探索尿镉作为人群镉暴露生物标志物的影响因素  

Factors influencing urinary cadmium as a biomarker of human cadmium exposure

作　　者：蒋梦珂 陈琦[2] 丁震[2] 孙宏[2] 徐燕 JIANG Mengke;CHEN Qi;DING Zhen;SUN Hong;XU Yan(College of Public Health,Nanjing Medical University,Nanjing,Jiangsu 211166,China;Department of Environment and Health,Jiangsu Provincial Center for Disease Control and Prevention,Nanjing,Jiangsu 210009,China)

机构地区：[1]南京医科大学公共卫生学院,江苏南京211166 [2]江苏省疾病预防控制中心环境与健康所,江苏南京210009

出　　处：《环境与职业医学》2021年第10期1057-1062,共6页Journal of Environmental and Occupational Medicine

基　　金：江苏省社会发展项目(BE2018745);卫生行业科研专项(20102001)。

摘　　要：[背景]对镉暴露进行健康风险评估通常采用尿镉作为暴露指标,但有一些新研究对以尿镉作为暴露生物标志物存在不同的意见。[目的]评估在横断面研究中尿镉作为人群镉暴露生物标志物的影响因素。[方法]采用横断面研究设计,选择中国东部无已知镉污染的某城市的居民为研究对象,共有1235名本地居民参与了研究。根据年龄划分为儿童(<12岁)、青少年(12~17岁)和成人(≥18岁)三组。收集研究对象的外周血与尿样,采用电感耦合等离子体质谱仪(ICP-MS)对生物样品中的镉进行测定,以中位数(M)和第25、75百分位数(P25,P75)表示尿镉、血镉以及尿肌酐的质量浓度(简称浓度)分布。对当年不吸烟的997名调查对象数据,采用自然立方样条函数建模描述尿镉、血镉和尿肌酐随年龄的变化特征。进一步采用多元线性回归模型评估尿镉与性别、年龄、血镉、尿肌酐和体重指数的相关性。[结果]人群尿镉的暴露水平在0.14~0.37μg·L^(-1)之间。青少年人群尿肌酐M(P25,P75)[1.31(0.89,1.80)g·L^(-1)]高于儿童[0.78(0.55,1.06)g·L^(-1)]和成人[0.94(0.62,1.33)g·L^(-1)](P<0.01)。未校正的尿镉在不吸烟的男性和女性中均随年龄增加而增加。在男性中,尿镉在约60岁时达到峰值,之后有所下降。而在女性中,尿镉在50岁之前逐渐增加,然后趋于平稳。在不同性别中,尿肌酐均在儿童时期增加,在青少年期达到峰值,然后随着年龄的增长稳步下降,到70岁之后又开始增加。多元回归分析模型发现未采用肌酐校正的尿镉在所有年龄组人群中均与血镉、尿肌酐相关,在成人中的影响因素还包括年龄和性别,而性别的作用在吸烟分层后不再具有统计学意义。在青少年和成人中,采用肌酐校正后的尿镉与血镉和尿肌酐相关;但在儿童中则不相关。无论是否采用肌酐校正,当前吸烟者的尿镉[校正前0.44(0.40,0.49)μg·L^(-1);校正后0.42(0.38,[Background]Health risk assessment of cadmium exposure usually uses urinary cadmium as an exposure indicator,but some new studies show disagreement on urinary cadmium as an exposure biomarker.[Objective]This cross-sectional study aims to assess the factors influencing urinary cadmium as a biomarker of human cadmium exposure.[Methods]Using a cross-sectional study design,we selected residents of a city in eastern China with no known cadmium contamination as study population.A total of 1235 local residents participated in the study and were classified by age into preteenagers(<12 years),teenagers(12-17 years),and adults(≥18 years)three groups.The peripheral blood and urine samples of the participants were collected,and cadmium in the biological samples was determined by inductively coupled plasma mass spectrometry(ICP-MS).The median(M)and the 25th and 75th percentiles(P25,P75)were used to represent the distributions of urinary cadmium,blood cadmium,and urinary creatinine.A natural cubic spline analysis was used to describe the changes of urinary cadmium,blood cadmium,and urinary creatinine with age in 997 current non-smoking participants.The correlations of urinary cadmium with sex,age,blood cadmium,urinary creatinine,and body mass index(BMI)were further assessed using multiple linear regression models.[Results]The urinary cadmium exposure levels in the selected residents ranged from 0.14 to 0.37μg·L^(-1).The teenagers’median(P25,P75)urinary creatinine[1.31(0.89,1.80)g·L^(-1)]was higher than preteenagers’s[0.78(0.55,1.06)g·L^(-1)]and adults’[0.94(0.62,1.33)g·L^(-1)](P<0.01).The un-adjusted urinary cadmium increased with higher age in both non-smoking men and women.In men,the urinary cadmium peaked at about 60 years of age and then declined.In women,however,the urinary cadmium increased gradually before age 50,then appeared stable.In both sexes,the urinary creatinine increased during preteenage period,peaked during teenage period,then declined steadily with age,and increased again after age 70.The result

关 键 词：镉暴露 尿镉 血镉 全年龄段人群 生物标志物 

分 类 号：R12[医药卫生—环境卫生学]