影响三地居民黄曲霉毒素B_1-白蛋白加合物的相关因素分析

Related Factors Influencing the Bio-effect of Aflatoxin B1 Exposure in Three Chinese Populations

[目的]分析影响存在肝癌发病率梯度的三地居民个体黄曲霉毒素生物效应的相关因素。[方法]对广西扶挼两个自然村农民、南宁和四川成都城市居民采用酶联免疫法检测血浆黄曲霉毒素B1-白蛋白加合物(AFB1-AlbuminAdducts,AAA)水平、肝炎病毒(hepatitisvirus,HV)标志物(HBV两对半,HCV、HDV、HEV和HGV抗体)及肝功能。[结果]扶挼47.2%(42/89)的居民至少1种HV感染标志物阳性;南宁和成都分别为15.8%(31/196)和22.7%(27/119)。Log(AAA)水平(n,x±s)为扶挼(89,2.44±0.16)和南宁(196,2.45±0.15)均高于成都(118,2.20±0.24),(P=0.000);但扶挼与南宁间差别无显著性(P=0.859)。南宁(P=0.023)、成都(P=0.026)两地男性AAA水平均高于女性。扶挼和成都两地HV感染者AAA水平均高于非感染者(P分别为0.447和0.041)。HV(-)组中,AAA水平与年龄(r=-0.199,P=0.000)和BMI(r=-0.158,P=0.006)负相关。HV(+)组AAA分别与白蛋白(P=0.000)、球蛋白(P=0.012)和天冬氨酸转氨酶(P=0.052)相关,而HV(-)组AAA分别与直接胆红素、间接胆红素、白蛋白、γ-谷氨酰转肽酶、总胆汁酸和碱性磷酸酶相关(P<0.05)。[结论]AFB1暴露的生物效应可能受肝炎病毒感染、性别、年龄和代谢等因素的影响。AAA与肝功能指标的相关性提示AFB1对肝脏实质或胆道细胞的损害作用。

[Objective] To investigate risk factors influencing bio-effect of the exposure to aflatoxin B1 in the residents of Fusui County and Nanning City of Guangxi Province and Chengdu City of Sichuan Province. [Methods] Residents from Fusui(89) ,Nanning (196) and Chengdu(118) were screened for AFB1-albumin adducts(AAA) levels and HV(HBV,HCV,HDV,HEV and HGV antibody) infection markers by enzyme-linked immunosorbent assay. [Results] Infection rate of HV in Fusui,Nanning and Chengdu was 47.2% (42/89), 15.8% (31/1%) and 22.7%(27/119), respectively. Log(AAA) level(n, mean±SD) of both Fusui (89, 2.44±0.16) and Nanning(196, 2.45±0.15) was significantly higher than that of Chengdu(118, 2.20±0.24)(P=0.000) .whereas the difierence of AAA level between Fusui and Nanning was not statistically significant(P=0.859). AAA level of males was higher than that of females and there was the statistically significant difference between males and females in both Nanning(P=0.023) and Chengdu(P=0.026) but not in Fusui group(P=0.176) . A higher level of AAA was seen in subjects with HV infection in Chengdu group(P=0.041) . There was negative-correlation between AAA level and age(r =-0.199,P=0.000),and between AAA level and BMI(r=-0.158, P=0. 006) in HV(-) subjects.There was a close association of AAA with GLO( P = 0.012) and AST(P=0.052) in HV(+) subjects, while a close association of AAA with DBIL,IBIL, ALB,GGT,TBA and ALP in HV(-) subjects(P<0.05) . [Conclusion] Age,gender, BMI and HV infection might modify the bio-effect of AFB1 in each individual. The association of AAA with liver function index suggests the injury by AFB1 to both parenchyma and biliary cells inside liver.