全氟烷基化学物与抑郁症的关联  

Association between perfluorinated alkyl substances and depression

作　　者：刘婧 张露露 贺颖倩 赵亚楠 郑山[1] 王敏珍[1] LIU Jing;ZHANG Lulu;HE Yingqian;ZHAO Yanan;ZHENG Shan;WANG Minzhen(Institute of Epidemiology and Health Statistics,School of Public Health,Lanzhou University,Lanzhou,Gansu 730000,China)

机构地区：[1]兰州大学公共卫生学院流行病与卫生统计学研究所,甘肃兰州730000

出　　处：《环境与职业医学》2023年第6期688-694,共7页Journal of Environmental and Occupational Medicine

基　　金：国家自然科学基金项目(41705122)。

摘　　要：[背景]全氟烷基化学物(PFAS)是一类合成有机氟化物,对大脑功能具有不良的健康影响,其对抑郁症的影响研究非常有限。[目的]探讨血清PFAS与抑郁症风险的关联性。[方法]基于2015—2018年美国全国健康和营养调查(NHANES)数据集,选取20岁及以上人群中相关资料完整者2626名研究对象。logistic回归与限制性立方样条用于分析血清PFAS浓度水平与抑郁症间的关联及剂量-反应关系,并对性别、年龄、种族、教育水平、婚姻状况、贫困程度、适度运动、肥胖程度、饮酒状况进行亚组分析。[结果]2626名研究对象中轻度以上抑郁症患者共666名(25.4%)。调整种族、教育水平、婚姻状况、肥胖程度、适度运动、饮酒史、可替宁及其他种类PFAS后,血清全氟辛烷磺酸(PFOS)与抑郁症患病风险为正相关(OR=1.85,95%CI:1.14~3.02),且呈非线性剂量-反应关系(χ^(2)=6.37,P非线性=0.012)。全氟壬酸(PFNA)与抑郁症患病风险为负相关(OR=0.23,95%CI:0.14~0.39),呈线性剂量-反应关系(P趋势<0.001,χ^(2)=35.13,P总体<0.001)。亚组分析后发现,男性、20~39岁和40~64岁人群对PFNA暴露敏感性更高(OR=0.15,95%CI:0.06~0.37;OR=0.16,95%CI:0.06~0.40;OR=0.18,95%CI:0.08~0.39)。PFOS仅在20~39岁人群(OR=3.00,95%CI:1.14~7.94)中表现具有统计学意义的健康影响。除性别和年龄分组外,在非西班牙裔黑人、同居者、当前饮酒者、高中以上学历者、肥胖患者中,PFAS暴露与抑郁症患病风险关联更显著。[结论]PFOS暴露可能与抑郁程度增加有关,而PFNA暴露则呈保护作用。[Background]Perfluorinated alkyl substances(PFAS)are a class of synthetic organic fluorides,which have adverse health effects on brain function,and limited research has been conducted on their effects on depression.[Objective]To assess potential correlation between serum PFAS and depression.[Methods]Using the 2015—2016 and 2017—2018 National Health and Nutrition Examination Survey(NHANES)datasets,2626 subjects with complete relevant information in people≥20 years old were selected.Logistic regression and restricted cubic splines were used to analyze the association and dose-response relationship between serum PFAS concentration and depression.Subgroup analysis was performed on sex,age,race,education level,marital status,family income to poverty ratio,moderate exercise,body mass index,and drinking status.[Results]Among the 2626 subjects,there were 666 patients(25.4%)with mild or above depression.After adjusting for race,education level,marital status,body mass index,moderate exercise,drinking history,cotinine,and other types of PFAS,serum perfluorooctane sulfonate(PFOS)was positively associated with the risk of depression(OR=1.85,95%CI:1.14,3.02),and showed a nonlinear dose-response relationship(χ^(2)=6.37,Pnonlinear=0.012).Perfluorononanoic acid(PFNA)was inversely associated with the risk of depression(OR=0.23,95%CI:0.14,0.39),and showed a linear dose-response relationship(Ptrend<0.001,χ^(2)=35.13,Poverall<0.001).After subgroup analysis,it was found that males,20-39 year-olds and 40-64 year-olds were more sensitive to PFNA exposure(OR=0.15,95%CI:0.06,0.37;OR=0.16,95%CI:0.06,0.40;OR=0.18,95%CI:0.08,0.39).PFOS only showed a statistically significant health effect in people aged 20-39 years(OR=3.00,95%CI:1.14,7.94).In addition,among subgroups of non-Hispanic blacks,cohabitants,current drinkers,high school graduates,and obese patients,exposure to PFAS was significantly associated with the risk of depression.[Conclusion]PFOS exposure may be associated with increased levels of depression,whereas PFNA exposure m

关 键 词：全氟烷基化学物 抑郁症 倾向性匹配 剂量-反应关系 全氟辛烷磺酸 全氟壬酸 

分 类 号：R12[医药卫生—环境卫生学]