杨胜, 陶娜, 罗明江, 赵训, 张元梅, 刘俊. 燃煤型氟中毒病区人群坚果摄入量的比较研究[J]. 环境与职业医学, 2019, 36(3): 204-209. DOI: 10.13213/j.cnki.jeom.2019.18454
引用本文: 杨胜, 陶娜, 罗明江, 赵训, 张元梅, 刘俊. 燃煤型氟中毒病区人群坚果摄入量的比较研究[J]. 环境与职业医学, 2019, 36(3): 204-209. DOI: 10.13213/j.cnki.jeom.2019.18454
YANG Sheng, TAO Na, LUO Ming-jiang, ZHAO Xun, ZHANG Yuan-mei, LIU Jun. Comparative study on dietary consumption of nuts among residents living in coal-burning endemic fluorosis area[J]. Journal of Environmental and Occupational Medicine, 2019, 36(3): 204-209. DOI: 10.13213/j.cnki.jeom.2019.18454
Citation: YANG Sheng, TAO Na, LUO Ming-jiang, ZHAO Xun, ZHANG Yuan-mei, LIU Jun. Comparative study on dietary consumption of nuts among residents living in coal-burning endemic fluorosis area[J]. Journal of Environmental and Occupational Medicine, 2019, 36(3): 204-209. DOI: 10.13213/j.cnki.jeom.2019.18454

燃煤型氟中毒病区人群坚果摄入量的比较研究

Comparative study on dietary consumption of nuts among residents living in coal-burning endemic fluorosis area

  • 摘要: 目的 坚果富含不饱和脂肪酸、蛋白质、维生素、植物化学物以及镁等营养素,许多研究发现坚果类食物能预防与氧化应激有关的慢性病,而氧化应激是氟中毒重要机制,但坚果与燃煤型氟中毒的流行病学研究还未见报道。因此,本研究拟比较燃煤型氟中毒病区人群的坚果摄入量。

    方法 横断面调查贵州省织金县燃煤型氟中毒病区成年居民699人,其年龄范围18~60岁。以是否患有氟斑牙和/或氟骨症为依据,将调查对象分为氟中毒组和非氟中毒组。采用结构式问卷面对面调查研究对象的一般社会人口学因素、行为习惯、燃煤型氟中毒相关的生活方式等,并且采用含75个条目的食物频数问卷调查居民既往一年的食物摄入量,尤其坚果类食物摄入情况,包括花生、瓜子、核桃、杏仁、开心果、芝麻、腰果等的摄入频率和每次的摄入量。用logistic回归分析坚果类食物与燃煤型氟中毒的关联。

    结果 本研究中氟中毒患者478人,非氟中毒221人,氟中毒组年龄、尿氟含量、使用燃煤烘烤粮食的比例明显高于非氟中毒组(P < 0.001),而人均收入、文化程度、蔬菜水果摄入量、总不饱和脂肪酸、镁、维生素A、维生素E等营养素明显低于非氟中毒组(P < 0.05)。氟中毒组坚果摄入量(8.43 g/d)低于非氟中毒组坚果摄入量(27.77 g/d)(P < 0.001)。单因素logistic回归分析发现坚果摄入量与燃煤型氟中毒呈负相关(趋势检验P < 0.001),校正一般社会因素、燃煤型氟中毒相关行为因素以及营养素和食物等因素后,发现坚果摄入量与燃煤型氟中毒仍然呈负关联(趋势检验P < 0.001)。与坚果摄入量最低四分位组相比,第3、4四分位组的OR及其95% CI分别为0.27(0.15,0.49)和0.19(0.09,0.39),均有统计学意义(P < 0.001)。将氟中毒人群分为氟斑牙和氟骨症进行分析,也发现氟斑牙和氟骨症与坚果摄入量均呈负相关(趋势检验P < 0.001)。

    结论 燃煤型氟中毒病区,氟中毒者的坚果摄入量明显低于非氟中毒者。

     

    Abstract: Objective Edible nuts are rich in unsaturated fatty acids, protein, vitamins, phytochemicals, and magnesium. Many studies have found that nuts play important roles in preventing chronic diseases related to oxidative stress, an important pathogenesis of fluorosis. However, no epidemiological studies on the relationship between nuts and coal-burning endemic fluorosis have been reported. Therefore, the present study aims to compare nuts intake among residents in coal-burning endemic fluorosis area.

    Methods This cross-sectional study conducted in Zhijin County of Guizhou Province included 699 participants at 18-60 years of age. The participants with dental fluorosis and/or skeletal fluorosis were assigned into fluorosis group, and those without into non-fluorosis group. Structured questionnaires were delivered to collect general sociodemographic status, lifestyle, and coal-burning related lifestyle through face-to-face interview. A 75-item food frequency questionnaire was used to assess habitual dietary intake in the past year, especially nuts including peanuts, melon seeds, walnuts, almonds, pistachios, sesame, and cashews. Logistic regression was used to analyze the relationship between nuts intake and coal-burning endemic fluorosis.

    Results There were 478 patients with fluorosis and 221 healthy residents without fluorosis in this cross-sectional study. The fluorosis group showed older age, higher urinary fluoride level, and more proportion of roasting gains by burning coal (P < 0.001), but nevertheless lower levels of household income, education level, and intakes of vegetables, fruits, total unsaturated fatty acids, magnesium, vitamin A, and vitamin E than the non-fluorosis group (P < 0.05). The average nuts intake of the fluorosis group (8.43 g/d) was lower than that of the nonfluorosis group (27.77 g/d) (P < 0.001). The univariate logistic regression analysis showed that nuts intake was inversely associated with coalburning endemic fluorosis (Ptrend < 0.001). After adjusting for general sociodemographic status, coal-burning related behaviors, nutrients, and food, a similar association was observed (Ptrend < 0.001). Compared with the lowest quartile of nuts intake, the ORs and 95% CIs of P50-P75 and P75-P100 were 0.27 (0.15, 0.49) and 0.19 (0.09, 0.39), respectively (P < 0.001). According to the sensitivity analysis on dental fluorosis and skeletal fluorosis, there was a significant dose-dependent inverse relationship between either dental or skeletal fluorosis and nuts intake (Ptrend < 0.001).

    Conclusion In the coal-burning endemic fluorosis area, fluorosis patients' nuts consumption is remarkably lower than healthy residents'.

     

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