环境镉暴露对血管内皮功能障碍的贡献度分析

The contribution of environmental cadmium exposure to vascular endothelial dysfunction

目的:探讨环境中不同镉(Cd)暴露水平对血管内皮功能障碍的贡献程度。方法:在广西某废弃铅锌矿周边及相邻乡镇非污染区的下属行政村屯招募当地20～80岁的常住居民共667名作为研究对象,以肱动脉血流介导的血管舒张功能(FMD)评价血管内皮功能,以尿镉(UCd)浓度反映机体慢性Cd暴露的程度。基于性别分层,按UCd浓度将研究对象分成低、中、高3个浓度组,运用Logistic回归和优势分析法分析不同Cd暴露水平对血管内皮功能障碍的影响和贡献大小。结果:低、中、高水平Cd暴露下,UCd对血管内皮功能障碍的贡献在男性中分别为1.1%、5.5%、8.6%,在女性中分别为7.1%、4.4%、3.2%;不同暴露水平下,UCd对血管内皮功能障碍发生风险的影响差异均无统计学意义(均P>0.05)。结论:不同Cd暴露水平对血管内皮功能障碍的贡献不同且存在性别差异,在男性中呈增高趋势,在女性中呈降低趋势。

Objective: To explore the contribution of different levels of environmental cadmium (Cd) exposure to vascular endothelial dysfunction. Methods: We recruited 667 residents aged 20-80 years old in the subordinate administrative village of an abandoned lead-zinc mine and the non-polluted area in an adjacent township in Guangxi.Vascular endothelial function was assessed by brachial artery flow-mediated dilatation (FMD),the degree of chronic Cd exposure was reflected by urinary cadmium (UCd).Subjects were divided into three groups of low,medium and high according to the concentration of UCd by sex,logistic regression and dominance analysis were used to analyze the effects of different Cd exposure levels on vascular endothelial dysfunction and its contribution. Results: At levels of low,medium and high of Cd exposure,the contribution of UCd to vascular endothelial dysfunction in men were 1.1%,5.5%,and 8.6%,respectively,in women were 7.1%,4.4%,and 3.2%,respectively.Under different exposure levels,there were no significant difference in the effects of UCd on the risk of vascular endothelial dysfunction (P >0.05). Conclusion: Different Cd exposure levels contribute differently to vascular endothelial dysfunction and there are gender differences,which are increased in men and decreased in women.