基准剂量法在氟性骨损伤相关指标评价中的应用与分析

Application of Benchmark Dose(BMD) Method for Fluoride Bone Injury Related Indicators

目的用基准剂量法对氟性骨损伤相关指标进行评价与分析,寻找氟性骨损伤敏感指标,为氟性骨损伤危险度评价提供依据。方法测定职业性氟暴露人群尿氟(UF)以及血清骨钙素(BGP)、血清降钙素(CT)、碱性磷酸酶(ALP)和骨特异性碱性磷酸酶(BALP)等指标,并计算各指标的尿氟基准剂量(BMD)值和基准剂量下限(BMDL)值。结果氟接触组UF、BGP、CT、ALP和BALP的均值分别为4.97 mg/L、6.59 ng/ml、81.03 pg/ml、83.56 U/L和147.56 U/L,与对照组比较,均明显升高,差异有统计学意义(P<0.05)。BGP值随氟负荷的增高而升高,差异有统计学意义(P<0.05);高负荷组CT、ALP和BALP值明显高于低负荷组,差异有统计学意义(P<0.05)。BGP和BALP的异常率随氟负荷增加而升高,线性趋势明显,差异有统计学意义(P<0.05)。BGP和BALP的BMD值分别是1.26、2.82 mg/L;BMDL值分别是0.88、2.01 mg/L。结论基准剂量法评价氟性骨损伤及其相关指标的应用简便易行,引起氟性骨损伤相关指标改变的尿氟BMD和BMDL值分别为1.26、0.88 mg/L。提示,BGP是氟性骨损伤的早期敏感指标。

Objective To assess and analyze the fluoride bone injury indicators with the BMD method, try to find the sensitive indicators of fluoride bone injury and provide the criteria for risk assessment.Methods Detect the urine fluoride（UF） and the indicators such as serum osteocalcin（BGP）,serum calcitonin（CT）, alkaline phosphatase（ALP） and bone specific alkaline phosphatase（BALP） of the subjects exposed to fluoride, calculate the BMD and BMDL values of these indicators.Results The means of UF,BGP,CT,ALP and BALP in fluoride exposure group were 4.97 mg/L,6.59 ng/ml,81.03 pg/ml,83.56 U/L and 147.56 U/L,which were higher than those of the control group,the differences were significant（P〈0.05）. BGP level increased when the fluoride load level increased,the differences were statistically significant（P〈0.05）.CT,ALP and BALP levels were higher than the low-load group only in the high-load group,the differences were significant（P〈0.05）.The abnormality rate of BGP and BALP increased with the increase of fluoride load,linear trend was clear,the difference was statistically significant（P〈0.05）.The respective BMD values of BGP and BALP were 1.26 and 2.82 mg/L;the BMDL values of each were 0.88 and 2.01 mg/L.Conclusions Application of benchmark dose method to evaluate fluoride bone injury related indicators is simple and convenient,the BMD and BMDL values of urinary fluoride are 1.26 and 0,88 mg/L which could be turned into the fluoride bone injury related indicators.So the study suggests that BGP could be is taken as a sensitive indicator for fluoride bone injury.