摘要
目的探讨饮水型地方性砷中毒(简称饮水型砷中毒)病区人群砷代谢模式及影响因素。方法2004年12月,采用整群抽样方法,选取内蒙古自治区巴彦淖尔市饮水型砷中毒病区内砷中毒人群(砷中毒组)与健康人群(对照组)作为调查对象,对其进行问卷调查。采用高效液相色谱-电感耦合等离子体质谱法检测调查对象家中饮用水砷含量,尿砷及其代谢产物[三价砷(As^(Ⅲ))、无机砷(iAs)、一甲基胂酸(五价,MMA^(V))、二甲基胂酸(五价,DMA^(V))、总砷(tAs)、无机砷百分比(iAs%)、一甲基胂酸百分比(MMA%)、二甲基胂酸百分比(DMA%)、一甲基化率(PMI)、二甲基化率(SMI)]水平;采用原子荧光光度计检测指甲砷和指甲硒水平。采用多元线性回归分析砷代谢模式的影响因素。结果共纳入调查对象536人,其中砷中毒组155人、对照组381人,水砷含量范围为0.0~825.7μg/L。与对照组比较,砷中毒组性别、文化程度、氟斑牙患病分布情况,差异均无统计学意义(均P>0.05);而年龄、婚姻状况、吸烟、饮酒、水砷含量分布情况,差异均有统计学意义(均P<0.05)。与对照组比较,砷中毒组尿As^(Ⅲ)、iAs、MMA^(V)、DMA^(V)、tAs、MMA%、MMA/DMA和指甲砷水平均较高(均P<0.05),尿DMA%、SMI和指甲硒水平均较低(均P<0.05),而尿iAs%和PMI水平差异均无统计学意义(均P>0.05)。性别、文化程度、水井深度、水砷含量、总井数和指甲砷水平是尿As^(Ⅲ)水平的影响因素(β=-19.82、-23.83、0.61、0.21、7.26、2.98,均P<0.05);年龄、水井深度、水砷含量和指甲砷水平是尿tAs水平的影响因素(β=3.18、3.25、1.31、15.59,均P<0.05);性别、文化程度、水井深度、水砷含量、总井数和指甲砷水平是尿iAs水平的影响因素(β=-20.47、-25.90、0.64、0.25、7.87、3.11,均P<0.05);年龄、性别、文化程度、水砷含量和指甲砷水平是尿MMA^(V)水平的影响因素(β=0.52、-17.07、-21.84、0.22、2.77,均P<0.05);年龄、水井深度、水砷含量和指甲砷水平是尿DMA^(V)水平的影响因素(β=2.35、2.47、0.85、9.22,均P<0.05)。结论与健康人群比较,饮水型砷中毒人群砷代谢模式存在差异,年龄、性别、文化程度、水井深度、水砷含量、总井数以及指甲砷水平可能是不同砷代谢模式的影响因素。
Objective To investigate the arsenic metabolism pattern and possible influencing factors in the population in drinking-water-borne endemic arsenic poisoning(drinking-water-borne arsenic poisoning for short)areas.Methods In December 2004,a cluster sampling method was used to select arsenic poisoning population(arsenic poisoning group)and healthy population(control group)in drinking-water-borne arsenic poisoning area of Bayannur City,Inner Mongolia Autonomous Region as the survey subjects.A questionnaire survey was conducted.Arsenic content in drinking water at home of survey subjects,the levels of urinary arsenic and its metabolites,including[trivalent arsenic(As^(Ⅲ)),inorganic arsenic(iAs),monomethylarsenic acid(pentavalent,MMA^(V)),dimethylarsenic acid(pentavalent,DMA^(V)),total arsenic(tAs),percentage of inorganic arsenic(iAs%),percentage of monomethylarsenic acid(MMA%),percentage of dimethylarsenic acid(DMA%),primary methylation index(PMI),secondary methylation index(SMI)]were tested using high performance liquid chromatography-inductively coupled plasma mass spectrometry;nail arsenic and nail selenium levels were tested using atomic fluorescence spectrometer.The influencing factors of arsenic metabolism pattern were analyzed by multiple linear regression.Results A total of 536 survey subjects were included,including 155 individuals in the arsenic poisoning group and 381 in the control group.The water arsenic level ranged from 0.0 to 825.7μg/L.Compared with the control group,there was no significant difference in the distribution of gender,education level and dental fluorosis in the arsenic poisoning group(P>0.05),but there were significant differences in the distribution of age,marital status,smoking,drinking and water arsenic(P<0.05).Compared with the control group,the levels of urinary As^(Ⅲ),iAs,MMA^(V),DMA^(V),tAs,MMA%,MMA/DMA and nail arsenic in the arsenic poisoning group were higher(P<0.05),while the levels of urinary DMA%,SMI and nail selenium were lower(P<0.05);but there was no statistically significant difference in the levels of urinary iAs%and PMI(P>0.05).Gender,education level,depth of wells,water arsenic,total number of wells and nail arsenic were the influencing factors of urinary As^(Ⅲ)(β=-19.82,-23.83,0.61,0.21,7.26,2.98,P<0.05).Age,depth of wells,water arsenic and nail arsenic were the influencing factors of urinary tAs(β=3.18,3.25,1.31,15.59,P<0.05).Gender,education level,depth of wells,water arsenic,total number of wells and nail arsenic were the influencing factors of urinary iAs(β=-20.47,-25.90,0.64,0.25,7.87,3.11,P<0.05).Age,gender,education level,water arsenic and nail arsenic were the influencing factors of urinary MMA^(V)(β=0.52,-17.07,-21.84,0.22,2.77,P<0.05).Age,depth of wells,water arsenic and nail arsenic were the influencing factors of urinary DMA^(V)(β=2.35,2.47,0.85,9.22,P<0.05).Conclusions Compared with healthy individuals,there are differences in arsenic metabolism pattern among individuals with drinking-water-borne arsenic poisoning.Age,gender,education level,depth of wells,water arsenic,total number of wells and nail arsenic may be influencing factors of different arsenic metabolism patterns.
作者
李梦昕
李昕晔
赵凡
刘聪
邓丹宇
狄震
崔娜
刘一君
孔畅
韦炳干
李艳红
夏雅娟
郭志伟
Li Mengxin;Li Xinye;Zhao Fan;Liu Cong;Deng Danyu;Di Zhen;Cui Na;Liu Yijun;Kong Chang;Wei Binggan;Li Yanhong;Xia Yajuan;Guo Zhiwei(School of Public Health,Inner Mongolia Medical University,Hohhot 010110,China;Research and Education Office,Inner Mongolia Autonomous Regional Center for Disease Control and Prevention(Inner Mongolia Autonomous Regional Academy of Preventive Medicine),Hohhot 010080,China;Department for Endemic Diseases Prevention and Control,Hangjinhou Banner Center for Disease Control and Prevention,Bayannur 015400,China;Institute for Endemic Disease Control and Prevention,Inner Mongolia Autonomous Regional Center for Disease Control andPrevention(Inner Mongolia Autonomous R egional Academy of Preventive Medicine),Hohhot 010080,China;Key Laboratory of Land Surface Pattern and Simulation,Institute of Geographic Sciences and Natural Resources Research,Chinese Academy of Sciences,Beijing 100101,China)
出处
《中华地方病学杂志》
CAS
北大核心
2024年第3期184-189,共6页
Chinese Journal of Endemiology
基金
中央引导地方科技发展资金项目(2021ZY0047)
"西部青年学者"项目
内蒙古自治区科技计划项目(2021GG0383)
内蒙古自治区卫生健康科技计划项目(202201161)
关键词
砷中毒
甲基化
代谢
线性回归分析
Arsenic poisoning
Methylation
Metabolism
Linear regression analysis
作者简介
李梦昕,对本文有同等贡献;李昕晔,对本文有同等贡献;通信作者:郭志伟,Email:gzwnmg@163.com
