银川市社区老年人尿中铁和砷浓度与血脂异常的关联性  

Association of urinary iron and arsenic levels with dyslipidemia in community⁃dwelling elderly in Yinchuan

作　　者：何沛 王瑞 段思宇 王玉华 白梅丽 孙健[1] 杨惠芳 HE Pei;WANG Rui;DUAN Siyu;WANG Yuhua;BAI Meili;SUN Jian;YANG Huifang(School of Public Health,Key Laboratory of Environment Factors and Chronic Disease Control,Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学公共卫生学院,宁夏环境因素与慢性病控制重点实验室,银川750004

出　　处：《中华疾病控制杂志》2023年第8期877-882,900,共7页Chinese Journal of Disease Control & Prevention

基　　金：宁夏自然科学基金(2022AAC05028);宁夏医科大学特殊人才启动项目(XT2019013)。

摘　　要：目的探讨银川市社区老年人尿中铁(Iron,Fe)和砷(Arsenic,As)浓度与血脂异常之间的关联性,为血脂异常防治策略的制定提供科学的环境流行病学证据。方法选取银川市老年人慢性病队列基线调查人群为研究对象,通过问卷调查收集研究对象一般人口学信息,通过健康体检对研究对象血脂、血压和肝功能等指标进行测定,同时收集调查对象晨尿10 mL。使用电感耦合等离子体质谱仪测定研究对象尿中Fe和As的浓度,并用尿肌酐校正,通过条件logistic回归分析模型分析尿中Fe和As浓度与血脂异常患病率之间的关联。结果血脂异常组老年人尿中Fe浓度(115.97μg/g肌酐)低于健康对照组(139.11μg/g肌酐),差异有统计学意义(Z=3.405,P<0.001);血脂异常组老年人尿中As浓度(77.25μg/g肌酐)高于健康对照组(67.45μg/g肌酐),差异有统计学意义(Z=-3.269,P=0.001)。多因素logistic回归分析模型结果显示,校正协变量后,尿中Fe浓度与老年人血脂异常存在负相关(OR=0.68,95%CI:0.57~0.82,P<0.001),尿中As浓度与老年人血脂异常存在正相关(OR=1.32,95%CI:1.09~1.59,P=0.001),且呈现剂量-反应关系(均P_(趋势)≤0.001)。按性别分层分析发现,在男性人群中,与Q1组相比,尿中Fe位于Q2、Q3和Q4组的血脂异常OR值(95%CI)分别为0.68(0.52~0.88)、0.70(0.54~0.92)和0.59(0.45~0.79),尿中As位于Q2、Q3和Q4组的血脂异常OR值(95%CI)分别为1.08(0.84~1.40)、1.31(1.01~1.71)和1.85(1.38~2.47);在女性人群中,与Q1组相比,仅尿中Fe位于Q4组的血脂异常OR值(95%CI)为0.76(0.59~0.98)。结论银川市社区老年人尿中较高浓度的Fe可能会降低血脂异常患病风险;尿中较高浓度的As可能会增加与血脂异常患病风险,这种关联在男性人群中更明显。Objective To explore the relationship between urinary iron and arsenic content and dyslipidemia in community⁃dwelling elderly people in Yinchuan City,and to provide scientific environmental epidemiological evidence for the formulation of dyslipidemia prevention strategies.Methods The baseline population of the Yinchuan Chronic Disease Cohort for the Elderly was selected as the study population.The general demographic information was collected through questionnaires,and blood lipids,blood pressure and liver function were measured through health checkups.We also collected 10 mL of morning urine at the baseline survey.The concentration of iron and arsenic in the urine of the study subjects was determined using an inductively coupled plasma⁃mass spectrometry and the anhydride was corrected with urine muscles.The association between urinary iron and arsenic levels and the prevalence of dyslipidemia was analyzed by conditional logistic regression.Results Urinary iron concentration in elderly people in the dyslipidemia group(115.97μg/g creatinine)was lower than that in the healthy control group(139.11μg/g creatinine),and the difference was statistically significant(Z=3.405,P<0.001);urinary arsenic concentration in elderly people in the dyslipidemia group(77.25μg/g creatinine)was higher than that in the healthy control group(67.45μg/g creatinine),and the difference was statistically significant(Z=-3.269,P=0.001).Multiple logistic regression analysis showed that after adjusting for covariates,urinary Fe(OR=0.68,95%CI:0.57-0.82,P<0.001)concentration was negatively associated with dyslipidemia in the elderly,and urinary As(OR=1.32,95%CI:1.09-1.59,P=0.001)concentration was positively associated with dyslipidemia in the elderly and showed a dose⁃response relationship(all P_(trend)≤0.001).Stratified analysis by gender found that in the male population,compared with the Q1 group,the ORs and their 95%CIs for dyslipidemia were 0.68(0.52-0.88),0.70(0.54-0.92),and 0.59(0.45-0.79)for urinary iron in the Q2,Q3,and Q4 grou

关 键 词：重金属 铁 砷 老年人 血脂异常 

分 类 号：R122.7[医药卫生—环境卫生学]