黄素丽, 王甜, 温莹, 钟丹蓉, 张艳炜, 周国宏, 刘宁, 彭朝琼, 余淑苑. 深圳某医院中老年体检人群血浆金属浓度与动脉粥样硬化的关联[J]. 环境与职业医学, 2021, 38(10): 1090-1098. DOI: 10.13213/j.cnki.jeom.2021.21219
引用本文: 黄素丽, 王甜, 温莹, 钟丹蓉, 张艳炜, 周国宏, 刘宁, 彭朝琼, 余淑苑. 深圳某医院中老年体检人群血浆金属浓度与动脉粥样硬化的关联[J]. 环境与职业医学, 2021, 38(10): 1090-1098. DOI: 10.13213/j.cnki.jeom.2021.21219
HUANG Suli, WANG Tian, WEN Ying, ZHONG Danrong, ZHANG Yanwei, ZHOU Guohong, LIU Ning, PENG Chaoqiong, YU Shuyuan. Associations of multiple plasma metals with atherosclerosis risk in mid-aged and elderly population from routine physical examination in a hospital of Shenzhen[J]. Journal of Environmental and Occupational Medicine, 2021, 38(10): 1090-1098. DOI: 10.13213/j.cnki.jeom.2021.21219
Citation: HUANG Suli, WANG Tian, WEN Ying, ZHONG Danrong, ZHANG Yanwei, ZHOU Guohong, LIU Ning, PENG Chaoqiong, YU Shuyuan. Associations of multiple plasma metals with atherosclerosis risk in mid-aged and elderly population from routine physical examination in a hospital of Shenzhen[J]. Journal of Environmental and Occupational Medicine, 2021, 38(10): 1090-1098. DOI: 10.13213/j.cnki.jeom.2021.21219

深圳某医院中老年体检人群血浆金属浓度与动脉粥样硬化的关联

Associations of multiple plasma metals with atherosclerosis risk in mid-aged and elderly population from routine physical examination in a hospital of Shenzhen

  • 摘要: 背景

    金属暴露可能与动脉粥样硬化(AS)发生有关,关于多金属暴露与AS风险关系的研究结论存在争议。

    目的

    探讨深圳市中老年体检人群中血浆多种金属水平与AS风险之间的关联。

    方法

    664名研究对象均来自2012—2017年于中山大学附属第八人民医院接受常规健康体格检查的中老年人群。通过问卷调查、体格检查等收集研究对象的人口学特征、生活方式及生理生化指标;采集研究对象的血浆,采用电感耦合等离子体质谱仪检测13种金属的质量浓度(后称浓度);采用颈动脉彩色超声测量颈总动脉内膜中层厚度,确定是否有AS。采用logistic回归模型和限制性立方样条图分析血浆金属浓度与AS风险的关联以及剂量- 反应关系。

    结果

    研究对象的平均年龄为(64.41±7.23)岁,男性占比52.26%(347/664),AS检出率为45.33%。校正混杂因素后,单金属logistic回归模型结果显示:与第一分位组相比,血浆铁、硒、镉的第四分位组AS风险下降,OR(95% CI)分别为0.50(0.29~0.88)、0.59(0.36~0.96)和0.54(0.33~0.90);而血浆铊的第三分位组AS风险上升OR(95% CI):1.75(1.08~2.83)。进一步采用多金属logistic逐步回归后发现,与第一分位组相比:血浆铁的第四分位组AS风险下降OR(95% CI):0.47(0.28~0.79),而血浆铊的第三分位组AS风险上升OR(95%CI):1.81(1.11~2.99);且随着铊浓度的升高,AS风险亦逐渐增加(P趋势=0.046)。限制性立方样条分析结果表明,血浆铁浓度增加与AS风险下降有关,两者之间呈现非线性剂量- 反应关系(非线性关联P=0.043,剂量- 反应关系P=0.022)。

    结论

    血浆铁浓度的增加可能与AS风险下降有关,而血浆铊浓度增加可能与AS风险增加有关。

     

    Abstract: Background

    Metal exposure is associated with the risk of atherosclerosis (AS), but current conclusions about the associations between exposure to multiple metals and AS remain controversial.

    Objective

    This study aims to investigate the associations of multiple metal exposure levels with the risk of AS among a mid-aged and elderly population from routine physical examination in Shenzhen, China.

    Methods

    A total of 664 mid-aged and elderly participants were recruited from population who ordered routine physical examination in the Eighth Affiliated Hospital, Sun Yat-Sen University of Shenzhen, China from 2012 to 2017. Information including demographic characteristics, lifestyles, physiological and biochemical indexes of the participants were collected through questionnaires and physical examinations. The concentrations of 13 metals in plasma were measured by inductively coupled plasma mass spectrometry (ICP-MS). Carotid intima-media thickness was measured by color Doppler ultrasound to evaluate AS. Logistic regression models and restricted cubic spline models were conducted to evaluate the associations and the dose-response relationships between multiple plasma metal levels and AS.

    Results

    The average age of the participants was (64.41±7.23) years, 52.26% (347/664) were males, and the prevalence of AS was 45.33%. After adjusting for confounding factors, the single-metal logistic regression models showed that referenced with the first quartile of each metal, the ORs (95% CIs) for the fourth quartiles of plasma iron, selenium, and cadmium were 0.50 (0.29-0.88), 0.59 (0.36-0.96), and 0.54 (0.33-0.90), respectively, and the OR (95%CI) for the third quartile of thallium was 1.75 (1.08-2.83). Further multi-metal stepwise logistic regression models indicated that referenced with the first quartile of each metal, the OR (95% CI) for the fourth quartile of iron was 0.47 (0.28-0.79), and it was 1.81 (1.11-2.99) for the third quartile of thallium; with increase in concentration of plasma thallium, AS risk was gradually increased (Ptrend=0.046). Moreover, the restricted cubic spline model revealed that AS risk declined with increased level of plasma iron, and a non-linear and inverse dose-response relationship was observed between them (P for non-linearity=0.043, P for overall association=0.022).

    Conclusion

    Elevated plasma iron may be associated with a lower risk of AS, and higher plasma thallium may be associated with a higher risk of AS.

     

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