中性粒细胞与淋巴细胞比例在多环芳烃和轻度认知功能障碍关系中的中介作用

Mediating role of neutrophil-lymphocyte ratio in association between polycyclic aromatic hydrocarbons and mild cognitive impairment

[背景]多环芳烃作为一种环境污染物,具有神经毒性,它可能通过诱导炎症引起轻度认知功能障碍(MCI)。中性粒细胞与淋巴细胞比例(NLR)是一种炎症指标,是否在多环芳烃暴露和MCI关系中发挥中介作用尚不清楚。[目的]探讨外周血NLR在焦化厂工人多环芳烃暴露与MCI关系中的中介作用。[方法]采用高效液相色谱-串联质谱联用法测定530名焦炉工人尿中的11种羟基多环芳烃(OH-PAHs),使用全自动血液分析仪进行常规血液检查并计算外周血NLR。使用二元logistic回归分析尿OH-PAHs与MCI的关系,使用多元线性回归分析尿OH-PAHs与外周血NLR的关系,使用中介效应方法分析外周血NLR在尿OH-PAHs和MCI关系中的作用。[结果]在调整混杂因素和其他OH-PAHs之后,二元logistic回归结果显示工人尿中2-羟基萘(2-OHNap)和1-羟基菲(1-OHPhe)的浓度每增加e倍(e为自然对数的底数),MCI阳性的OR(95%CI)分别为1.21(1.02~1.43)和1.25(1.04~1.51);NLR浓度每增加一个单位,MCI阳性的OR(95%CI)为1.56(1.12~2.18);多元线性回归分析结果显示焦炉工的尿1-OHPhe浓度每增加一个自然对数单位,外周血NLR水平增加0.05(95%CI:0.01~0.10);中介分析结果显示外周血NLR在尿1-OHPhe与MCI关系中起到部分中介作用,中介比例为9.8%。[结论]焦化厂工人多环芳烃暴露可能通过外周血NLR上升而增加MCI阳性的风险。

[Background]As a group of environmental pollutants,polycyclic aromatic hydrocarbons(PAHs)are neurotoxic and may cause mild cognitive impairment(MCI)by inducing inflammation.Whether neutrophil-lymphocyte ratio(NLR),an inflammatory indicator,plays a mediating role in the relationship between PAHs exposure and MCI is unclear yet.[Objective]To investigate a potential mediating role of NLR in the association between exposure to PAHs and MCI in coke oven plant workers.[Methods]Eleven urine hydroxylated PAHs(OH-PAHs)of 530 coke oven plant workers were determined by high performance liquid chromatography tandem mass spectrometry.NLR was derived from participants'routine blood examination results using a fully automated haematology analyser.The associations between urinary OH-PAHs and MCI were analyzed by binary logistic regression,the associations between urinary OH-PAHs and NLR were analyzed by multiple linear regression,and the role of NLR in the relationship between urinary OH-PAHs and MCI was evaluated by mediating effect analysis.[Results]After controlling for confounding factors and other OH-PAHs,the results of binary logistic regression showed that for every e-fold(e is the base of the natural logarithm)increase in the concentration of 2-hydroxynaphthalene(2-OHNap)and 1-hydroxyphenanthrene(1-OHPhe),the OR(95%CI)values of reporting MCI positive were 1.21(1.02,1.43)and 1.25(1.04,1.51)respectively.For each unit increase of NLR,the OR(95%CI)of reporting MCI positive was 1.56(1.12,2.18).The results of multiple linear regression showed that each unit increase in natural log-trans formed levels of 1-OHPhe was associated with 0.05(95%CI:0.01,0.10)increase of NLR.The results of mediating effect analysis showed that the association between urinary 1-OHPhe and MCI was partially mediated by peripheral blood NLR,with a mediation ratio of 9.8%.[Conclusion]Exposure to PAHs in coke oven plant workers may increase the risk of reporting MCI positive partially through increased NLR in peripheral blood.