总摄氟量与成人血清骨钙素的相关关系及其基准剂量

Relationship between the daily total intake of fluoride and serum osteocalcin in adults and its benchmark dose

目的探讨总摄氟量与血清骨钙素的剂量-效应关系及总摄氟量的基准剂量(benchmark dose,BMD),为氟骨症防治及总摄氟量标准的修订提供参考。方法选择瓦庙村和新淮村为调查点,以家庭手压井饮水氟含量为依据,分别从瓦庙村和新淮村分层随机抽取103名和43名成年常住居民为被调查对象,调查内容包括家庭饮水和食物中氟含量,每日各种食物、饮水的摄入量,检测室内外空气中氟含量和血清骨钙素含量。计算每日总摄氟量,并根据每日总摄氟量将被调查对象分为四组:A组的总摄氟量为≤1. 16 mg/(人·d)、B组> 1. 16 mg/(人·d)、C组> 3. 48 mg/(人·d)、D组>4. 99 mg/(人·d),分别统计各组血清骨钙素含量及血清骨钙素的异常率。结果瓦庙村居民的总摄氟量和血清骨钙素显著高于新淮村(P<0. 01)。随着总摄氟量的增加,血清骨钙素含量逐渐增加,血清骨钙素的异常率也逐渐增加,总摄氟量与血清骨钙素及血清骨钙素异常率有显著的剂量-效应关系。依据血清骨钙素的异常率计算的总摄氟量的基准剂量和基准剂量下限(benchmark dose lower limitation,BMDL)分别为1. 00 mg/(人·d)和0. 67 mg/(人·d)。结论骨钙素可能是氟接触人群骨损伤早期筛查的敏感指标;按照骨钙素计算的总摄氟量的BMDL显著低于国家总摄氟量标准。

Objective To explore the dose-response relationship between total fluoride intake and serum osteocalcin and the benchmark dose(BMD)of total fluoride intake so as to provide references for prevention and control of endemic skeletal fluorosis and revision of the national standard for total fluoride intake.Methods Wamiao and Xinhuai villages were selected as the investigation sites.Based on the fluoride concentration in drinking water in the household hand-pressed wells,a stratified random sampling method was used to recruit 103 adult permanent residents from Wamiao village and 43 from Xinhuai village.The surveyed contents included fluoride concentration in drinking water and food,daily intake of various foods and drinking water,and detection of fluoride in indoor and outdoor air and serum osteocalcin level.The daily total fluoride intake was calculated,and then all the subjects were divided into four groups(including groups A,B,C and D with the total fluoride intake≤1.16 mg/(person·day),>1.16 mg/(person·day),>3.48 mg/(person·day)and>4.99 mg/(person·day)respectively)according to the daily total fluoride intake.The serum osteocalcin level and the abnormal rate of serum osteocalcin in each group were statistically analyzed.Results The total fluoride intake and serum osteocalcin in the residents of Wamiao village were significantly higher than those in the residents of Xinhuai village(both P<0.01).Serum osteocalcin level and the abnormal rate of serum osteocalcin gradually increased with the increment of total fluoride intake.There was a significant dose-response relationship between the total fluoride intake and serum osteocalcin,serum osteocalcin abnormal rate.The BMD and the benchmark dose lower limitation(BMDL)of total fluoride intake calculated based on the abnormal rate of serum osteocalcin were 1.00 mg/(person·day)and0.67 mg/(person·day)respectively.Conclusions Osteocalcin may be a sensitive indicator for early screening of bone injury in people exposed to fluoride.The BMDL of total fluoride intake calculated according to osteocalcin is significantly lower than that of the national standard.