人群中镉暴露和C反应蛋白的关联性研究  

Relationship between Cadmium Exposure and Blood C Reactive Protein in Adults

作　　者：向俊 李明炎 胡春平[3] Xiang Jun;Li Mingyan;Hu Chunping(Medical College of Wuhan University of Science and Technology,Wuhan 430065,China;Hubei Provincial Center for Disease Control and Prevention,Wuhan 430079,China;Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]武汉科技大学医学院,武汉430065 [2]湖北省疾病预防控制中心,武汉430079 [3]华中科技大学同济医学院附属同济医院统计科,武汉430030

出　　处：《华中科技大学学报（医学版）》2019年第6期681-685,共5页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：湖北省大学生创新创业计划项目(No.201910488020)

摘　　要：目的阐明人群中镉暴露与C反应蛋白水平之间的关联,探讨镉暴露可能的致病机制。方法采用1999~2002年美国健康与营养调查数据资料,根据①年龄≥18岁;②已提供尿液及血液样本并检测尿镉及血镉水平;③C反应蛋白水平<10 mg/dL;④关键协变量(年龄、体质量指数、性别、种族、教育程度、血清可替宁水平和饮酒)无缺失值的标准遴选符合要求的研究对象。利用广义线性模型分析自然对数转换后的尿镉及血镉水平与自然对数转换后的C反应蛋白水平之间的关联。结果共纳入2455位研究对象,人群尿镉暴露水平中位数为0.33μg/L,血镉暴露水平中位数为0.40μg/L。在总人群中,C反应蛋白水平升高与尿镉、血镉暴露增加有关(尿镉:β=0.155,95%CI:0.090~0.220;血镉:β=0.097,95%CI:0.012~0.181)。在以性别分组的亚组分析中,男性中尿镉及血镉水平与C反应蛋白水平均存在显著关联(尿镉:β=0.256,95%CI:0.165~0.347;血镉:β=0.190,95%CI:0.075~0.306);在女性中尿镉及血镉水平与C反应蛋白水平无显著关联(尿镉:β=0.045,95%CI:-0.048~0.137;血镉:β=0.024,95%CI:-0.100~0.148)。结论 C反应蛋白水平的升高与体内镉暴露增加有关。Objective The purpose of this study is to elucidate the relationship between cadmium exposure and levels of blood C-reactive protein and to explore the possible pathogenic mechanism of cadmium exposure.Methods Data was extracted from the National Health and Nutrition Examination Survey(NHANES).On the basis of inclusion criteria including ①aged 18 years or older;②having cadmium examinations in urinary and blood samples;③the concentration of C-reactive protein less than 10 mg/dL;④no missing value on the key confounders(age,BMI,sex,race/ethnicity,educational attainment,serum cotinine levels,and alcohol consumption).The relationship between cadmium exposure and blood C-reactive protein was estimated using generalized linear model,with adjustment for potential confounders.Results A total of 2455 objects were included in the present study.The median value of urinary cadmium and blood cadmium was 0.33 μg/L and 0.40 μg/L,respectively.The associations between cadmium exposure and C-reactive protein were significant in all participants(βUrine-cd=0.155,95%CI:0.090,0.220;βBlood-cd=0.097,95%CI:0.012,0.181).In the subgroup analysis,the relationships of urinary cadmium or blood cadmium with blood C-reactive protein were significant in males(βUrine-cd=0.256,95%CI:0.165,0.347;βBlood-cd=0.190,95%CI:0.075,0.306).The associations between urine cadmium/blood cadmium and blood C-reactive protein were insignificant in females(βUrine-cd=0.045,95%CI:-0.048,0.137;βBlood-cd=0.024,95%CI:-0.100,0.148).Conclusion The increased cadmium exposure was associated with elevated blood C-reactive protein in American adults.

关 键 词：镉暴露 尿镉 血镉 C反应蛋白 

分 类 号：R135.1[医药卫生—劳动卫生]