中国9个长寿地区65岁及以上人群血铅浓度与认知功能受损的关联研究

Association of blood lead level with cognition impairment among elderly aged 65 years and older in 9 longevity areas of China

目的探讨65岁及以上人群血铅水平与认知功能受损的关联。方法研究对象来自2017-2018年在我国9个长寿地区开展的“老年健康生物标志物队列研究”,最终将1684名血铅和认知功能数据完整的65岁及以上人群纳入本研究。通过问卷调查和体格检测,收集调查对象的人口学特征、生活方式、健康状况及认知功能评分等信息;同时采集调查对象的静脉血以检测血铅水平。根据血铅水平的四分位数将调查对象分为4组(Q_(1)-Q_(4)组),采用多因素logistic回归模型分析血铅浓度与认知功能受损的关系,采用限制性三次样条检验血铅浓度与认知受损之间是否存在非线性关联。结果1684名研究对象年龄为(83.1±11.1)岁,其中女性843名(50.1%);认知功能受损者191名(11.3%)。调整相关混杂因素后,老年人血铅浓度每升高10μg/L,认知功能受损患病风险OR(95%CI)值为1.05(1.01~1.10);与血铅浓度Q1组老年人相比,血铅浓度较高者认知功能受损的患病风险较高,Q_(2),Q_(3),Q_(4)组的OR(95%CI)值分别为1.19(0.69~2.05)、1.45(0.84~2.51)和1.92(1.13~3.27)。结论我国9个长寿地区65岁及以上老年人血铅水平与认知功能受损患病风险存在关联。

Objective To investigate the association between blood lead concentrations and cognition impairment among Chinese older adults aged 65 or over.Method Data was collected in 9 longevity areas from Heathy Aging and Biomarkers Cohort Study between 2017 and 2018.This study included 1684 elderly aged 65 years and older.Information about demographic characteristics,socioeconomic factors,health status and cognitive function score of respondents were collected by questionnaire survey and physical examination.Venous blood of the subjects was collected to detect the blood lead concentration.Subjects were stratified into four groups(Q_(1)-Q_(4))by quartile of blood lead concentration.Multivariate logistic regression model was used to analyze the association between blood lead concentration and cognitive impairment.The linear or non-linear association between blood lead concentration and cognitive impairment were described by restrictive cubic splines(RCS).Results Among the 1684 respondents,843(50.1%)were female and 191(11.3%)suffered from cognition impairment.After adjusting for confounding factors,the OR value and 95%CI of cognition impairment was 1.05(1.01-1.10)for every 10μg/L increase in blood lead concentration in elderly;Compared with the elderly in Q1,the elderly with higher blood lead concentration had an increased risk of cognitive impairment.The OR value and 95%CI of Q_(2),Q_(3)and Q_(4) groups were 1.19(0.69-2.05),1.45(0.84-2.51)and 1.92(1.13-3.27),respectively.Conclusion Higher blood lead concentration is associated with cognitive impairment among the elderly aged 65 years and older in 9 longevity areas in China.