向敏, 杨慧花, 张梓骞, 张晓敏, 杨良乐. 酚类化合物暴露与血脂关联的定群研究[J]. 环境与职业医学, 2024, 41(7): 728-734. DOI: 10.11836/JEOM23375
引用本文: 向敏, 杨慧花, 张梓骞, 张晓敏, 杨良乐. 酚类化合物暴露与血脂关联的定群研究[J]. 环境与职业医学, 2024, 41(7): 728-734. DOI: 10.11836/JEOM23375
XIANG Min, YANG Huihua, ZHANG Ziqian, ZHANG Xiaomin, YANG Liangle. A panel study of associations between phenolic compound exposure and blood lipid levels[J]. Journal of Environmental and Occupational Medicine, 2024, 41(7): 728-734. DOI: 10.11836/JEOM23375
Citation: XIANG Min, YANG Huihua, ZHANG Ziqian, ZHANG Xiaomin, YANG Liangle. A panel study of associations between phenolic compound exposure and blood lipid levels[J]. Journal of Environmental and Occupational Medicine, 2024, 41(7): 728-734. DOI: 10.11836/JEOM23375

酚类化合物暴露与血脂关联的定群研究

A panel study of associations between phenolic compound exposure and blood lipid levels

  • 摘要: 背景

    酚类化合物被广泛用作增塑剂、抗菌剂和防腐剂,对人体具有内分泌干扰作用。既往关于酚类化合物暴露与血脂的流行病学研究主要基于单次尿样检测,忽略了潜在的滞后效应,研究结论也并不一致。

    目的

    探讨不同滞后天数的酚类化合物短期暴露对成人血脂水平的影响。

    方法

    采用固定群组研究设计,于2017—2018年招募143名武汉成人(男性43名,女性100名),分别在夏、秋、冬3季进行重复调查。每季连续收集4 d晨尿,第1天进行问卷调查,第4天进行体格检查和空腹血样采集。共纳入126人(340人次,1251份尿样)进行统计分析。采用超高效液相色谱-串联质谱联用仪测定尿样中6种酚类化合物双酚A(BPA)、双酚S(BPS)、三氯生(TCS)、对羟基苯甲酸甲酯(MeP)、对羟基苯甲酸乙酯(EtP)和对羟基苯甲酸丙酯(PrP)的浓度。运用线性混合效应模型(LMEs)、多源信息模型和广义线性模型分析个体三季不同滞后天数中,尿酚类化合物与甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、TG与HDL-C的比值(TG/HDL-C)之间的关联,并依据不同个体特征进行分层分析。

    结果

    经协变量和多重校正后,LMEs表明,在体检当天(Lag 0 d),与BPA低浓度组(<LOD)相比,高浓度组(≥LOD)TG/HDL-C升高16.48%(95%CI:4.41%,29.94%)(PFDR<0.05),且上述关联在男性(P交互=0.028)和有吸烟史的人群(P交互=0.040)中更显著。此外,在滞后第2天(Lag 2 d),与TCS低浓度组(<LOD)相比,高浓度组(≥LOD)的TG升高13.22%(95%CI:3.73%,23.56%)(PFDR<0.05)。分层分析结果显示,尿TCS与TG升高的关联在年龄<50岁的人群中更显著(P交互=0.037)。未发现其他滞后天数的尿酚类化合物与血脂存在关联。

    结论

    成人BPA和TCS短期暴露对血脂存在不利影响,且上述关联在男性、有吸烟史和年龄<50岁的人群中更显著。

     

    Abstract: Background

    Phenolic compounds, which are widely used as plasticizers, antibacterial agents, and preservatives in industrial production, have endocrine disrupting effects on humans. Previous epidemiological studies on the associations between phenolic compound exposure and blood lipids are mainly based on single measurement of spot urine samples, neglecting potential lag effects of phenolic compounds, and the conclusions are inconsistent.

    Objective

    To investigate the effects of short-term exposure to phenolic compounds at different lag days on blood lipid levels in adults.

    Methods

    We recruited 143 adults (43 males and 100 females) in Wuhan for three consecutive seasonal rounds of repeated visits: summer and autumn rounds of 2017 and winter of 2018. Morning urine samples were collected for four consecutive days during each round. A set of questionnaires were also distributed on the first day. Physical examinations and fasting venous blood sample collection were conducted on the fourth day. A total of 126 adults were included for analysis (340 person-time, 1251 urine samples). The concentrations of six urinary phenolic compounds bisphenol A (BPA), bisphenol S (BPS), triclosan (TCS), methyl paraben (MeP), ethyl paraben (EtP), and propyl paraben (PrP) were determined by ultra-high-performance liquid chromatography-tandem mass spectrometry. Linear mixed-effect models (LMEs), multiple informant models, and generalized linear models were utilized to estimate the associations of urinary phenolic compounds at different lag days with total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and the ratio of TG to HDL-C (TG/HDL-C). Stratified analyses were conducted by selected characteristics.

    Results

    After covariate and multiple adjustments, the LMEs indicated that a change in urinary BPA at lag 0 day from the low concentration group (<LOD) to the high concentration group (≥LOD) was associated with a 16.48% (95%CI: 4.41%, 29.94%) increase in TG/HDL-C (P FDR<0.05), and this association was more pronounced in men (P interaction=0.028) and smokers (P interaction=0.040). In addition, a change in urinary TCS at lag 2 day from the low concentration group (<LOD) to the high concentration group (≥LOD) was associated with a 13.22% (95%CI: 3.73%, 23.56%) increase in TG (P FDR<0.05). The positive association of TCS with TG was more evident in subjects aged < 50 years (P interaction=0.037). No significant associations were found between urinary phenolic compounds at other lag days and blood lipids.

    Conclusion

    Short-term exposures to BPA and TCS are positively correlated with unfavorable changes in blood lipids in adults, and the association seem to be more pronounced in men, smokers, or individuals aged < 50 years.

     

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