镉污染地区中老年人群膳食模式与其镉和铅内暴露水平关系

Relationship between dietary patterns and internal exposure levels of cadmium and lead among middle-aged and elderly populations in cadmium-polluted areas:a cross-sectional survey

目的探讨镉污染地区中老年人群不同膳食模式与其镉和铅内暴露水平的关系,为采用合理膳食模式减少该地区人群的镉和铅内暴露水平提供科学依据。方法于2019年7—12月在广东省北部镉污染地区随机招募600名在该地区居住≥20年的中老年人群进行问卷调查、体格检查以及尿镉(UCd)、血镉(BCd)、血铅(BPb)的测定,通过因子分析确定中老年人群的膳食模式,并应用多因素广义线性模型分析膳食模式与其自然对数转换重金属(LnUCd、LnBCd、LnBPb)水平之间的关系。结果广东省北部镉污染地区最终纳入分析的414名中老年人群通过因子分析得到蔬果、优质蛋白、蛋白饮品和面粉4种膳食模式,累计方差贡献率为50.618%;中老年人群UCd、BCd和BPb水平的M(P25,P75)分别为7.32(4.12,14.85)μg/g Ucr、6.42(3.40,11.55)μg/L和55.93(38.76,79.12)μg/L;在调整了性别、年龄、职业、地区、吸烟情况、服药史和体质指数等混杂因素后,多因素广义线性模型分析结果显示,蔬果膳食模式因子得分处于T2水平(β=–0.121,95%CI=–0.225~–0.017)和T3水平(β=–0.108,95%CI=–0.213~–0.003)中老年人群的LnBPb水平均较因子得分处于T1水平中老年人群低,优质蛋白膳食模式因子得分处于T3水平中老年人群的LnUCd水平(β=–0.224,95%CI=–0.436~–0.013)和LnBCd水平(β=–0.245,95%CI=–0.434~–0.057)均较因子得分处于T1水平中老年人群低。结论镉污染地区中老年人群倾向蔬果膳食模式与低BPb水平相关,倾向优质蛋白膳食模式与低UCd和BCd水平相关。

Objective To explore the relationship between different dietary patterns and internal exposure levels of cadmium and lead among middle-aged and elderly populations in cadmium-polluted areas,and to provide a scientific basis for adopting reasonable dietary patterns to reduce cadmium and lead internal exposure levels in these populations.Methods From July to December 2019,600 middle-aged and elderly individuals who had lived in cadmium-polluted areas in northern Guangdong province for≥20 years were randomly recruited to participate in questionnaire surveys,physical examinations,and measurements of urinary cadmium(UCd),blood cadmium(BCd),and blood lead(BPb).Factor analysis was used to determine the dietary patterns of the middle-aged and elderly populations,and a multifactor generalized linear model was used to analyze the relationship between dietary patterns and natural log-transformed heavy metal(LnUCd,LnBCd,LnBPb)levels.Results A total of 414 middle-aged and elderly individuals from cadmiumpolluted areas in northern Guangdong province were finally included in the analysis.Four dietary patterns were obtained through factor analysis:fruits and vegetables,high-quality protein,protein beverages,and flour,with a cumulative variance contribution rate of 50.618%.The M(P25,P75)of UCd,BCd,and BPb levels in the middle-aged and elderly populations were 7.32(4.12,14.85)μg/g Ucr,6.42(3.40,11.55)μg/L,and 55.93(38.76,79.12)μg/L,respectively.After adjusting for confounding factors such as gender,age,occupation,region,smoking status,medication history,and body mass index,the results of the multifactor generalized linear model analysis showed that the LnBPb levels of middle-aged and elderly individuals with fruit and vegetable dietary pattern factor scores at the T2 level(β=–0.121,95%CI:–0.225––0.017)and T3 level(β=–0.108,95%CI:–0.213––0.003)were lower than those with factor scores at the T1 level.The LnUCd level(β=–0.224,95%CI:–0.436––0.013)and LnBCd level(β=–0.245,95%CI:–0.434––0.057)of middle-aged and elderly individuals with high-quality protein dietary pattern factor scores at the T3 level were lower than those with factor scores at the T1 level.Conclusion A preference for fruit and vegetable dietary patterns was associated with lower blood lead levels,while a preference for high-quality protein dietary patterns was associated with lower urinary cadmium and blood cadmium levels among middle-aged and elderly populations in cadmium-polluted areas.