有机磷酸酯阻燃剂暴露与健康老年人甲状腺功能相关激素关联的定群研究

A panel study on the association of organophosphate ester flame retardant exposure with thyroid function related hormones in healthy older adults

目的探索全血有机磷酸酯(OPEs)阻燃剂暴露与健康老年人群甲状腺功能相关激素的关联。方法采用定群研究设计,选取山东济南甸柳社区76名60~69岁的健康老年人为研究对象,于2018年9月至2019年1月开展5次人群流行病学现场调查与生物样本采集。通过问卷调查和体格检查,收集调查对象的社会人口学特征、饮食情况和健康状态等多维度信息。同时,采集空腹静脉血以检测OPEs、促甲状腺激素(TSH)、三碘甲状腺原氨酸(T_(3))和甲状腺素(T_(4))等指标水平。采用线性混合效应模型分析全血OPEs暴露对老年人甲状腺功能相关激素的影响。结果76名研究对象均至少完成两次及以上随访调查,最终共纳入350人次;研究对象年龄为(65.07±2.76)岁,男女各半,均为38名。共有8种检出率超过50%的OPEs被纳入,∑OPEs的M(Q_(1),Q_(3))为3.85(2.33,5.74)ng/ml。其中,烷基OPEs是主要的OPEs类型,M(Q_(1),Q_(3))为1.27(0.64,2.50)ng/ml。TSH、T_(3)和T_(4)的M(Q_(1),Q_(3))分别为3.74(2.55,5.69)μIU/ml、1.32(1.10,1.60)ng/ml和45.04(36.96,53.27)ng/ml。线性混合效应模型分析结果显示,TnBP和TEHP暴露每增加一个四分位数水平,老年人TSH分别显著下降9.93%(95%CI:-15.17%,-4.36%)和11.14%(95%CI:-15.94%,-6.06%)。性别分层分析结果显示,在男性老年人中,TEHP暴露与TSH水平呈负向关联,而女性老年人的TSH水平降低可能与TnBP暴露有关。结论全血OPEs暴露与健康老年人TSH水平下降有关联,且这种影响存在性别差异。

Objective To explore the impact of whole blood organophosphate esters(OPEs)flame retardant exposure on thyroid function-related hormones in healthy older adults.Methods In this panel study,five repeated population-based epidemiological surveys and biological sample collection were conducted from September 2018 to January 2019,with 76 healthy older adults aged 60-69 years in the Dianliu Community of Jinan,Shandong Province.Information on the sociodemographic characteristics,diet,and health status of the respondents was systematically gathered through questionnaires and physical examinations.Fasting venous blood was collected to determine the levels of OPEs,thyroid-stimulating hormone(TSH),triiodothyronine(T_(3)),and thyroxine(T_(4)).A linear mixed-effects model was used to analyze the impact of OPEs exposure on thyroid function-related hormones in healthy older adults.Results Each of the 76 subjects participated in at least two follow-up visits,resulting in a total of 350 person visits.The age of the study participants was(65.07±2.76)years,with 38 participants of both sexes.A total of eight OPEs were included with a detection rate exceeding 50%,and the M(Q_(1),Q_(3))for∑OPEs was 3.85(2.33,5.74)ng/ml,with alkyl-OPEs being the major type of OPEs with an M(Q_(1),Q_(3))of 1.27(0.64,2.50)ng/ml.The M(Q_(1),Q_(3))for TSH,T_(3),and T_(4) was 3.74(2.55,5.69)μIU/ml,1.32(1.10,1.60)ng/ml,and 45.04(36.96,53.27)ng/ml,respectively.Linear mixed-effects model showed that TSH was significantly decreased by 9.93%(95%CI:-15.17%,-4.36%)and 11.14%(95%CI:-15.94%,-6.06%)in older adults for each quartile level increase in TnBP and TEHP exposures,respectively.Gender-stratified analysis indicated that TEHP exposure was negatively associated with TSH levels in male older adults,whereas a decrease in TSH levels among female older adults was associated with TnBP exposure.Conclusion Exposure to whole blood OPEs is associated with decreased TSH levels among healthy older adults,with notable gender differences.