天津市涉农地区不同水平氟暴露对成年人肝肾功能指标影响研究  

Effect of different levels of fluoride exposure on liver and renal function parameters in adults in agriculture-related areas of Tianjin,China

作　　者：李芳 王洋[1] 崔玉山[1] 张丹丹[1] 段雅妮 李文凤[1] LI Fang;WANG Yang;CUI Yu-shan;ZHANG Dan-dan;DUAN Ya-ni;LI Wen-feng(Institute of Environment and Public Health,Tianjin Centers for Disease Control and Prevention,Tianjin 300011,China)

机构地区：[1]天津市疾病预防控制中心环境健康与公共卫生所,天津300011

出　　处：《环境卫生学杂志》2025年第2期97-104,共8页JOURNAL OF ENVIRONMENTAL HYGIENE

基　　金：国家自然科学基金项目(82173641);天津市卫生健康科技项目(TJWJ2022QN092);天津市第二批卫生健康行业高层次人才选拔培养工程项目(TJSQNYXXR-D2-151);天津市医学重点学科(专科)建设项目流行病学(非传染病预防与控制)(TJYXZDXK-051A)。

摘　　要：目的研究不同水平氟暴露对成年人肝肾功能指标的影响。方法以人群为基础开展现况调查,在天津市涉农地区随机选择成年人共836人进行问卷调查、体格检查和随机一次尿样、空腹血样检测。采用国家标准化离子选择电极法测定水氟浓度。使用全自动生化分析仪检测血糖、血脂及肝肾功能相关指标。采用线性回归模型、限制性立方样条模型和二元Logistic回归模型评估氟暴露水平与肝肾功能指标的关系。结果校正协变量后(年龄、性别、文化程度、BMI、腰围、家庭人均年收入、吸烟、饮酒频率、高血压、高血糖、血脂异常),线性回归模型中,水氟摄入量与血清ALB呈负相关(β=-15.36,P=0.011),氟斑牙患病程度与eGFR呈负相关(β=-2.33,P=0.013),氟斑牙患病程度与血清TBIL呈正相关(β=3.88,P=0.015);限制性立方样条模型中,氟斑牙患病程度与肾功能不全呈线性剂量-反应关系(P=0.009,P非线性=0.579);Logistic回归模型中,较高的氟暴露水平(水氟浓度或氟斑牙患病情况)与肾功能异常(或肾功能不全)有关(P=0.015,P=0.004),未发现不同氟暴露水平与本次调查涉及的其余肾脏和肝脏指标有关。结论高氟地区长期接触氟化物可能导致成人肝肾功能指标的变化,对肝肾功能产生有害影响,尤其是肾功能。Objective To investigate the effect of different levels of fluoride exposure on liver and renal function parameters.Methods The population-based prevalence study was conducted with a total of 836 adults randomly selected from the agriculture-related areas in Tianjin,China for questionnaire survey,physical examination,and collection of random urine and fasting blood samples.The national standardized ion selective electrode method was used to measure the concentration of water fluoride,and an automatic biochemical analyzer was used to measure blood glucose,blood lipids,and liver and renal function parameters.The linear regression model,the restricted cubic spline model,and the binary logistic regression model were used to investigate the association between fluoride exposure level and liver and renal function parameters.Results After adjustment for related covariates(age,sex,education level,body mass index,waist circumference,annual per capital income of the family,frequencies of drinking and smoking,hypertension,hyperglycemia,and dyslipidemia),the linear regression model analysis showed that water fluorine intake was negatively correlated with serum albumin(β=-15.36,P=0.011),and the degree of dental fluorosis was negatively correlated with estimated glomerular filtration rate(β=-2.33,P=0.013)and was positively correlated with serum total bilirubin(β=3.88,P=0.015);the restricted cubic spline model analysis showed a linear dose-response relationship between the degree of dental fluorosis and renal insufficiency(P=0.009,P non-linear=0.579);the logistic regression analysis showed that a relatively high level of fluoride exposure(water fluoride concentration or the prevalence of dental fluorosis)was associated with abnormal renal function(or renal insufficiency)(P=0.015,P=0.004).No association was observed between the different levels of fluoride exposure and the other liver and renal parameters examined in this study.Conclusion Long-term fluoride exposure in areas with a high level of fluoride may cause changes in

关 键 词：高氟暴露 肾功能 肝功能 指标 成年人 

分 类 号：R123.9[医药卫生—环境卫生学] R599[医药卫生—公共卫生与预防医学]