中国9个长寿地区65岁及以上老年人尿镉水平与超敏C反应蛋白的关联  

Association of urinary cadmium with high sensitive C-reactive protein among the elderly aged 65 years and older in nine longevity areas of China

作　　者：李成橙[1] 吕跃斌 陈晨[1] 周锦辉 顾珩[1] 魏源 赵峰[1] 路凤 刘迎春[1] 曹兆进[1] 施小明[1] LI Chengcheng;LYU Yuebin;CHEN Chen;ZHOU Jinhui;GU Heng;WEI Yuan;ZHAO Feng;LU Feng;LIU Yingchun;CAO Zhaojin;SHI Xiaoming(National Institute of Environmental Health/Key Laboratory of Environment and Population Health,Chinese Center for Disease Control and Prevention,Beijing 100021,China;School of Public Health,Jilin University,Changchun,Jilin 130012,China;Department of Data Resources and Statistics,Beijing Municipal Health Commission Information Center/Beijing Municipal Health Commission Policy Research Center,Beijing 100034,China)

机构地区：[1]中国疾病预防控制中心环境与健康相关产品安全所/环境与人群健康重点实验室,北京100021 [2]吉林大学公共卫生学院,吉林长春130012 [3]北京市卫生健康委信息中心/政策研究中心,数据资源与统计部,北京100034

出　　处：《环境与职业医学》2021年第10期1063-1068,共6页Journal of Environmental and Occupational Medicine

基　　金：国家自然科学基金(82025030,81941023,81872707);国家重点研发计划(2018YFC 2000400)。

摘　　要：[背景]镉对心血管系统损伤的机制尚不清楚,炎症反应是可能的机制之一,然而镉与超敏C反应蛋白的人群流行病学证据十分有限。[目的]探讨65岁及以上人群尿镉水平与超敏C反应蛋白(hs-CRP)的关联。[方法]数据来源于“老年健康生物标志物队列研究”项目,以2017—2018年调查的中国9个长寿地区1860名65岁及以上老年人为样本研究对象。通过问卷调查和体格检测,收集调查对象的人口学特征、生活方式及饮食习惯等信息;同时采集调查对象的静脉血和尿液,分别检测hs-CRP和尿镉水平。以hs-CRP质量浓度>3.0 mg·L^(-1)定义为hs-CRP高水平。根据经肌酐校正的尿镉水平的三分位数将研究对象分为低、中、高水平镉暴露组。采用广义线性混合效应模型分析尿镉水平与hs-CRP升高的关联,并进一步分析不同性别、年龄组的研究对象尿镉水平和hs-CRP之间的关联。[结果]1860名研究对象的年龄为(83.41±11.24)岁,其中男性917名(49.30%),529名(28.44%)研究对象>90岁;319名(17.15%)研究对象hs-CRP处于高水平,研究对象肌酐校正后尿镉水平的M(P_(25),P_(75))为1.12(0.63,2.06)μg·g^(-1)。低、中、高水平镉暴露组的研究对象经肌酐校正的尿镉水平分别为<0.79μg·g^(-1)、0.79~<1.66μg·g^(-1)和≥1.66μg·g^(-1),相应3组人群hs-CRP高水平率分别为15.44%、17.77%和18.35%(P>0.05)。在调整了年龄、性别和文化程度等因素后,尿镉水平每升高一个自然对数单位,hs-CRP升高的OR为1.14(95%CI:0.96~1.36),无统计学意义;但按尿镉水平分组后,与低水平镉暴露组相比,中、高水平镉暴露组hs-CRP升高的OR分别为1.49(95%CI:1.04~2.13)和1.58(95%CI:1.07~2.33),均有统计学意义。亚组分析发现与低水平镉暴露组相比,男性和女性老年人高水平镉暴露组hs-CRP升高的OR分别为1.82(95%CI:1.04~3.19)和1.48(95%CI:0.91~2.41);≤90岁和>90岁的老年人高水平镉暴露组hs-CRP升高的OR分别为1.85(95%CI[Background]The mechanism of cadmium damaging cardiovascular system is still unclear,and inflammation is considered to be one of the possible mechanisms.However,the epidemiological evidence of the association between cadmium and high sensitive C-reactive protein(hs-CRP)is limited.[Objective]This study aims to investigate the association of urinary cadmium level with hs-CRP among the elderly aged 65 years and older.[Methods]A total of 1860 participants aged 65 years and older were recruited in nine longevity areas from the Heathy Aging and Biomarkers Cohort Study between 2017 and 2018.Information including demographic characteristics,life styles,and diet was collected by questionnaire and physical examination.Meanwhile,venous blood and urine samples were collected to detect the levels of hs-CRP and urinary cadmium.Elevated hs-CRP was defined as hs-CRP>3.0 mg·L^(-1).The respondents were stratified into three groups(low,middle,and high)according to the tertiles of creatinine-adjusted urinary cadmium level.Generalized linear mixed models were used to analyze the association of urinary cadmium with hs-CRP.In order to assess effect modifications by age and sex,stratified models with interaction terms were also constructed.[Results]The age of the participants was(83.41±11.24)years,917(49.30%)participants were male,529(28.44%)participants aged>90 years,and 319(17.15%)participants were defined as elevated hs-CRP.The median(P_(25),P_(75))urinary cadmium level after creatinine correction of the total participants was 1.12(0.63,2.06)μg·g^(-1),and the levels of the participants with low,middle,and high urinary cadmium were<0.79,0.79-1.66μg·g^(-1),and≥1.66μg·g^(-1),respectively.The rates of elevated hs-CRP were 15.44%,17.77%,and 18.35%among the participants with low,middle,and high urinary cadmium,respectively(P>0.05).After adjustment for sex,age,education,and other variables,for each increase of a natural logarithmic unit of urinary cadmium,the OR for elevated hs-CRP was 1.14(95%CI:0.96-1.36;P>0.05).Compared with th

关 键 词：老年人 尿镉 超敏C反应蛋白 重金属 横断面研究 

分 类 号：R12[医药卫生—环境卫生学]