环境镉污染区人群镉暴露水平与肾损伤间的关系

发布时间：2018-07-12 18:46

本文选题：环境镉污染 + 镉暴露　；参考：《中国疾病预防控制中心》2012年硕士论文

【摘要】：[目的] 了解环境镉污染区人群的镉暴露水平及人群肾损害情况,观察不同镉暴露水平下人群的肾损伤的变化情况,即探索不同环境镉暴露水平下人群的尿镉水平以及尿NAG、尿β2-M等健康效应指标的消长规律与变化幅度。 [方法] 本论文所用的膳食调查数据与人群健康调查数据均来源于中国疾病预防控制中心环境所于2010年完成的《贵州赫章镉污染区环境镉污染及人群健康状况调查报告》,该项目已经通过环保部验收。通过对环境镉污染区201户546人的连续三日膳食调查获得当地人群的膳食数据,结合当地主要农作物样品中的镉含量,估算出人群的膳食镉暴露水平,以此来衡量人群的环境镉暴露水平；并在污染区与对照区开展人群的健康损害情况调查,收集调查对象的尿样(污染区948份,对照区403份),通过检测尿样中尿镉、尿NAG、尿β2-M等指标以了解人群的肾功能状况。然后将人群环境镉暴露水平与尿镉及肾损伤指标对应起来进行研究,观察在不同镉暴露水平下人群的尿镉及肾损伤指标的变化情况。农作物样本镉含量采用石墨原子吸收法检测；尿镉采用等离子发射光谱-质谱法(ICP-MS)检测；尿NAG采用分光光度计比色法检测；尿β2-M采用放射免疫分析法检测；尿肌酐采用碱性苦味酸测定法检测。 [结果] 1)污染区人群镉累积摄入量的均值为1735.20mg,明显高于对照区镉累积摄入量456.64mmg；而两区人群间尿镉及肾损伤指标值的分析结果为污染区的尿镉值显著高于对照区值(P0.01),而对照区的尿NAG要高于污染区(P0.01),尿β2-M两区间未见差异(P0.05)。 2)将污染区人群按照镉累积摄入量不同划分为5个镉累积摄入组,根据分组数据统计分析发现：同等镉摄入水平下,人群各尿镉及肾损伤指标值的性别差异不大；而且人群的尿镉、尿β2-M指标值的年龄差异也不大(P0.05),但是人群尿NAG水平却有随年龄增长的而上升的趋势(P0.05) 3)镉累积摄入量分组数据分析结果表明：污染区人群的尿镉水平随镉累积摄入量的增长而升高(P0.05),且尿镉的这种变化趋势与性别、年龄因素无关；而尿NAG、β2-M却未呈现出类似的趋势；尿镉分组数据分析结果表明：污染区人群的尿NAG、β2-M随尿镉的增长而升高(P0.05),且这种变化趋势与性别、年龄因素无关。 4)分别以镉累积摄入水平与村别(污染区各村的镉暴露水平不同)为分组依据,进行镉累积摄入量与尿镉及肾损伤指标的曲线回归分析。结果发现：各镉累积摄入组、各村别的尿镉值与镉累积摄入量的关系均呈“S”曲线上升模式；而尿NAG、β2-M与镉累积摄入量的关系未呈现出类似趋势。 5)单因素卡方分析与多因素Logistic回归分析结果表明：镉累积摄入量为污染区人群的尿镉、尿β2-M异常率的影响因素(P0.05),即随着镉累积摄入量的增加,污染区人群的尿镉、尿β2-M的发生异常的风险会升高。 [结论] 1)污染区人群终生镉累积摄入量(75岁)男性为2286.9mg,女性为2015.0mg,刚刚超过WHO建议的健康效应暴露阈值2000mg,而且相比于国内其它镉污染区的情况,赫章的镉污染情况不是很严重。 2)在当前的环境镉暴露水平下,作为体内镉负荷指标的尿镉随着镉累积摄入量的增多而升高的趋势已经显现,但是当地的镉暴露人群并未出现明显的肾损伤情况。
[Abstract]:[Objective]
To investigate the level of cadmium exposure and renal damage in the population of environmental cadmium polluted areas, and to observe the changes of renal damage in the crowd at different levels of cadmium exposure, that is to explore the level of urine cadmium in the crowd at different levels of cadmium exposure and the law and change range of the index of the health effect of urine NAG, urine beta 2-M and so on.
[method]
The data of dietary survey and population health survey used in this paper were derived from the report on the environmental cadmium pollution and the health status of the population in the cadmium polluted area of Hezhang, Guizhou, which was completed in 2010 by the environment of China Center for Disease Control and prevention. The project has been accepted by the Ministry of environmental protection.
In order to measure the level of dietary cadmium exposure in the population, the level of cadmium exposure in the population was estimated through the dietary data of 546 people from 201 households in the environmental cadmium polluted area and the dietary data of the local population, combined with the cadmium content in the local major crop samples. The urine samples (948 polluted areas and 403 control areas) were collected to investigate the renal function of the urine samples, such as urine, cadmium, urine NAG, and urine beta 2-M, and then the cadmium exposure level of the crowd was corresponded with the urine cadmium and kidney damage indexes to observe the urine cadmium and kidney damage at different levels of cadmium exposure. The change of the injury index.
The content of cadmium in crop samples was detected by graphite atomic absorption spectrometry; urine cadmium was detected by plasma emission spectrometry (ICP-MS); urine NAG was detected by spectrophotometer colorimetry; urine beta 2-M was detected by radioimmunoassay; urine creatinine was detected by alkaline picric acid assay.
[results]
1) the average cadmium intake of the population in the polluted area was 1735.20mg, which was significantly higher than the cadmium accumulated intake of 456.64mmg in the control area, while the results of urinary cadmium and kidney damage in the two areas were significantly higher than those of the control area (P0.01), while the urine NAG in the control area was higher than that in the polluted area (P0.01), and the interval of urinary beta 2-M two was not poor. Difference (P0.05).
2) the population of the polluted area was divided into 5 cadmium accumulative intake groups according to the difference of cadmium accumulation intake. According to the statistical analysis of the group data, it was found that the sex difference of urine cadmium and kidney damage index of the crowd was not significant, and the age difference of urine cadmium and urine beta 2-M index of the crowd was not significant (P0.05), but the population urine NAG water But there is an upward trend in age (P0.05).
3) the analysis of cadmium cumulative intake group data showed that the urine cadmium level in the polluted area increased with the increase of the cumulative intake of cadmium (P0.05), and the trend of urine cadmium was not related to sex and age, while urine NAG, beta 2-M did not show a similar trend; urine cadmium group data analysis showed that the urine of contaminated area population was urine. NAG and 2-M increased with the increase of urinary cadmium (P0.05), and this trend was independent of sex and age.
4) on the basis of the cumulative intake of cadmium and the villages in the village (the levels of cadmium exposure in the villages of the polluted areas) as the basis, the cumulative intake of cadmium and urine cadmium and kidney damage indexes were analyzed. The results showed that the relationship between the cadmium accumulated intake of each village and the cumulative intake of cadmium in each village was on the "S" curve. The relationship between NAG, beta 2-M and cumulative intake of cadmium did not show a similar trend.
5) single factor chi square analysis and multiple factor Logistic regression analysis showed that the cumulative intake of cadmium was the influence factor (P0.05) of urinary cadmium and urinary beta 2-M (P0.05), that is, the risk of urinary cadmium and urinary beta 2-M increased with the increase of cumulative cadmium intake.
[Conclusion]
1) the lifetime cadmium intake (75 years old) of the population in the polluted area was 2286.9mg and the female was 2015.0mg. The exposure threshold of the health effect recommended by WHO was 2000mg, and the cadmium pollution in Hezhang was not very serious compared to the other cadmium contaminated areas in China.
2) in the current environmental cadmium exposure level, the trend of cadmium in urine as a indicator of cadmium load in the body increases with the increase of cumulative cadmium intake, but there is no obvious renal damage in the local cadmium exposed population.
【学位授予单位】：中国疾病预防控制中心
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R114

【参考文献】