低浓度重金属(镉、铅、汞)混合暴露与骨密度的关联分析  

Correlation analysis of low concentration heavy metal mixed exposure(cadmium,lead,and mercury) and bone density

作　　者：许译元 刘锶施 施怡 宋琴 XU Yi-yuan;LIU Si-shi;SHI Yi;SONG Qin(Department of Preventive Medicine,School of Public Health,Hangzhou Normal University,Hangzhou,Zhejiang 311121,China)

机构地区：[1]杭州师范大学公共卫生学院预防医学系,浙江杭州311121

出　　处：《现代预防医学》2024年第21期4015-4021,共7页Modern Preventive Medicine

基　　金：杭州师范大学交叉学科研究项目(2024JCXK01)。

摘　　要：目的 探索低浓度重金属(镉、铅、汞)混合暴露与骨密度之间的关联,以及碱性磷酸酶(ALP)、骨碱性磷酸酶(BAP)、甲状旁腺激素(PT)、钙(Ca)、磷(P)在其中发挥的中介效应。方法 以NHANES调查数据为基础进行横断面研究,纳入研究对象共1 465人,使用多项式logistic回归分析相关危险因素,并进一步用贝叶斯核函数(BKMR)分析镉、铅、汞混合暴露对骨密度的影响,采用R软件的Mediation包(bootstrap法)分析ALP、BAP、PT、Ca、P在镉(Cd)、铅(Pb)、汞(Hg)暴露与骨密度的关系中的中介效应。结果 多项式logistic回归结果显示Cd浓度在第三个三分位数(T3)时骨质减少风险增大(OR=1.56,95%CI:1.08~2.26);Pb浓度在第二个三分位数(T2)时骨质减少风险增大(OR=1.49,95%CI:1.06~2.08);Hg浓度在T3时骨质疏松风险降低(OR=0.38,95%CI:0.15~0.94)。BKMR模型分析显示Cd、Pb、Hg混合暴露浓度升高会导致骨密度分数(T-score)降低,Cd、Pb、Hg后验纳入概率分别为1、1、0.47。中介分析显示Cd能通过ALP和Ca的中介效应影响骨密度,中介比例分别为-32.3%、-64.9%。Hg能通过ALP和BAP的中介效应影响骨密度,中介比例分别为7.3%、61.8%。Pb能通过ALP、BAP、PT的中介效应影响骨密度,中介比例分别为38.9%、97.6%、1.5%。结论低浓度镉、铅、汞混合暴露浓度与T-score呈负相关,ALP、BAP、PT、Ca的中介效应具有统计学意义。Objective To explore the association between mixed exposure to low concentrations of heavy metals(cadmium,lead,mercury) and bone density,as well as the mediating effects of alkaline phosphatase(ALP),bone-specific alkaline phosphatase(BAP),parathyroid hormone(PT),calcium(Ca),and phosphorus(P).Methods A cross-sectional study was conducted based on NHANES survey data,including a total of 1 465 participants.Polynomial logistic regression was used to analyze re-lated risk factors,and Bayesian Kernel Machine Regression(BKMR) was employed to assess the impact of mixed exposure to cadmium,lead,and mercury on bone density.The mediation effects of ALP,BAP,PT,Ca,and P in the relationship between exposure to cadmium(Cd),lead(Pb),mercury(Hg),and bone density were analyzed using the Mediation package in R software(Bootstrap method).Results The results of polynomial logistic regression indicated that the risk of bone loss increased at the third quartile(T3) of Cd concentration(OR=1.56,95%CI:1.08-2.26);the risk also increased at the second quartile(T2)of Pb concentration(OR=1.49,95%CI:1.06-2.08).Conversely,the risk of osteoporosis decreased at T3 of Hg concentration(OR=0.38,95%CI:0.15-0.94).BKMR model analysis revealed that increased concentrations of cadmium,lead,and mercury were associated with a decrease in bone density scores(T-score),with posterior inclusion probabilities for Cd,Pb,and Hg being 1,1,and 0.47,respectively.Mediation analysis showed that Cd influenced bone density through the mediating effects of ALP and Ca,with mediation proportions of-32.3% and-64.9%,respectively.Hg affected bone density through the mediating effects of ALP and BAP,with mediation proportions of 7.3% and 61.8%.Pb influenced bone density through the mediating effects of ALP,BAP,and PT,with mediation proportions of 38.9%,97.6%,and 1.5%,respectively.Conclusion There is a negative correlation between low concentrations of mixed exposure of cadmium,lead,and mercury and T-score,and the mediating effects of ALP,BAP,PT,and Ca are statistically signifi

关 键 词：重金属 混合暴露 骨密度 中介效应 

分 类 号：R714.257[医药卫生—妇产科学]