多环芳香烃暴露与类风湿关节炎的相关性研究  

Association between polycyclic aromatic hydrocarbons and rheumatoid arthritis

作　　者：李晓亚 范慧珍 李江[4] 樊丹平 路相臣 吕爽[1,5] 夏娅 肖诚 Li Xiaoya;Fan Huizhen;Li Jiang;Fan Danping;Lu Xiangchen;Lyu Shuang;Xia Ya;Xiao Cheng(Institute of Clinical Medical Sciences,China-Japan Friendship Hospital,Beijing 100029,China;Graduate School of Peking Union Medical College,Chinese Academy of Medical Sciences/Peking Union Medical College,Beijing 100730,China;Department of Gastroenterology,People’s Hospital of Yichun City,Yichun 336000,China;Department of Laboratory Medicine,China-Japan Friendship Hospital,Beijing,100029,China;Beijing University of Chinese Medicine,Beijing 100029,China;Emergency Department,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院临床医学研究所,北京100029 [2]中国医学科学院/北京协和医学院研究生院,北京100730 [3]宜春市人民医院消化内科,336000 [4]中日友好医院检验科,北京100029 [5]北京中医药大学中医学院,北京100029 [6]中日友好医院急诊科,北京100029

出　　处：《中华老年医学杂志》2020年第1期67-72,共6页Chinese Journal of Geriatrics

摘　　要：目的基于大样本数据分析多环芳香烃(PAHs)暴露与类风湿关节炎(RA)的相关性。方法从美国国家健康与营养调查数据库筛选2005—2014年资料完整的RA患者(RA组)和非RA人群(非RA组)为研究对象,通过Logistic回归模型分析尿中8个单羟基(OH-)PAHs与RA之间的关系。结果共有357例RA患者和5256例非RA对照者纳入研究,经Logistic分析调整混杂因素后,与最低四分位数(Q1)浓度水平比较,OH-PAHs混合物在最高四分位数(Q4)浓度水平会增加RA患病的风险(OR=1.60、95%CI:1.16~2.23,P<0.05)。对于单个化合物,与Q1比较,1-羟基萘(OR=1.59、95%CI:1.14~2.23)、2-羟基萘(OR=1.66、95%CI:1.19~2.32)、2-羟基芴(OR=1.61、95%CI:1.17~2.22)、3-羟基芴(OR=1.64、95%CI:1.18~2.27)和1-羟基菲(OR=1.38、95%CI:1.00~1.94)、在Q4浓度水平下显著增加RA患病的风险(均P<0.05);而1-羟基芘(OR=0.60、95%CI:0.43~0.83)却在Q2浓度水平下能够降低RA的风险(P<0.01)。结论PAHs混合暴露是RA的危险因素,而单个OH-PAH化合物与RA发病之间的关联性是双向的,其依赖于OH-PAHs的种类和浓度。Objective To analyze the association between polycyclic aromatic hydrocarbons(PAHs)exposure and rheumatoid arthritis(RA)based on large sample data.Methods The RA patients(RA group)and non-RA patients(non-RA group)with complete data were selected from the National Health and Nutrition Survey Database in the United States(NHANES)(2005—2014).The logistic regression model was used to analyze the association between 8 monohydroxylated(OH-)PAH metabolites in the urine and RA.Results A total of 357 RA patients and 5,256 non-RA participants were included.After adjusting the confounding factors by logistic analysis,the level of OH-PAHs mixture at the highest quartile(Q4)was associated with increased risk of RA compared with that at the lowest quartile(Q1)(OR=1.60,95%CI:1.16-2.23).For a single kind of OH-PAHs,the Q4 levels of 1-hydroxynaphthalene(OR=1.59,95%CI:1.14-2.23),2-hydroxynaphthalene(OR=1.66,95%CI:1.19-2.32),2-hydroxyfluorene(OR=1.61,95%CI:1.17-2.22),3-hydroxyfluorene(OR=1.64,95%CI:1.18-2.27)and 1-hydroxyphenanthrene(OR=1.38,95%CI:1.00-1.94)were all associated with significantly increased risk of RA compared with the Q1 level(all P<0.05).However,the Q2 level of 1-hydroxypyrene(OR=0.60,95%CI:0.43-0.83)was related to a decreased incidence of RA(P<0.01).Conclusions OH-PAHs mixed exposure is a risk factor for RA.The association between the level of individual OH-PAH and the rate of RA is bidirectional and is depended on the type and concentration of OH-PAHs.

关 键 词：关节炎 类风湿 多环化合物 烃类 芳香 

分 类 号：R593[医药卫生—内科学]