镉暴露与肺功能水平及慢性阻塞性肺疾病的关系  

Relationship between cadmium exposure and pulmonary function level and chronic obstructive pulmonary disease

作　　者：柯红霞 张建平[2] 靳思慧 周立[3] 柴守范[2] 马莉[1] Ke Hongxia;Zhang Jianpin;Jin Sihui;Zhou Li;Chai Shoufan;Ma Li(School of Public Health,Lanzhou University,Lanzhou 730000,China;Gansu Provincial Hispital of TCM,Lanzhou 730050,China;Neonotal Pediatrics,MCH Hospital of Lanzhou,Lanzhou 730030,China)

机构地区：[1]兰州大学公共卫生学院,兰州730000 [2]甘肃省中医院急诊科,兰州730050 [3]兰州市妇幼保健院新生儿科,兰州730030

出　　处：《中华劳动卫生职业病杂志》2023年第4期241-246,共6页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：甘肃省科技计划项目(21JR1RA056);兰州市城关区科技计划项目(2021-9-12、2020-2-11-13)。

摘　　要：目的分析美国成年人群血镉和尿镉水平及其分布特点,分析其与肺功能剂量反应关系并探讨该指标对慢性阻塞性肺疾病患病风险的影响。方法于2022年3月,以美国国家健康营养调查(NHANES)数据有2007至2012年调查的3 785例人群为研究对象,收集性别、年龄等人口学数据和肺功能、血镉浓度和、尿镉浓度等检测数据。采用Mann-Whitney U检验或Kruskal-Wallis H检验、多变量线性回归和限制性立方样条法以及Logistic回归分析,分析其血镉、尿镉水平与肺功能及慢性阻塞性肺疾病患病风险的关系。结果美国成年人群血镉、尿镉的几何均数分别为0.37、0.28 μg/L,一秒用力呼气量(FEV1)、用力肺活量(FVC)、一秒率(FEV1/FVC)在镉暴露水平组间差异有统计学意义,血镉、尿镉浓度与FEV1/FVC水平均呈负向线性剂量反应关系(Poverall<0.001,Pnon-linear=0.152;Poverall<0.001,Pnon-linear=0.926);且与最低四分位数浓度(Q1)比较,最高四分位数血镉浓度(Q4)(OR=1.934,Ptrend=0.000)和尿镉浓度(OR= 1.683,Ptrend=0.000 )均可能增加慢性阻塞性肺疾病患病风险。结论美国成年人群血镉、尿镉水平与肺功能之间存在负向关联,镉暴露可能会增加慢性阻塞性肺疾病的患病风险。Objective To analyze the levels and distribution characteristics of blood cadmium and urinary cadmium in American adults,to analyze the relationship between blood cadmium and urinary cadmium and pulmonary function dose response,and to explore the effect of this index on the risk of chronic obstructive pulmonary disease.Methods In March 2022,3785 patients from 2007 to 2012 in NHANES database were selected as the subjects.Collect demography data such as gender and age,and test data such as lung function,blood cadmium concentration and Urine cadimium concentration.The relationship between blood and urine cadmium levels and lung function and pulmonary function and chronic obstructive pulmonary diease(COPD)was analyzed by Mann-Whitney U test or Kruskal-Wallis H test,multivariate linear regression and restricted cubic spline method.Results The geometric mean of blood cadmium and urine cadmium in American adults was 0.37 g/L and 0.28 g/L,FEV1 and FEV1/FVC among different cadmium exposure groups was statistically significant,and there was a negative linear dose-response relationship between serum Cd and urine Cd concentrations and FEV1/FVC levels(Poverall<0.001,Pnon-linear=0.152;Poverall<0.001,Pnon-linear=0.926).Compared with the lowest quartile concentration(Q1),the highest quartile blood cadmium concentration(Q4)(OR=1.934,Ptrend=0.000)and urinary cadmium concentration(OR=1.683,Ptrend=0.000)may increased the risk of chronic obstructive pulmonary disease.Conclusion There is a negative correlation between blood cadmium,urinary cadmium levels and lung function in American adults,and cadmium may increase the risk of chronic obstructive pulmonary disease.

关 键 词：镉 职业暴露 慢性阻塞性肺疾病 肺功能 剂量反应关系 美国国家健康与营养调查 

分 类 号：R563.9[医药卫生—呼吸系统]