脑功能连接在职业铝暴露致工人认知功能下降中的中介作用  

Mediating role of brain functional connectivity in cognitive decline induced by occupational aluminum exposure in workers

作　　者：赵丹 高丹 宦佳萍 韩笑 宋静[1] 王林平[1] 牛侨[1] 路小婷[1] ZHAO Dan;GAO Dan;HUAN Jiaping;HAN Xiao;SONG Jing;WANG Linping;NIU Qiao;LU Xiaoting(School of Public Health,Shanxi Medical University,Taiyuan,Shanxi 030001,China)

机构地区：[1]山西医科大学公共卫生学院,山西太原030001

出　　处：《环境与职业医学》2023年第3期239-245,共7页Journal of Environmental and Occupational Medicine

基　　金：山西省自然科学研究面上项目(202103021224226);山西省回国留学人员科研资助项目(2021-084)。

摘　　要：[背景]职业铝暴露危害工人的认知功能。目前对于职业铝作业人群认知功能障碍的评估缺少脑功能影像资料。脑功能连接值在职业铝暴露引起认知功能下降中的作用尚不明确。[目的]探讨脑功能连接值在职业铝暴露引起的认知功能下降中的中介效应,探索认知损害与脑功能连接的关系,寻找合适的职业铝暴露所致早期认知变化的影像学凭证。[方法]本研究利用前期横断面调查,依据铝作业职工、40周岁以上、铝作业工龄>1年、蒙特利尔国际认知评估(MoCA)量表(北京版)评分<26分,选择20例职工为病例组,并在同期的非铝作业职工中根据1∶2匹配原则,选择基本状况(年龄、吸烟情况、饮酒情况等)与之相符的40名健康职工为对照组。收集研究对象的基本信息,检测血浆铝水平、认知功能水平,利用磁共振成像测定默认模式网络(DMN)不同脑功能连接值。利用中介效应分析研究脑功能连接在铝暴露与认知功能关系中的作用。[结果]病例组的血浆铝浓度是对照组的1.76倍[(33.04±12.02)μg·L^(-1)vs(18.74±8.95)μg·L^(-1),P<0.05],MoCA得分比对照组低9.5分[(18.35±2.64)vs(27.85±0.92),P<0.05]。病例组DMN1、DMN2的平均功能连接值比对照组低(P<0.05),病例组左楔前叶、左中扣带回皮层、左上内侧回、左侧中央前回、左侧小脑的平均功能连接值与对照组相比也出现了下降(P<0.05)。血浆铝浓度与DMN1、MoCA量表得分呈负相关(b=-0.004,95%CI:-0.008~-0.001;b=-0.15,95%CI:-0.233~-0.067;P<0.05),DMN1、DMN2的平均功能连接值和MoCA分数呈正相关(b=10.945,95%CI:5.574~16.316;b=10.107,95%CI:2.457~17.758;P<0.05)。随着血浆铝浓度的增加,MoCA得分降低,但当血浆铝质量浓度超过19.50μg·L^(-1)继续增加时,MoCA得分降低幅度变缓。随着DMN1的增加,MoCA得分增加,但当DMN1功能连接值超过1.05继续增加时,MoCA得分增加幅度变缓。中介效应分析结果显示,DMN1功能连接[Background]Occupational aluminum exposure may associate with cognitive impairment in workers.At present,brain functional imaging data are not available for evaluating cognitive dysfunction in workers with occupational exposure to aluminum.The role of brain functional connectivity in cognitive decline associated with occupational aluminum exposure is not clear yet.[Objective]To explore potential mediating effect of brain functional connectivity value on cognitive decline induced by occupational aluminum exposure,to assess the relationship between cognitive impairment and brain functional connectivity,and to identify appropriate imaging evidence of early cognitive changes induced by occupational aluminum exposure.[Methods]This study used a subset data from a previous cross-sectional survey.Based on the data of aluminum-exposed workers,over 40 years old,aluminum-exposed working years>1 year,Montreal International Cognitive Assessment(MoCA)(Beijing version)score<26 points,20 workers were selected as the case group,and 40 healthy workers with the same basic conditions(age,smoking,drinking,etc.)in non-aluminum production were selected as the control group with a 1∶2 matching ratio.The basic information of the subjects was collected,plasma aluminum level and cognitive function level were evaluated,and different brain functional connectivity values of default mode network(DMN)were measured by magnetic resonance imaging.The mediating effect analysis was conducted to examine the role of brain functional connectivity in the relationship between aluminum exposure and cognitive function.[Results]The plasma aluminum concentration of the case group was 1.76 times higher than that of the control group[(33.04±12.02)μg·L^(−1) vs(18.74±8.95)μg·L^(−1),P<0.05];the MoCA score was 9.5 points lower[(18.35±2.64)vs(27.85±0.92),P<0.05].The mean functional connection values of DMN1 and DMN2 in the case group were lower than those in the control group(P<0.05).The mean functional connection values of the left precuneus,left mid

关 键 词：职业铝暴露 认知功能下降 磁共振成像 功能连接 中介效应 

分 类 号：R13[医药卫生—劳动卫生]