背景:该研究旨在探索锰浓度与所有原因之间的关联,心血管疾病(CVD)相关,和美国普通人群中癌症相关的死亡率。
方法:我们整合了2011年至2018年国家健康与营养检查调查的数据。根据纳入和排除标准总共选择了9,207名受试者。锰浓度与万因的关系,CVD相关,通过构建Cox比例风险回归模型和受限三次样条(RCS)图分析癌症相关死亡率.此外,按年龄分层的亚组分析,性别,种族/民族,高血压,糖尿病(DM),慢性心脏病,慢性心力衰竭,心绞痛,心脏病发作,中风,和BMI进一步进行。
结果:在完全调整模型中,与最低四分位数相比,所有原因的95%置信区间(CI)的调整后风险比,CVD相关,锰四分位数的癌症相关死亡率为(1.11(0.87,1.41),0.96(0.74,1.23),和1.23(0.96,1.59);趋势的P值=0.041),(0.86(0.54,1.37),0.87(0.55,1.40),和1.07(0.67,1.72);趋势的P值=0.906),和(1.45(0.92,2.29),1.14(0.70,1.88),和1.26(0.75,2.11);趋势的P值=0.526),分别。RCS曲线显示锰浓度与全因死亡率和CVD相关死亡率之间呈U型关系(非线性P值<0.05)。然而,锰浓度与癌症相关死亡率之间的联系增加,然后减少(非线性P值<0.05).锰暴露与性别呈正相关(相关系数,r=0.19,P值<0.001),与年龄呈负相关(相关系数,r=-0.11,P值<0.001)和血清肌酐(相关系数,r=-0.12,P值<0.001),分别。
结论:我们的研究结果表明,在美国人群中,血清锰浓度升高与全因死亡率和CVD相关死亡率相关,血清锰维持在8.67-9.23µg/L之间可能会促进公众健康。
BACKGROUND: The study aimed to explore the association between manganese concentration and all-cause, cardiovascular disease (CVD)-related, and cancer-related mortality in the general population of the United States.
METHODS: We integrated the data from the National Health and Nutrition Examination Survey from 2011 to 2018. A total of 9,207 subjects were selected based on the inclusion and exclusion criteria. The relationship between manganese concentration and all-cause, CVD-related, and cancer-related mortality was analyzed by constructing a Cox proportional hazard regression model and a restricted cubic spline (RCS) plot. Additionally, subgroup analyses stratified by age, sex, race/ethnicity, hypertension, diabetes mellitus (DM), chronic heart disease, chronic heart failure, angina pectoris, heart attack, stroke, and BMI were further performed.
RESULTS: In the full adjusted model, compared with the lowest quartile, the adjusted hazard ratios with 95% confidence intervals (CIs) for all-cause, CVD-related, and cancer-related mortality across manganese quartiles were (1.11 (0.87,1.41), 0.96 (0.74, 1.23), and 1.23 (0.96, 1.59); P-value for trend =0.041), (0.86 (0.54, 1.37), 0.87 (0.55, 1.40), and 1.07 (0.67, 1.72); P-value for trend =0.906), and (1.45 (0.92, 2.29), 1.14 (0.70, 1.88), and 1.26 (0.75, 2.11); P-value for trend =0.526), respectively. The RCS curve shown a U-shaped association between manganese concentration and all-cause mortality and CVD-related mortality (P-value for nonlinear <0.05). However, there was an increase and then a decrease in the link between manganese concentration and cancer-related mortality (P-value for nonlinear <0.05). Manganese
exposure was positively correlated with sex (correlation coefficient, r =0.19, P-value <0.001) and negatively correlated with age (correlation coefficient, r =-0.11, P-value <0.001) and serum creatinine (correlation coefficient, r =-0.12, P-value <0.001), respectively.
CONCLUSIONS: Our findings suggest that elevated serum manganese concentrations are associated with all-cause and CVD-related mortality in the U.S. population and that maintenance of serum manganese between 8.67-9.23 µg/L may promote public health.