尿金属暴露与肝损伤标志物的独立和联合关联：来自 NHANES 2013-2016 的结果。
Independent and combined associations of urinary metals exposure with markers of liver injury: Results from the NHANES 2013-2016.
机构信息
Department of Epidemiology and Health Statistics, The Key Laboratory of Typical Environmental Pollution and Health Hazards of Hunan Province, School of Basic Medicine, School of Public Health, Hengyang Medical School, University of South China, Hengyang, 421001, China; Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China; Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China.
Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China.
出版信息
Chemosphere. 2023 Oct;338:139455. doi: 10.1016/j.chemosphere.2023.139455. Epub 2023 Jul 8.
BACKGROUND
Heavy metals entering the human body could cause damage to a variety of organs. However, the combined harmful effects of exposure to various metals on liver function are not well understood. The purpose of the study was to investigate the independent and joint relationships between heavy metal exposure and liver function in adults.
METHODS
The study involved 3589 adults from the National Health and Nutrition Examination Survey. Concentrations of urinary metals, including arsenic (As), cadmium (Cd), lead (Pb), antimony (Sb), barium (Ba), thallium (Tl), tungsten (W), uranium (U), were determined in urine using inductively coupled plasma mass spectrometry. Data for liver function biomarkers included alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transaminase (GGT), and alkaline phosphatase (ALP). Survey-weighted linear regression and quantile g-computation (qgcomp) were employed to evaluate the relationship of urinary metals with the markers of liver injury.
RESULTS
Cd, U and Ba were found to have positive correlations with ALT, AST, GGT, and ALP in the survey-weighted linear regression analyses. According to the qgcomp analyses, the total metal mixture was positively correlated with ALT (percent change: 8.15; 95% CI: 3.84, 12.64), AST (percent change: 5.55; 95% CI: 2.39, 8.82), GGT (percent change: 14.30; 95% CI: 7.81, 21.18), and ALP (percent change: 5.59; 95% CI: 2.65, 8.62), and Cd, U, and Ba were the main contributors to the combined effects. Positive joint effects were observed between Cd and U on ALT, AST, GGT and ALP, and U and Ba had positive joint effects on ALT, AST and GGT.
CONCLUSION
Exposures to Cd, U, and Ba were individually associated with multiple markers of liver injury. Mixed metal exposure might be adversely correlated with markers of liver function. The findings indicated the potential harmful effect of metal exposure on liver function.
背景
重金属进入人体会对多种器官造成损害。然而，人们对于接触各种金属对肝功能的联合有害影响知之甚少。本研究旨在探讨成年人重金属暴露与肝功能之间的独立和联合关系。
方法
这项研究涉及了来自全国健康和营养调查的 3589 名成年人。采用电感耦合等离子体质谱法测定尿液中砷（As）、镉（Cd）、铅（Pb）、锑（Sb）、钡（Ba）、铊（Tl）、钨（W）、铀（U）等金属的浓度。肝功能生物标志物的数据包括丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、γ-谷氨酰转移酶（GGT）和碱性磷酸酶（ALP）。采用调查加权线性回归和分位数 g 计算（qgcomp）评估尿液金属与肝损伤标志物之间的关系。
结果
在调查加权线性回归分析中，Cd、U 和 Ba 与 ALT、AST、GGT 和 ALP 呈正相关。根据 qgcomp 分析，金属总混合物与 ALT（百分比变化：8.15%；95%置信区间：3.84%，12.64%）、AST（百分比变化：5.55%；95%置信区间：2.39%，8.82%）、GGT（百分比变化：14.30%；95%置信区间：7.81%，21.18%）和 ALP（百分比变化：5.59%；95%置信区间：2.65%，8.62%）呈正相关，Cd、U 和 Ba 是联合效应的主要贡献者。在 ALT、AST、GGT 和 ALP 上，Cd 和 U 之间观察到了阳性的联合效应，U 和 Ba 在 ALT、AST 和 GGT 上也有阳性的联合效应。
结论
接触 Cd、U 和 Ba 与多种肝损伤标志物单独相关。混合金属暴露可能与肝功能标志物呈负相关。这些发现表明金属暴露对肝功能可能有潜在的有害影响。
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