2011—2018年美国青少年全血5种重金属水平与内脏脂肪的关联研究

万婷雅; 陶成哲; 卢俐妤; 张般若; 刘敏; 汤静雅; 徐俏俏; 范赟; 秦玉峰; 陆春城

doi:10.13421/j.cnki.hjwsxzz.2024.05.008

2011—2018年美国青少年全血5种重金属水平与内脏脂肪的关联研究

Relationship between levels of five heavy metals in whole blood and visceral adipose tissue in adolescents in the United States, 2011-2018

摘要

摘要:
目的该研究旨在评估全血中镉(Cd)、铅(Pb)、锰(Mn)、汞(Hg)、硒(Se)5种重金属含量和内脏脂肪组织(VAT)累积之间的关联。
方法基于2011—2018年美国国家健康和营养调查(NHANES)数据库, 选取4 668名8~19岁的青少年, 进行人群横断面研究。应用广义线性回归估计全血5种金属水平和VAT累积之间的关联; 应用限制性三次样条法(RCS)评估非线性关联; 根据年龄、身体质量指数(body mass index, BMI)、文化程度和家庭收入-贫困比率(poverty income ratio, PIR)对研究人群进行分层分析。
结果 2011—2018年美国青少年全血Cd、Pb、Mn、Hg、Se的几何平均浓度为0.13 μg/L、0.53 μg/dL、10.34 μg/L、0.41 μg/L、183.67 μg/L, VAT质量的中位数为186.89 g。VAT质量的分布具有明显的性别差异。在男性青少年中, 全血Pb水平与VAT质量呈负相关(β=-0.037, 95%CI: -0.052~-0.021), 而在女性中, 全血Cd水平与VAT质量呈正相关(β=0.041, 95%CI: 0.004~0.077)。男性和女性的全血Mn水平均与VAT具有正相关, 且在女性中关联更强(男性: β=0.107, 95%CI: 0.079~0.136;女性: β=0.238, 95%CI: 0.180~0.295)。RCS分析发现, 全血Cd水平和VAT质量之间的关联呈J型, 男性的全血Pb水平和VAT质量呈反J型关联。
结论美国青少年的全血5种金属水平与VAT质量有关。本研究有助于识别重金属暴露对代谢健康的危害, 但未来仍需要开展进一步的研究来阐明重金属暴露对VAT毒性效应的潜在机制。

Abstract:
Objective To investigate the associations of whole blood levels of five heavy metals, including cadmium (Cd), lead (Pb), manganese (Mn), mercury (Hg), and selenium (Se), with the accumulation of visceral adipose tissue (VAT).
Methods Based on the 2011-2018 National Health and Nutrition Examination Survey database, a population-based cross-sectional study involving 4 668 adolescents aged 8-19 years in the United States (U.S.) was conducted. Generalized linear regression and restricted cubic splines were applied to model the linear and non-linear relationships between whole-blood heavy metal levels and VAT accumulation, respectively. In addition, stratified analyses were performed according to age, the body mass index (BMI), education levels, and the family poverty-income ratio.
Results The geometric mean blood concentrations of Cd, Pb, Mn, Hg, and Se of the U.S. adolescents from 2011 to 2018 were 0.13 μg/L, 0.53 μg/dL, 10.34 μg/L, 0.41 μg/L, and 183.67 μg/L, respectively, and the median VAT mass was 186.89 g. The distribution of VAT mass differed significantly by gender. In male adolescents, blood Pb levels were negatively associated with VAT mass (β=-0.037, 95% confidence intervalCI: -0.052 to -0.021), while in female adolescents, blood Cd levels were positively associated with VAT mass (β=0.041, 95%CI: 0.004 to 0.077). Whole blood Mn levels were significantly associated with VAT mass in both males and females, with a stronger association in females (β for males=0.107, 95%CI: 0.079 to 0.136; β for females=0.238, 95%CI: 0.180 to 0.295). The RCS model revealed a J-shaped relationship between whole blood Cd levels and VAT mass, and a reverse J-shaped relationship between whole blood Pb levels and VAT mass in males.
Conclusion The levels of the five heavy metals in whole blood are associated with VAT mass in U.S. adolescents. The result can help understand the metabolic health risks posed by heavy metal exposure, but further research is needed to clarify the mechanism underlying the toxicity of heavy metals to VAT.

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