中国部分地区40~89岁中老年人尿镉水平与甲状腺激素水平的关联研究  

Association of urine cadmium levels with thyroid hormone levels among middle-aged and older adults aged 40-89 years in selected areas of China

作　　者：吴昌恣 王晓晨 陈悦 李峥 张翼[2] 魏源 吴兵 张文丽[2] 杨正雄 董晓杰[2] 郝瑞婷 叶秀[2] 魏露茜 曲英莉[2] 储海燕[1] 吕跃斌 朱英[2] 徐东群[2] 施小明 Wu Changzi;Wang Xiaochen;Chen Yue;Li Zheng;Zhang Yi;Wei Yuan;Wu Bing;Zhang Wenli;Yang Zhengxiong;Dong Xiaojie;Hao Ruiting;Ye Xiu;Wei Luxi;Qu Yingli;Chu Haiyan;Lyu Yuebin;Zhu Ying;Xu Dongqun;Shi Xiaoming(Center for Global Health,School of Public Health,Nanjing Medical University,Nanjing 211166,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)

机构地区：[1]南京医科大学公共卫生学院全球健康中心,南京211166 [2]中国疾病预防控制中心环境与人群健康重点实验室,中国疾病预防控制中心环境与健康相关产品安全所,北京100021

出　　处：《中华预防医学杂志》2025年第2期209-215,共7页Chinese Journal of Preventive Medicine

基　　金：中国疾病预防控制中心环境所青年科学基金(2022YSRF03);国家自然科学基金项目(82230111,82025030,82222063,U22A20404)。

摘　　要：目的:探索我国部分地区40~89岁中老年人尿镉与甲状腺激素水平的关系。方法:基于2019年10月至2020年8月“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6 588名40~89岁的中老年人。通过问卷调查和体格检查收集人口学特征、膳食及患病情况等资料,采集随机中段尿进行尿镉、尿肌酐的检测;采集空腹静脉血进行三碘甲状腺原氨酸(T3)和甲状腺素(T4)的检测。采用线性混合效应模型探索尿镉水平与甲状腺激素水平的关联,采用限制性立方样条探索两者的剂量-反应关系。结果:研究对象年龄为(63.48±12.18)岁,男性占51.28%,尿镉水平 M( Q1, Q3)为2.48(1.36,4.42)μg/g·肌酐,T3为(1.96±0.51)nmol/L,T4为(113.75±29.11)nmol/L。线性混合效应模型结果显示自然对数转换后的尿镉每升高1个单位,T3和T4 变化的 β(95% CI)分别为0.027(0.009,0.044)nmol/L和2.019(1.084,2.953)nmol/L。限制性立方样条结果显示尿镉水平与T3和T4均呈正向非线性关联(均 P非线性<0.05)。 结论:我国部分地区40~89岁中老年人尿镉水平与T3和T4呈正向关联。ObjectiveTo explore the relationship between urinary cadmium levels and thyroid hormone levels in people aged 40-89 years old in selected areas of China.MethodsBased on the"Investigation of the Impact of Soil Quality of Agricultural Land on Human Health in Typical Areas"project from October 2019 to August 2020,a multi-stage stratified random sampling method was used to include 6588 middle-aged and older adults aged 40-89.Demographic characteristics,dietary frequency and disease status were collected through the questionnaire and physical examination.Urinary cadmium and urinary creatinine were detected by random midstream urine.Fasting venous blood was collected for the detection of Triiodothyronine(T3)and Thyroxine(T4).The linear mixed effects model was used to explore the association of urine cadmium levels with thyroid hormone levels.Its dose-response relationship was explored by using the restricted cubic spline.ResultsThe age of the subjects was(63.48±12.18)years,with males accounting for 51.28%.The M(Q 1,Q 3)of urinary cadmium level,T3 and T4 was 2.48(1.36,4.42)μg/g·creatinine,(1.96±0.51)nmol/L and(113.75±29.11)nmol/L,respectively.The linear mixed effects model showed that the changes of T3 and T4 were 0.027(0.009,0.044)nmol/L and 2.019(1.084,2.953)nmol/L for each one-unit increase(natural logarithm transformed)of urinary cadmium.The restricted cubic spline showed that there was a positive nonlinear association between urinary cadmium and T3 as well as T4(all P nonlinear<0.05).ConclusionIn selected areas of China,the urinary cadmium level of middle-aged and older adults aged 40-89 years is positively associated with T3 and T4.

关 键 词：镉 甲状腺激素 横断面研究 中老年人 

分 类 号：R446.1[医药卫生—诊断学]