與環境毒素暴露風險之流行病學基礎。 | zh_TW |
| dc.description.abstract | Chronic kidney disease (CKD) has a high prevalence in Taiwan, and in addition to traditional risk factors, environmental exposures also play an important role. Climate change has increased the risk of fungal contamination in agricultural crops, making exposure to nephrotoxic mycotoxins an important public health issue. However, there is currently a lack of biomonitoring data on multiple mycotoxins in Taiwan, and epidemiological evidence linking these exposures to early markers of kidney injury in humans is also limited internationally. This cross-sectional study recruited 195 residents from agricultural communities in Taiwan between 2022 and 2025. Urinary concentrations of nine mycotoxins (AFB1, CIT, DON, FB1, OTA, ZEN, AOH, NIV, and STER) were quantified using ultraperformance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS), with creatinine adjustment applied to account for urine dilution. The study investigated the statistical associations and potential biological mechanisms between single and multiple mycotoxin exposures and early kidney injury markers, including albumin to creatinine ratio (ACR), N-acetyl-β-D-glucosaminidase to creatinine ratio (NAGCr), as well as markers of kidney function, including estimated glomerular filtration rate based on creatinine (eGFRCr) and estimated glomerular filtration rate based on cystatin C (eGFRCys). The results showed that the overall detection rate of mycotoxins in the study population reached 82%. Deoxynivalenol (DON) and citrinin (CIT) were the predominant mycotoxins, with detection rates of 56% and 44%, respectively. Co-occurrence of multiple mycotoxins was observed in 58.7% of participants. Multiple linear regression analysis revealed that, after adjusting for age, sex, diabetes, hypertension, use of traditional Chinese medicine, and nonsteroidal anti-inflammatory drugs (NSAID), urinary CIT concentration was significantly positively associated with ACR (β = 0.154, p = 0.038) and with NAGCr (β = 0.170, p = 0.002). Bayesian kernel machine regression (BKMR) further indicated a positive overall mixture effect on NAGCr, with CIT contributing the highest posterior inclusion probability, suggesting a dominant role in early kidney injury under mixture exposure. In conclusion, urinary mycotoxin exposure was prevalent in this agricultural population and was associated with early kidney injury markers. These findings provide biomonitoring evidence and support the need for further investigation into environmental mycotoxin exposure and kidney health, particularly under the increasing risk of fungal contamination associated with climate change. | en |
| dc.description.provenance | Submitted by admin ntu (admin@lib.ntu.edu.tw) on 2026-08-28T16:12:57Z No. of bitstreams: 0 | en |
| dc.description.provenance | Made available in DSpace on 2026-08-28T16:12:57Z (GMT). No. of bitstreams: 0 | en |
| dc.description.tableofcontents | 誌謝 i
中文摘要 i ABSTRACT iii 目 次 v 圖 次 ix 表 次 xi 第一章 緒論 1 1.1腎臟疾病負擔 1 1.1.1全球腎臟疾病盛行率與趨勢 1 1.1.2臺灣腎臟疾病現況與醫療負擔 2 1.1.3農業族群之職業與環境性腎臟病風險因子 2 1.2氣候變遷與黴菌毒素之關聯 4 1.3黴菌毒素 5 1.3.1受法規監管黴菌毒素與新興黴菌毒素 5 1.3.2黴菌毒素來源與暴露途徑 6 1.3.3黴菌毒素之腎毒性 6 1.3.4全球黴菌毒素生物偵測趨勢 8 1.4資料缺口 10 1.5研究目的 11 第二章 材料與方法 12 2.1研究設計與研究對象 12 2.2化學品與試劑 13 2.3資料收集 14 2.3.1問卷調查 14 2.3.2臨床檢驗項目 14 2.3.3腎臟功能與早期損傷指標定義 14 2.4尿液中多重黴菌毒素定量分析 16 2.4.1標準品與檢量線製備 17 2.4.2尿液樣本前處理 17 2.4.3 極致液相層析串聯質譜儀分析 18 2.5分析方法確效 18 2.6尿液中代謝物分析 19 2.6.1檢體製備與核磁共振量測 20 2.6.2 1H NMR光譜擷取與處理 20 2.6.3代謝物鑑定與統計前處理 21 2.7統計方法 21 2.7.1描述性統計 21 2.7.2單一黴菌毒素濃度與腎臟功能與早期損傷指標之關聯性分析 22 2.7.3不同尿液稀釋校正方法之敏感度分析 23 2.7.4多重黴菌毒素混合暴露與交互作用分析 24 2.7.5黴菌毒素暴露與腎臟功能與早期損傷指標之潛在中介效應分析 25 2.7.6尿液代謝物於黴菌毒素與腎臟功能與早期損傷指標之潛在中介效應分析 26 第三章 結果 28 3.1分析方法確效與品質管制結果 28 3.2受試者基本人口學資料 28 3.3尿液中黴菌毒素分析結果 29 3.4描述性統計 30 3.5單一黴菌毒素濃度與腎臟功能與早期損傷指標之關聯性分析 32 3.5.1農民職業分層分析 33 3.5.2糖尿病與高血壓狀態分層分析 34 3.6不同尿液稀釋校正方法之敏感度分析 36 3.7多重黴菌毒素混合暴露與交互作用分析 36 3.7.1混合暴露整體效應分析 36 3.7.2單一暴露反應曲線 37 3.7.3雙變數交互作用分析 38 3.8黴菌毒素暴露與腎臟健康之潛在中介效應分析 39 3.9代謝物中介效應分析 39 3.9.1尿液中代謝物鑑定結果 39 3.9.2黴菌毒素、代謝物與腎臟早期損傷與功能指標之間的相關性 40 3.9.3代謝物中介效應分析結果 41 第四章 討論 43 4.1 CIT之主要膳食暴露來源 43 4.2尿液中黴菌毒素濃度之比較 44 4.3黴菌毒素與早期腎臟損傷之關聯及可能機制 45 4.4多重黴菌毒素混合暴露之聯合效應與潛在交互作用 46 4.5 NAGCr扮演早期腎小管損傷中介角色 47 4.6尿液代謝物與黴菌毒素對腎臟指標之中介效應 48 4.7研究限制 49 第五章 結論與未來展望 51 參考資料 53 附 錄 65 附 件 102 中英對照表 105 | - |
| dc.language.iso | zh_TW | - |
| dc.subject | 黴菌毒素 | - |
| dc.subject | 生物偵測 | - |
| dc.subject | 早期腎損傷 | - |
| dc.subject | 微量白蛋白與肌酸酐比值 | - |
| dc.subject | N-乙醯-β-D-氨基葡萄糖苷酶 | - |
| dc.subject | 貝葉斯核機器迴歸模型 | - |
| dc.subject | Mycotoxins | - |
| dc.subject | Biomonitoring | - |
| dc.subject | Early kidney injury | - |
| dc.subject | Albumin to creatinine ratio (ACR) | - |
| dc.subject | N-acetyl-β-D-glucosaminidase (NAG) | - |
| dc.subject | Bayesian kernel machine regression (BKMR) | - |
| dc.title | 探討尿液中黴菌毒素與腎臟功能與早期損傷指標之 關聯性:以台灣農業社區為例 | zh_TW |
| dc.title | Association between urinary mycotoxin concentrations and markers of kidney function and early injury: a cross-sectional study in Taiwanese agricultural communities | en |
| dc.type | Thesis | - |
| dc.date.schoolyear | 114-2 | - |
| dc.description.degree | 碩士 | - |
| dc.contributor.oralexamcommittee | 林靖愉;黃柏菁;楊孝友 | zh_TW |
| dc.contributor.oralexamcommittee | Ching-Yu Lin;Po-Chin Huang;Hsiao-Yu Yang | en |
| dc.subject.keyword | 黴菌毒素; 生物偵測; 早期腎損傷; 微量白蛋白與肌酸酐比值; N-乙醯-β-D-氨基葡萄糖苷酶; 貝葉斯核機器迴歸模型 | zh_TW |
| dc.subject.keyword | Mycotoxins; Biomonitoring; Early kidney injury; Albumin to creatinine ratio (ACR); N-acetyl-β-D-glucosaminidase (NAG); Bayesian kernel machine regression (BKMR) | en |
| dc.relation.page | 110 | - |
| dc.identifier.doi | 10.6342/NTU202604377 | - |
| dc.rights.note | 未授權 | - |
| dc.date.accepted | 2026-08-17 | - |
| dc.contributor.author-college | 公共衛生學院 | - |
| dc.contributor.author-dept | 食品安全與健康研究所 | - |
| dc.date.embargo-lift | N/A | - |
| 顯示於系所單位： | 食品安全與健康研究所 | |
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