社区人群晨尿1-溴丙烷代谢产物与外周血液参数的关联
Associations of morning urinary 1-bromopropane metabolite with peripheral blood parameters in a community-based population
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摘要:
背景 环境污染物1-溴丙烷广泛存在于生活环境中，但其对一般人群的健康影响仍不明确。
目的 评估社区人群尿1-溴丙烷代谢产物与血常规指标的关联。
方法 以武汉-珠海队列基线的3 512名18~80岁社区成年居民为研究对象，通过问卷调查收集人口学基本特征、疾病史以及生活习惯等相关信息，体格检查测定身高、体重和血压等指标，使用全自动血液分析仪测定血常规指标，并应用超高效液相色谱耦合电喷雾串联质谱仪检测晨尿中1-溴丙烷代谢产物N-乙酰基-S-(正丙基)-L-半胱氨酸（BPMA）。采用广义线性模型和logistic回归模型分析尿BPMA浓度与血常规指标及其异常情况的关联，进一步按照个体因素和生活方式分层，分析不同亚组尿BPMA浓度与血常规指标的关联，并且探究各分层变量对上述关联的效应修饰作用。所有模型均校正了性别和年龄等混杂因素。
结果 研究对象年龄为（52.78±12.77）岁，男性占30.1%。尿BPMA经尿肌酐校正后的中位数（M）及第25、75百分位数（P25，P75）浓度为0.90（0.50，1.73）mg·mol−1。连续性数据分析显示，尿BPMA浓度自然对数转换值每增加1个单位，白细胞数、淋巴细胞数、淋巴细胞百分比、平均血红蛋白浓度和血小板数分别减少0.078×109 L−1、0.031×109 L−1、0.307%、3.518 g·L−1和2.469×109 L−1（均P<0.05）；红细胞比容和平均红细胞体积水平分别增加0.440%和1.140 fL（均P<0.05）；平均血小板体积和平均血小板体积与血小板计数比值的自然对数转换值分别增加0.014 fL和0.020（均P<0.05）。以BPMA为四分位等级变量分析发现，尿BPMA与淋巴细胞百分比、平均血红蛋白浓度和血小板数呈负向剂量-效应关系（均Ptrend<0.05）；与红细胞比容、平均红细胞体积、平均血小板体积和平均血小板体积与血小板计数比值呈现正向剂量-效应关系（均Ptrend<0.05）。体重指数、吸烟和饮酒修饰了尿BPMA浓度与红细胞数、平均血红蛋白浓度、淋巴细胞百分比和血红蛋白等部分血常规指标的关联（均P<0.05）。此外，尿BPMA与平均红细胞体积和红细胞体积分布宽度异常上升以及平均血红蛋白浓度异常下降的风险增加相关，OR及其95%CI分别为1.316（1.171~1.478）、1.255（1.030~1.528）和1.200（1.035~1.392）。
结论 一般社区人群1-BP的暴露与白细胞和血小板计数的降低以及血细胞形态或功能发生异常变化有关。
Abstract:Background As an environmental pollutant, 1-bromopropane (1-BP) is ubiquitous in the living environment. However, its health effects on the general population are still unclear.
Objective To assess the associations between urinary 1-BP metabolite and blood routine indices in a Chinese community population.
Methods A total of 3512 community residents aged 18-80 years from the baseline of the Wuhan-Zhuhai cohort were included in our study. The demographic characteristics, disease history, and lifestyles of the participants were collected through questionnaires. Height, weight, blood pressure, and other anthropometrics were collected through physical examination. Blood routine indicators were tested using an automated hematology analyzer. Urinary 1-BP metabolite N-Acetyl-S-(n-propyl)-L-cysteine (BPMA) was measured by ultra-high-performance liquid chromatography coupled with electrospray ionization tandem mass spectrometry. Generalized linear models and logistic regression models were used to assess the associations of urinary BPMA with blood routine indices and the risks of abnormal blood routine indices, respectively. Besides, stratified analysis and effect modification analysis were further conducted to investigate the effects of individual characteristics and lifestyles on the associations of urinary BPMA with blood routine indices. All models were adjusted for gender, age, and other potential confounders.
Results The mean age of the study population (30.1% male) was (52.78±12.77) years. The median (P25, P75) level of urinary BPMA adjusted for urinary creatinine was 0.90 (0.50, 1.73) mg·mol−1. In the analysis with target indicator as continuous variable, each 1-unit increase in natural logarithm-transformed urinary BMPA level was associated with a 0.078×109 L−1, 0.031×109 L−1, 0.307%, 3.518 g·L−1, and 2.469×109 L−1 decrease in white blood cell, lymphocyte, lymphocyte percentage, mean corpuscular hemoglobin concentration, and platelet levels, respectively (allPs<0.05); and with a 0.440%, 1.140 fL, 0.014 fL, and 0.020 increase in hematocrit, mean corpuscular volume, and natural logarithm-transformed levels of mean platelet volume and mean platelet volume/platelet, respectively (allPs<0.05). The categorical analysis across quartiles of BPMA level showed that BPMA was inversely associated with lymphocyte percentage, mean corpuscular hemoglobin concentration, and platelet levels in a dose-dependent manner (allPtrend<0.05), and positively related to hematocrit, mean corpuscular volume, mean platelet volume, and mean platelet volume/platelet levels in a dose-dependent manner (allPtrend<0.05). Body mass index, smoking, and drinking modified the associations of urinary BPMA level with red blood cell, mean corpuscular hemoglobin concentration lymphocyte percentage, and hemoglobin (allPs<0.05). In addition, urinary BPMA was associated with an increased risk of abnormal increase in mean corpuscular volume (OR=1.316, 95%CI: 1.171-1.478) and red blood cell volume distribution width (OR=1.255, 95%CI: 1.030-1.528), and abnormal decrease in mean corpuscular hemoglobin concentration (OR=1.200, 95%CI: 1.035-1.392).
Conclusion Exposure to 1-BP of the general population is associated with decreased white blood cells and platelets, as well as abnormal change of blood cell morphology or function.
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