我国部分地区40~89岁中老年人尿镉水平与外周血白细胞分类计数的关联研究  

Association of urinary cadmium levels with peripheral leukocyte classification counts among middle-aged and older adults aged 40-89 in selected areas of China

作　　者：罗宇菲 魏源 王晓晨 张翼[2] 张文丽[2] 吴兵 杨正雄[2] 董晓杰[2] 郝瑞婷 陆一夫 符小霜 朱子月 朱英[2] 吕跃斌[2] 徐东群[2] 施小明[1,2,4] Luo Yufei;Wei Yuan;Wang Xiaochen;Zhang Yi;Zhang Wenli;Wu Bing;Yang Zhengxiong;Dong Xiaojie;Hao Ruiting;Lu Yifu;Fu Xiaoshuang;Zhu Ziyue;Zhu Ying;Lyu Yuebin;Xu Dongqun;Shi Xiaoming(School of Public Health,Anhui Medical University,Hefei 230032,China;China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health,Chinese Center for Disease Control and Prevention,Beijing 100021,China;School of Public Health,Jilin University,Changchun 130012,China;Center for Global Health,School of Public Health,Nanjing Medical University,Nanjing 211166,China)

机构地区：[1]安徽医科大学公共卫生学院,合肥230032 [2]中国疾病预防控制中心环境与人群健康重点实验室,环境与健康相关产品安全所,北京100021 [3]吉林大学公共卫生学院,长春130012 [4]南京医科大学公共卫生学院,南京211166

出　　处：《中华预防医学杂志》2024年第6期839-846,共8页Chinese Journal of Preventive Medicine

基　　金：国家自然科学基金(82230111,82025030,82222063)。

摘　　要：目的探讨我国部分地区40~89岁中老年人尿镉水平与外周血白细胞分类计数的关联。方法本研究基于2019—2020年“典型地区农用地土壤质量对人群健康影响调查”项目,采用多阶段分层随机抽样方法,共纳入5600名40~89岁的中老年人。收集研究对象的基线特征,进行体格检查;采集随机中段尿以检测尿镉和尿肌酐;采集空腹静脉血以检测白细胞计数、中性粒细胞计数、淋巴细胞计数、单核细胞计数和嗜酸性粒细胞计数。采用线性混合效应模型分析尿镉水平与外周血白细胞分类计数的关联,并采用限制性立方样条函数探索二者之间的剂量-反应关系。结果研究对象的年龄为(63.17±12.02)岁;男性为2851名(50.91%);尿肌酐校正后尿镉水平的M(Q1,Q3)为2.69(1.52,4.69)μg/g·肌酐。校正相关混杂因素后,线性混合效应模型分析结果显示,尿肌酐校正后尿镉水平每增加1个单位,白细胞计数和淋巴细胞计数的变化百分比[%(95%CI)]分别为-1.70%(-2.61%,-0.79%)和-1.57%(-2.86%,-0.26%)。限制性立方样条函数分析结果显示,尿肌酐校正后尿镉水平与白细胞计数、淋巴细胞计数分别呈负向线性关系(均P非线性>0.05)。结论我国部分地区40~89岁中老年人尿肌酐校正后尿镉水平与白细胞计数、淋巴细胞计数呈负向关联。Objective To investigate the association of urinary cadmium levels with peripheral leukocyte classification counts among middle-aged and older adults aged 40 to 89 years in selected areas of China.Methods The research was based on the survey of the impact of soil quality of agricultural land on human health in typical areas conducted in 2019-2020.A total of 5600 middle-aged and older adults aged 40 to 89 years were included by using a multi-stage stratified random sampling method.Baseline characteristics of the subjects were collected and physical examinations were performed.Random midstream urine was collected to measure urinary cadmium and urinary creatinine and fasting venous blood was collected to measure the leukocyte count,neutrophil count,lymphocyte count,monocyte count and eosinophil count.The linear mixed effect model was used to analyse the association of urinary cadmium levels with leukocyte classification counts,and the dose-response relationship between them was analyzed by using the restricted cubic spline(RCS)function.Results The age of the subjects was(63.17±12.02)years;2851(50.91%)were males;and the M(Q1,Q3)of urinary creatinine-corrected urinary cadmium levels was 2.69(1.52,4.69)μg/g·creatinine.After adjusting for confounding factors,the results of linear mixed effects model analysis showed that for each 1-unit increase in urinary creatinine-corrected urinary cadmium level,the percentage change[%(95%CI)]of leukocyte count and lymphocyte count was-1.70%(-2.61%,-0.79%)and-1.57%(-2.86%,-0.26%),respectively.RCS function showed a negative linear relationship between urinary creatinine-corrected urinary cadmium levels and leukocyte counts and lymphocyte counts,respectively(all Pnon-linear>0.05).Conclusion Urinary cadmium levels are negatively associated with leukocyte count and lymphocyte count among middle-aged and older adults aged 40 to 89 years in selected areas of China.

关 键 词：镉 白细胞计数 淋巴细胞计数 中老年人 

分 类 号：R114[医药卫生—卫生毒理学]