钢铁企业高温作业工人维生素C营养状况与血尿酸关系

Relations between the nutritional status of vitamin C and the serum uric acid level among heat-exposed steelworkers

目的了解钢铁企业高温作业工人维生素C营养状况与其血尿酸水平的关系。方法于2016年6—7月采用整群抽样方法选取钢铁企业高温作业工人224人,进行膳食调查和汗、尿液样品收集,用体重差法计算出汗量,测定工作场所湿球黑球温度指数及汗、尿中维生素C和血清血尿酸含量。结果钢铁高温作业工人维生素C平均摄入量为(102.0±23.3)mg/d,低于高温作业人员推荐量;尿中排出的维生素C平均值为(6.1±2.3)mg/g Cr,体内维生素C水平不足者占95.1%;工人工间汗中维生素C排出量为(16.3±7.8)mg。高温作业Ⅳ级工人维生素C的工间汗中排出量高于Ⅲ级工人,其体内水平低于Ⅲ级工人,差异均有统计学意义(P<0.01)。工人血尿酸平均浓度为(421.6±86.2)μmol/L,血尿酸偏高的占38.4%,其中高温作业Ⅳ级工人的血尿酸水平高于Ⅲ级工人,差异有统计学意义(P<0.01)。经单因素相关分析,高温作业工人维生素C摄入量与其血尿酸水平呈负相关(r=-0.181,P=0.007);工间汗中维生素C排出量与血尿酸水平呈正相关(r=0.180,P=0.007);体内维生素C水平与血尿酸水平呈负相关(r=-0.186,P=0.007)。经多重线性逐步回归分析,维生素C摄入量、体内维生素C水平均与血尿酸水平呈负相关,工间汗中维生素C排出量与血尿酸水平呈正相关,差异均有统计学意义(β值分别为-0.813,-5.736,2.171,均P<0.05)。结论本次调查的钢铁企业高温作业工人维生素C的营养状况较差,血尿酸水平偏高;工人维生素C的摄入、消耗和体内水平均对血尿酸浓度有影响。

Objective To understand the relations between the nutritional status of vitamin C and the serum uric acid level of heat-exposed steelworkers. Methods A total of 224 heat-exposed steelworkers were investigated by cluster sampling during June -July,2016. Diet surveys were conducted. The sweat and urine samples were collected, and the volume of sweat was calculated by comparing the difference of weight. The wet-bulb globe temperature index was measured in operational sites. The contents of vitamin C in sweat and urine and the uric acid in serum were measured. Results Vitamin C intake of heat-exposed steelworkers was (102.0±23.3) mg/d, which was lower than the recommended nutrient intake in Dietary Guide for Workers in Hot Environment(WS/T 577-2017). The average excretion ratio of vilamin C and creatinine in urine was (6.1 ±2.3) mg/g Cr, the heat-exposed steelworkers with vitamin C deficiency accounted for 95」%. The vitamin C losses in sweat during an eight-hour work of heat-exposed steelworkers was (16.3±7.8) mg;Compared with steelworkers with III -grade high-temperature operation, the vitamin C losses in sweat of steelworkers with IV -grade high -temperature operation was higher, the levels of vitamin C in urine were lower (P<0.01). The levels of uric acid in serum of steelworkers were (421.6±86.2)μmol/L, 38.4% of which were higher than 440 pimol/L. The levels of serum uric acid of steelworkers IV -grade high -temperature operation was higher than those with DI -grade high-temperature operation (P<0.01). Vitamin C intake of heat-exposed steelworkers had an negative correlation with the serum uric acid level (r=-0.181, P=0.007);The serum uric acid levels were positively correlated with the vitamin C losses in sweat (r=0.180, P=0.007),and negatively correlated with the excretion ratio of vitamin C and creatinine in urine β=-0.186, P=0.007). Multiple linear stepwise regression analysis showed that vitamin C intake 0=-0.813, P<0.05) and levels of vitamin C in urine(0=-5.736, P<0.05) were negatively correlated with the serum uric acid level, vitamin C losses were positively correlated with serum uric acid level (/3=2.171, P<0.05). Conclusion In the present study on the nutritional status, vitamin C was deficient among heat-exposed steelworkers, and serum uric acid is relatively higher. Vitamin C intake and losses in sweat have an effect on serum uric acid level of heat-exposed steelworkers.