朱美琴, 纪宏先, 余丽丽, 刘艳丽, 李冬, 高祖雄, 杨丽婷, 周尚成, 李晓雯, 丁洪成, 王静. 湖北省十堰市城区学龄前儿童尿金属水平与肥胖的关系[J]. 环境与职业医学, 2021, 38(9): 986-993. DOI: 10.13213/j.cnki.jeom.2021.21065
引用本文: 朱美琴, 纪宏先, 余丽丽, 刘艳丽, 李冬, 高祖雄, 杨丽婷, 周尚成, 李晓雯, 丁洪成, 王静. 湖北省十堰市城区学龄前儿童尿金属水平与肥胖的关系[J]. 环境与职业医学, 2021, 38(9): 986-993. DOI: 10.13213/j.cnki.jeom.2021.21065
ZHU Meiqin, JI Hongxian, YU Lili, LIU Yanli, LI Dong, GAO Zuxiong, YANG Liting, ZHOU Shangcheng, LI Xiaowen, DING Hongcheng, WANG Jing. Association of urinary metals levels with obesity in urban preschoolers in Shiyan of Hubei Province[J]. Journal of Environmental and Occupational Medicine, 2021, 38(9): 986-993. DOI: 10.13213/j.cnki.jeom.2021.21065
Citation: ZHU Meiqin, JI Hongxian, YU Lili, LIU Yanli, LI Dong, GAO Zuxiong, YANG Liting, ZHOU Shangcheng, LI Xiaowen, DING Hongcheng, WANG Jing. Association of urinary metals levels with obesity in urban preschoolers in Shiyan of Hubei Province[J]. Journal of Environmental and Occupational Medicine, 2021, 38(9): 986-993. DOI: 10.13213/j.cnki.jeom.2021.21065

湖北省十堰市城区学龄前儿童尿金属水平与肥胖的关系

Association of urinary metals levels with obesity in urban preschoolers in Shiyan of Hubei Province

  • 摘要: 背景

    金属暴露与成人肥胖有关,但缺乏关于学龄前儿童的研究证据。

    目的

    分析学龄前儿童尿金属水平与肥胖的关系。

    方法

    采用横断面设计,在湖北省十堰市城区抽取1 595名学龄前儿童进行问卷调查和体格检查。根据世界卫生组织的相关标准,体质指数(BMI)≥同性别年龄第95百分位数(P95)为肥胖。采用电感耦合等离子体质谱法检测晨尿中24种金属浓度。根据尿金属浓度四分位数水平,将研究对象分为Q1~Q4组,用LASSO回归筛选多金属暴露模型中的变量,用二元logistic模型评估学龄前儿童单金属及多金属暴露水平与肥胖的关系。

    结果

    本研究最终纳入1 471名儿童,平均年龄(4.4±1.0)岁,男童占55.6%。总肥胖率为11.82%。在校正肥胖相关因素(性别、年龄、出生体重等)的单金属模型中,钒、铜、锰、铀Q3组儿童的肥胖患病风险分别是Q1组的52%、56%、55%、75%,钼、钒、铷、铝、镉、砷、铀、铊Q4组儿童的肥胖患病风险分别是Q1组的54%、56%、59%、52%、50%、39%、73%、55%;除铜、锰外,上述金属与儿童肥胖患病风险均具有线性趋势(均P趋势 < 0.05)。通过LASSO回归筛选出6个金属钒、铝、镉、砷、铀、钛,共同构建多金属暴露模型。结果显示,砷Q4组对应的肥胖患病风险是Q1组的50%(95% CI:0.28~0.87),并仍存在线性趋势(P趋势=0.046);铀Q3组对应的肥胖患病风险是Q1组的53%(95% CI:0.31~0.91),但无线性趋势(P趋势=0.131)。

    结论

    湖北省十堰市学龄前儿童部分尿金属水平与肥胖呈负相关,其中砷和铀可能是肥胖的重要影响因素。

     

    Abstract: Background

    Metal exposure is associated with obesity in adults, but evidence from studies on preschool children is insufficient.

    Objective

    This study is designed to analyze the relationship between urinary metal levels and obesity in preschool children.

    Methods

    In the cross-sectional study, a questionnaire survey and a physical examination were conducted among 1 595 preschoolers in Shiyan of Hubei Province. According to the standards of the World Health Organization, body mass index (BMI) ≥ the 95th (P95) percentile for their age and sex is considered to be obese. The urinary concentrations of 24 metals were determined by inductively coupled plasma mass spectrometry. The participants were divided into Q1 to Q4 groups according to the quartiles of urinary metal concentrations. The relationships between exposure levels to mono-metals and poly-metals and obesity in the preschoolers were evaluated by binary logistic models, and variables in the polymetallic exposure model were screened by Lasso regression.

    Results

    A total of 1 471 children were included in this study, with a mean age of (4.4±1.0) years, and boys accounted for 55.6%. The overall obesity rate was 11.8%. In single-metal models that was adjusted for obesity-related factors (such as sex, age, birth weight), the risks of obesity for children in the vanadium, copper, manganese, and uranium Q3 groups were 52%, 56%, 55%, and 75% of those in the Q1 groups; the risks of obesity for children in the molybdenum, vanadium, rubidium, aluminum, cadmium, arsenic, uranium, and thallium Q4 groups were 54%, 56%, 59%, 52%, 50%, 39%, 73%, and 55% of those in the Q1 groups, respectively; except copper and manganese, above metals had a linear trend with the risk of childhood obesity (Ptrend < 0.05). Six metals such as vanadium, aluminum, cadmium, arsenic, uranium, and titanium selected by LASSO regression were included in the polymetallic exposure model, and the results showed that the risk of obesity for children in the arsenic Q4 group was 50% (95% CI: 0.28-0.87) of that in the Q1 group, and there was still a linear trend (Ptrend=0.046); the risk of obesity for children in the uranium Q3 group was 53% (95% CI: 0.31-0.91) of that in the Q1 group, but there was no linear trend (Ptrend=0.131).

    Conclusion

    Some urinary metal levels are negatively correlated with obesity of preschool children in Shiyan city of Hubei province, among which arsenic and uranium may be potential critical influencing factors for obesity.

     

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