不同硒水平地区老年人全血营养元素水平分析

Comparison of six nutrient elements status in whole blood of older adults among four areas with different soil selenium levels

目的分析不同土壤硒水平地区60岁及以上农村老年人全血硒、锌、铜、镁、钙、铁水平及其影响因素, 为进一步评估不同土壤硒水平地区人群健康风险提供依据。方法 2017 - 2018年在湖北省恩施土家族苗族自治州(以下简称恩施州)选择土壤硒含量呈梯度差异的极高硒地区(土壤硒含量≥3.000 mg/kg)、高硒地区(土壤硒含量为0.400 ~ < 3.000 mg/kg)、足硒地区(土壤硒含量为0.175 ~ < 0.400 mg/kg)和低硒地区[土壤硒含量< 0.175 mg/kg], 各抽取1个行政村作为调查点;每个调查点抽取100名60岁及以上老年人作为调查对象(男女各半)。采用面对面问卷调查方式收集调查对象一般人口学、生活行为方式等基本信息, 进行体格检查并采集清晨空腹静脉血;利用水浴消解-电感耦合等离子体质谱法检测人群全血硒、锌、铜、镁、钙和铁6种元素含量, 并进行营养元素水平影响因素分析。结果共纳入调查对象416人, 其中男性208人、女性208人, 年龄为(72.43 ± 5.25)岁, 身体质量指数(BMI)为(22.67 ± 3.49)kg/m2。不同硒水平地区人群全血硒、锌、铜、镁、钙和铁元素水平比较差异均有统计学意义(Z/F = 288.30、3.24、14.81、29.14、131.28、3.37, P均< 0.05)。其中, 与低硒地区和足硒地区比较, 高硒地区和极高硒地区人群全血硒水平均较高, 极高硒地区全血锌水平均较低(P均< 0.05);与足硒地区比较, 低硒地区、高硒地区和极高硒地区全血铜水平均较低, 全血镁、钙水平均较高(P均< 0.05), 且极高硒地区全血铁水平较低(P < 0.05)。不同硒水平地区人群硒、锌、铜、镁、钙、铁缺乏率比较差异均有统计学意义(χ^(2) = 140.83、15.39、31.90、17.49、157.60、30.33, P均< 0.01)。总人群营养元素水平影响因素分析结果显示, 全血锌、铜、钙和铁水平在性别间比较差异均有统计学意义(P均< 0.05);吸烟人群全血锌和铁水平均高于不吸烟人群, 全血铜水平低于不吸烟人群(P均< 0.01);饮酒人群全血锌和铁水平均高于不饮酒人群(P均< 0.05)。结论不同土壤硒水平地区老年人全血6种营养元素水平均存在差异, 评估不同土壤硒水平地区人群健康风险需同时考虑多种营养元素水平。

Objective To analyze the differences in whole blood selenium(Se),zinc(Zn),copper(Cu),magnesium(Mg),calcium(Ca),and iron(Fe)levels of rural older adults among areas with different soil selenium levels,and explore the main factors associated with the six nutrient elements status,so as to provide a basis for further evaluating the health risks of people in areas with different soil selenium levels.Methods Four administrative villages were randomly selected from the Se-deficient(soil Se content<0.175 mg/kg),Se-sufficient(soil Se content 0.175-<0.400 mg/kg),Se-rich(soil Se content 0.400-<3.000 mg/kg)and Se-excessive(soil Se content≥3.000 mg/kg)areas,respectively,in Enshi Tujia and Miao Autonomous Prefecture(Enshi Prefecture)of Hubei Province in 2017-2018.And 100 elderly people aged 60 years or older(half male and half female)were randomly selected as the survey subjects in each servey site.The basic information such as general demography and lifestyle was collected through face-to-face questionnaires.Physical examination was performed and fasting venous blood was collected in the morning.The contents of blood Se,Zn,Cu,Mg,Ca,and Fe were determined by inductively coupled plasma mass spectrometry.The main factors associated with the six nutrient elements status were analyzed.Results A total of 416 subjects were included,including 208 males and 208 females,whose average age was(72.43±5.25)years,and body mass index(BMI)was(22.67±3.49)kg/m2.There were significant differences of blood Se,Zn,Cu,Mg,Ca and Fe levels between the areas with different Se levels(Z/F=288.30,3.24,14.81,29.14,131.28,3.37,P<0.05).Compared with Se-deficient and Se-sufficient areas,blood Se level was higher in Se-rich and Se-excessive areas and blood Zn level was lower in Se-excessive area(P<0.05);compared with Se-sufficient area,blood Cu level was lower in Se-deficient,Se-rich and Se-excessive areas,but blood Mg and Ca levels were higher(P<0.05),and the blood Fe level was lower in Se-excessive area(P<0.05).There were significant differences in the deficiency rates of Se,Zn,Cu,Mg,Ca and Fe among the elderly in different Se level areas(χ^(2)=140.83,15.39,31.90,17.49,157.60,30.33,P<0.01).There were significant differences in blood Zn,Cu,Ca and Fe levels between two gender groups(P<0.05);the blood Zn and Fe levels of the smokers were higher than those of the non-smokers,and the blood Cu level was lower than that of the non-smokers(P<0.05);the blood Zn and Fe levels of the drinkers were higher than those of the non-drinkers(P<0.05).Conclusions The levels of six nutrient elements in the whole blood of the elderly in areas with different soil Se levels are different.To assess the health risks of the population in areas with different soil Se levels,it is necessary to consider the levels of multiple nutrient elements at the same time.