Environmental exposure

环境暴露
  • 文章类型: Journal Article
    社会经济上处于不利地位的亚群更容易受到细颗粒物(PM2.5)的影响。然而,由于先前的研究集中在个人层面的社会经济特征上,背景剥夺如何改变PM2.5暴露与心血管健康之间的关系尚不清楚.
    评估由不同社会经济特征定义的亚群之间PM2.5暴露与心血管疾病相关的差异。
    这项队列研究使用了2016至2022日历年来自“我们所有人”研究计划的电子健康记录(EHR)参与者的纵向数据。从2023年9月25日至2024年2月23日进行统计分析。
    根据参与者的住址,卫星衍生的5年平均PM2.5暴露在3位邮政编码级别。
    从EHRs获得急性心肌梗死(MI)和中风。使用分层Cox比例风险回归模型来估计PM2.5暴露与MI或中风之间的风险比(HR)。我们评估了由3个社会经济特征定义的亚群:情境剥夺(较少剥夺,更被剥夺),家庭年收入(≥5万美元,<5万美元),和种族和种族(非西班牙裔黑人,非西班牙裔白人)。我们计算了HR(RHR)的比率,以量化这些亚群之间的差异。
    共分析了210554名参与者(40%年龄>60岁;59.4%女性;16.7%西班牙裔,19.4%非西班牙裔黑人,56.1%非西班牙裔白人,7.9%其他[美洲印第安人,亚洲人,超过1个种族和种族]),其中发现了954例MI和1407例卒中病例.较高的PM2.5水平与较高的MI和卒中风险相关。然而,弱势群体(更贫困,年收入<5万美元,黑人种族)更容易受到高PM2.5水平的影响。由情境剥夺定义的群体之间的差异最为明显。例如,PM2.5从6μg/m3增加到10μg/m3,卒中的HR为1.13(95%CI,0.85-1.51),相对于2.57(95%CI,2.06-3.21),相对于2.46(95%CI,1.07-2.01),在每年50000美元或更多的人群中,相对于2.27(95%CI,1.73-2.97),在每年的人群中,相对于1.76美元情境剥夺的RHR最高(2.27;95%CI,1.59-3.24),与收入(1.55;95%CI,1.05-2.29)和种族和民族(1.62;95%CI,1.02-2.58)相比。
    在这项队列研究中,虽然个人种族、种族和收入在PM2.5与心血管风险的不利关系中仍然至关重要,情境剥夺是一个更强大的社会经济特征,可以改变PM2.5暴露的关联。
    UNASSIGNED: Socioeconomically disadvantaged subpopulations are more vulnerable to fine particulate matter (PM2.5) exposure. However, as prior studies focused on individual-level socioeconomic characteristics, how contextual deprivation modifies the association of PM2.5 exposure with cardiovascular health remains unclear.
    UNASSIGNED: To assess disparities in PM2.5 exposure association with cardiovascular disease among subpopulations defined by different socioeconomic characteristics.
    UNASSIGNED: This cohort study used longitudinal data on participants with electronic health records (EHRs) from the All of Us Research Program between calendar years 2016 and 2022. Statistical analysis was performed from September 25, 2023, through February 23, 2024.
    UNASSIGNED: Satellite-derived 5-year mean PM2.5 exposure at the 3-digit zip code level according to participants\' residential address.
    UNASSIGNED: Incident myocardial infarction (MI) and stroke were obtained from the EHRs. Stratified Cox proportional hazards regression models were used to estimate the hazard ratio (HR) between PM2.5 exposure and incident MI or stroke. We evaluated subpopulations defined by 3 socioeconomic characteristics: contextual deprivation (less deprived, more deprived), annual household income (≥$50 000, <$50 000), and race and ethnicity (non-Hispanic Black, non-Hispanic White). We calculated the ratio of HRs (RHR) to quantify disparities between these subpopulations.
    UNASSIGNED: A total of 210 554 participants were analyzed (40% age >60 years; 59.4% female; 16.7% Hispanic, 19.4% Non-Hispanic Black, 56.1% Non-Hispanic White, 7.9% other [American Indian, Asian, more than 1 race and ethnicity]), among whom 954 MI and 1407 stroke cases were identified. Higher PM2.5 levels were associated with higher MI and stroke risks. However, disadvantaged groups (more deprived, income <$50 000 per year, Black race) were more vulnerable to high PM2.5 levels. The disparities were most pronounced between groups defined by contextual deprivation. For instance, increasing PM2.5 from 6 to 10 μg/m3, the HR for stroke was 1.13 (95% CI, 0.85-1.51) in the less-deprived vs 2.57 (95% CI, 2.06-3.21) in the more-deprived cohort; 1.46 (95% CI, 1.07-2.01) in the $50 000 or more per year vs 2.27 (95% CI, 1.73-2.97) in the under $50 000 per year cohort; and 1.70 (95% CI, 1.35-2.16) in White individuals vs 2.76 (95% CI, 1.89-4.02) in Black individuals. The RHR was highest for contextual deprivation (2.27; 95% CI, 1.59-3.24), compared with income (1.55; 95% CI, 1.05-2.29) and race and ethnicity (1.62; 95% CI, 1.02-2.58).
    UNASSIGNED: In this cohort study, while individual race and ethnicity and income remained crucial in the adverse association of PM2.5 with cardiovascular risks, contextual deprivation was a more robust socioeconomic characteristic modifying the association of PM2.5 exposure.
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  • 文章类型: Journal Article
    急性呼吸道感染是由急性病毒或细菌感染引起的传染病。根据世卫组织2018年的一份报告,在全球700万5岁以下儿童死亡后,暴露于室内和周围空气环境污染是导致呼吸系统问题风险较高的因素。住房条件,如墙体材料,屋顶类型,厨房位置,卫生条件,和烹饪燃料类型是五岁以下儿童急性呼吸道疾病的家庭水平预测因子。
    这项研究使用了EDHS-2016二级数据,具有全国代表性。数据收集期为2016年1月18日至2016年6月27日。在16650项调查中,10,006个有5岁以下儿童的家庭。这项研究的结果变量是急性呼吸道感染症状。使用STATA版本17.1进行分析。在进行分析之前对数据进行加权以恢复样本的代表性。在双变量分析中,p值<0.2用于筛选多变量。使用方差膨胀因子检查多重共线性。然后,本研究采用多水平多变量回归模型分析急性呼吸道感染症状和可能的预测变量.多变量回归分析中p值<0.05的变量被认为是具有统计学意义的预测因子。
    大多数(95.00%)家庭通常使用固体燃料进行烹饪,和家庭主要建筑材料:81.44和91.03%的家庭地板和墙壁是用未经加工的天然材料建造的,分别。5岁以下儿童急性呼吸道感染症状患病率为7.955%(7.397,8.551%)。调查结果显示,五岁以下儿童的急性呼吸道感染症状与儿童年龄有显著关联,腹泻状态,residence,区域,燃料类型,粪便处理,墙体材料,和地板材料。
    干预措施应针对可改变的因素,例如对最小的孩子进行适当的粪便处理,告知恶劣住房条件对健康的影响,例如改善墙壁和地板建筑材料,以减少五岁以下儿童的急性呼吸道感染症状。
    UNASSIGNED: Acute respiratory infection is an infectious illness caused by acute viral or bacterial infection. According to a 2018 WHO report, exposures to indoor and ambient air environmental pollution were contributing factors to a higher risk of respiratory problems following 7 million deaths of children under five globally. Housing conditions such as wall material, roof type, kitchen location, sanitation condition, and cooking fuel type are household-level predictors of acute respiratory disease among children under five years of age.
    UNASSIGNED: This research used EDHS-2016 secondary data, which are nationally representative. The data collection period was from January 18, 2016, to June 27, 2016. Among the 16,650 total surveys, 10,006 households that had children below 5 years of age. The outcome variable for this study was acute respiratory infection symptoms. Analyses were performed using STATA Version 17.1. The data were weighted before performing analysis to reinstate the representativeness of the sample. In the bivariable analysis, a p value <0.2 was used to screen for multivariable. Multicollinearity was checked using the variance inflation factor. Then, a multilevel multivariable regression model was used in this study for the analysis of acute respiratory infection symptoms and possible predictor variables. Variables with a p value <0.05 in multivariable regression analysis were considered statistically significant predictors.
    UNASSIGNED: Most (95.00%) households commonly used solid fuel for cooking, and household main construction materials: 81.44 and 91.03% of floors and walls of households were constructed with unprocessed natural materials, respectively. The prevalence of acute respiratory infection symptoms among children under five years of age was 7.955% (7.397, 8.551%). The findings indicated that acute respiratory infection symptoms among children under five years of age were significantly linked with the age of the children, diarrhea status, residence, region, fuel type, stool disposal, wall material, and floor material.
    UNASSIGNED: Interventions should target modifiable factors such as proper stool disposal of the youngest child, informing the health effects of poor housing conditions such as improving wall and floor construction material to reduce acute respiratory infection symptoms among children under five years of age.
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  • 文章类型: Journal Article
    邻苯二甲酸酯(PAEs)是一类最丰富且研究最频繁的假持久性有机污染物。无创尿液是评估PAE暴露的有效基质,但是需要重复采样来克服这种偏差。这为现场收集增加了很多工作量,并且检测成本呈指数增长。因此,这项研究的目的是进行范围审查,以描述使用其他非侵入性基质的检测方法和有效性,比如指甲和头发,用于评估PAEs的长期暴露。PubMed,WebofScienceandChinaNationalKnowledgeInfrastructure(CNKI),从2000年1月1日至2024年4月3日检索了电子数据库,纳入了12项研究.九项和三项研究使用了头发和指甲,分别,作为检测PAE暴露的非侵入性矩阵。五篇文章比较了指甲或头发和尿液测试的结果,以评估PAE暴露的有效性。还描述了这些非侵入性样品的预处理和检测方法。这篇综述的结果表明,与指甲相比,头发可能更适合作为评估长期PAEs暴露的非侵入性替代矩阵.然而,样品处理程序,如从头发中提取和纯化化合物,在各种研究中并不统一;因此,进一步探索和优化这一过程,以及额外的研究证据来评估其有效性,需要为评估长期PAE暴露水平的头发检测方法的推广和应用提供科学依据。
    The phthalic acid esters (PAEs) are one class of the most abundant and frequently studied pseudo-persistent organic pollutants. Noninvasive urine is an effective substrate for evaluating PAE exposure, but repeated sampling is needed to overcome this bias. This adds much work to on-site collection and the cost of detection increases exponentially. Therefore, the aim of this study was to conduct a scope review to describe the detection methods and validity of the use of other noninvasive matrices, such as nails and hair, for assessing long-term exposure to PAEs. The PubMed, Web of Science and China National Knowledge Infrastructure (CNKI), electronic databases were searched from 1 January 2000 to 3 April 2024, and 12 studies were included. Nine and three studies used hair and nails, respectively, as noninvasive matrices for detecting PAE exposure. Five articles compared the results of nail or hair and urine tests for validity of the assessment of PAE exposure. The preprocessing and detection methods for these noninvasive samples are also described. The results of this review suggest that, compared with nails, hair may be more suitable as a noninvasive alternative matrix for assessing long-term exposure to PAEs. However, sample handling procedures such as the extraction and purification of compounds from hair are not uniform in various studies; therefore, further exploration and optimization of this process, and additional research evidence to evaluate its effectiveness, are needed to provide a scientific basis for the promotion and application of hair detection methods for assessing long-term PAE exposure levels.
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  • 文章类型: Journal Article
    空气污染长期以来一直是一个重大的环境健康问题。以前的研究采用了不同的方法来调查空气污染对公众健康的影响,然而,很少有人彻底检查其时空异质性。基于此,本研究基于多因素健康决策理论框架,结合空间Durbin模型和时空加权回归模型,调查了2013-2020年中国31个省份空气污染对公众健康影响的时空异质性.研究结果表明:(1)以中国呼吸系统疾病(IRD)发病率衡量的空气污染与公共卫生表现出显著的空间正相关和局部空间聚集性。(2)空气污染表现出显著的空间溢出效应。在控制了经济发展和生活环境因素后,包括可支配收入,人口密度,和城市化率,空气污染对IRD的直接和间接空间影响分别为3.552和2.848。(3)中国IRD主要受空气污染等各种因素的影响,经济发展,生活条件,和医疗保健,其影响程度表现出不均匀的时空分布趋势。这项研究的结果对减轻空气污染和维护公众健康具有相当的现实意义。
    Air pollution has long been a significant environmental health issue. Previous studies have employed diverse methodologies to investigate the impacts of air pollution on public health, yet few have thoroughly examined its spatiotemporal heterogeneity. Based on this, this study investigated the spatiotemporal heterogeneity of the impacts of air pollution on public health in 31 provinces in China from 2013 to 2020 based on the theoretical framework of multifactorial health decision-making and combined with the spatial durbin model and the geographically and temporally weighted regression model. The findings indicate that: (1) Air pollution and public health as measured by the incidence of respiratory diseases (IRD) in China exhibit significant spatial positive correlation and local spatial aggregation. (2) Air pollution demonstrates noteworthy spatial spillover effects. After controlling for economic development and living environment factors, including disposable income, population density, and urbanization rate, the direct and indirect spatial impacts of air pollution on IRD are measured at 3.552 and 2.848, correspondingly. (3) China\'s IRD is primarily influenced by various factors such as air pollution, economic development, living conditions, and healthcare, and the degree of its influence demonstrates an uneven spatiotemporal distribution trend. The findings of this study hold considerable practical significance for mitigating air pollution and safeguarding public health.
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  • 文章类型: Journal Article
    系统性硬化症(SSc)的特征在于异质性的临床表达,可能反映了每个患者的不同遗传背景。该疾病的主要致病事件的定义已经取得进展,可以总结为内皮损伤和功能障碍。炎症与免疫系统和纤维化的激活。该疾病的病因仍有待澄清,最初的事件可能归因于遗传易感受试者中环境刺激的重复作用。本手稿的目的是审查有关SSc与环境因素关联的最新和相关数据。
    Systemic sclerosis (SSc) is characterised by a heterogeneous clinical expression probably reflecting the different genetic background of each patient. Progress has been made in the definition of the principal pathogenetic events of the disease that can be summarised in endothelial damage and dysfunction, inflammation with activation of immune system and fibrosis. The aetiology of the disease still remains to be clarified and probably the first events are attributable to the repeated action of environmental stimuli in genetically predisposed subjects.The aim of the present manuscript is to review the most recent and relevant data regarding the association of SSc with environmental factors.
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  • 文章类型: Journal Article
    越来越多的证据表明重金属暴露与糖尿病之间存在相关性。糖尿病视网膜病变(DR)是糖尿病的一种常见且不可逆的并发症,可导致失明。然而,关于重金属暴露对DR影响的研究仍然很少。因此,本研究旨在探讨重金属暴露与DR之间的潜在相关性。
    这项研究纳入了2005年至2018年国家健康和营养检查调查(NHANES)的1,146名糖尿病患者。通过尿液测试测量重金属水平。加权逻辑回归,贝叶斯核机回归(BKMR),加权分位数和(WQS)回归,利用有限三次样条(RCS)研究了暴露于10种重金属与DR之间的潜在关系。最后,根据血糖控制状况进行亚组分析.
    在1,146名参与者中,239(20.86%)被诊断为DR。与没有DR的患者相比,患有DR的患者的血糖控制较差,慢性肾脏疾病的患病率更高。此外,WQS回归模型和BKMR模型均显示混合重金属暴露与DR风险之间存在正相关.加权logistic回归结果显示钴(Co)和锑(Sb)暴露与DR风险呈正相关(OR=1.489,95CI:1.064-2.082,p=0.021;OR=1.475,95%CI:1.084-2.008,p=0.014),而汞(Hg)暴露仅在血糖控制良好的组中促进DR(OR=1.509,95%CI:1.157-1.967,p=0.003)。RCS分析的结果证实了这些发现。
    重金属暴露与DR风险增加有关,尤其是Sb,Co,和汞暴露。然而,我们需要精心设计的前瞻性研究来验证这些发现.
    UNASSIGNED: Mounting evidence suggests a correlation between heavy metals exposure and diabetes. Diabetic retinopathy (DR) is a prevalent and irreversible complication of diabetes that can result in blindness. However, studies focusing on the effects of exposure to heavy metals on DR remain scarce. Thus, this study aimed to investigate the potential correlation between heavy metals exposure and DR.
    UNASSIGNED: A total of 1,146 diabetics from the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018 were included in this study. Heavy metal levels were measured via urine testing. Weighted logistic regression, Bayesian kernel machine regression (BKMR), weighted quantile sum (WQS) regression, and restricted cubic spline (RCS) were utilized to investigate the potential relationships between exposure to 10 heavy metals and DR. Finally, subgroup analysis was conducted based on the glycemic control status.
    UNASSIGNED: Among the 1,146 participants, 239 (20.86%) were diagnosed with DR. Those with DR had worse glycemic control and a higher prevalence of chronic kidney disease compared to those without DR. Moreover, both the WQS regression and BKMR models demonstrated a positive relationship between exposure to mixed heavy metals and the risk of DR. The results of weighted logistic regression revealed a positive correlation between cobalt (Co) and antimony (Sb) exposure and the risk of DR (OR = 1.489, 95%CI: 1.064-2.082, p = 0.021; OR = 1.475, 95% CI: 1.084-2.008, p = 0.014), while mercury (Hg) exposure was found to promote DR exclusively in the group with good glycemic control (OR = 1.509, 95% CI: 1.157-1.967, p = 0.003). These findings were corroborated by the results of the RCS analysis.
    UNASSIGNED: Heavy metal exposure is associated with an increased risk of DR, especially Sb, Co, and Hg exposure. Nevertheless, well-designed prospective studies are warranted to validate these findings.
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  • 文章类型: Journal Article
    对环境酚类物质暴露与估计的肾小球滤过率(eGFR)之间的相关性进行了有限的调查。我们的目标是建立一个强大且可解释的机器学习(ML)模型,该模型将环境酚暴露与eGFR相关联。
    我们构建环境酚类与eGFR之间关联的数据集是从国家健康和营养调查(NHANES,2013-2016)。包含五个ML模型,并通过酚暴露对eGFR回归进行微调。回归评价指标用于提取模型的局限性。然后利用最有效的模型进行回归,使用Shapley加法解释(SHAP)和博弈论python包来表示模型的回归能力,并对其特征进行了解释。
    该研究在3,371名参与者中确定了表现最好的随机森林(RF)回归变量,平均绝对误差为0.621,确定系数为0.998。6种环境酚与eGFR的线性回归模型显示尿液中三氯生(TCS)和双酚S(BPS)的浓度与eGFR呈正相关,相关系数分别为β=0.010(p=0.026)和β=0.007(p=0.004)。SHAP值表明BPS(1.38),双酚F(BPF)(0.97),2,5-二氯苯酚(0.87),TCS(0.78),BP3(0.60),尿液中的双酚A(BPA)(0.59)和2,4-二氯苯酚(0.47)参与了该模型。
    RF模型有效地确定了美国NHANES2013-2016年参与者中酚类暴露与eGFR之间的相关性。研究结果表明,BPA,BPF,和BPS与eGFR呈负相关。
    UNASSIGNED: Limited investigation is available on the correlation between environmental phenols\' exposure and estimated glomerular filtration rate (eGFR). Our target is established a robust and explainable machine learning (ML) model that associates environmental phenols\' exposure with eGFR.
    UNASSIGNED: Our datasets for constructing the associations between environmental phenols\' and eGFR were collected from the National Health and Nutrition Examination Survey (NHANES, 2013-2016). Five ML models were contained and fine-tuned to eGFR regression by phenols\' exposure. Regression evaluation metrics were used to extract the limitation of the models. The most effective model was then utilized for regression, with interpretation of its features carried out using shapley additive explanations (SHAP) and the game theory python package to represent the model\'s regression capacity.
    UNASSIGNED: The study identified the top-performing random forest (RF) regressor with a mean absolute error of 0.621 and a coefficient of determination of 0.998 among 3,371 participants. Six environmental phenols with eGFR in linear regression models revealed that the concentrations of triclosan (TCS) and bisphenol S (BPS) in urine were positively correlated with eGFR, and the correlation coefficients were β = 0.010 (p = 0.026) and β = 0.007 (p = 0.004) respectively. SHAP values indicate that BPS (1.38), bisphenol F (BPF) (0.97), 2,5-dichlorophenol (0.87), TCS (0.78), BP3 (0.60), bisphenol A (BPA) (0.59) and 2,4-dichlorophenol (0.47) in urinary contributed to the model.
    UNASSIGNED: The RF model was efficient in identifying a correlation between phenols\' exposure and eGFR among United States NHANES 2013-2016 participants. The findings indicate that BPA, BPF, and BPS are inversely associated with eGFR.
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  • 文章类型: Journal Article
    煤是几种化学物质的混合物,其中许多具有诱变和致癌作用,是造成全球死亡率和疾病负担的关键因素。以前的研究表明,煤炭与职业暴露个体的端粒缩短有关,然而,人们对采矿和燃烧煤炭对居住在附近的人的端粒的影响知之甚少。因此,这项调查的主要目的是评估邻近燃煤电厂和煤矿对环境暴露个体基因组不稳定性的影响,在探索与个体特征的潜在关联的同时,氧化应激,炎症反应,和无机元素的存在。这项研究涉及来自热电厂周围三个城市和一个未接触煤炭和副产品的城市的80名男性参与者。从每个参与者的外周血样本中提取DNA,使用定量实时聚合酶链反应(qPCR)方法评估端粒长度(TL)。与未暴露组(5638±2452bp)相比,暴露个体(6227±2884bp)之间没有观察到显着差异。然而,TL降低与年龄和心血管疾病的风险有关;并且发现更长的TL与血液样品中硅和磷浓度的增加有关。在TL与彗星测定(视觉评分)之间没有观察到相关性,微核试验,氧化应激,和炎症结果。需要进一步的研究来确定这些变化与疾病发作和过早死亡之间的潜在相关性。
    Coal is a mixture of several chemicals, many of which have mutagenic and carcinogenic effects and are a key contributor to the global burden of mortality and disease. Previous studies suggest that coal is related to telomeric shortening in individuals occupationally exposed, however little is known about the effects of mining and burning coal on the telomeres of individuals living nearby. Therefore, the primary objective of this investigation was to assess the impact of proximity to coal power plants and coal mines on the genomic instability of individuals environmentally exposed, while also exploring potential associations with individual characteristics, oxidative stress, inflammatory responses, and the presence of inorganic elements. This study involved 80 men participants from three cities around a thermoelectric power plant and one city unexposed to coal and byproducts. DNA was extracted from peripheral blood samples obtained from each participant, and the telomeres length (TL) was assessed using quantitative real-time polymerase chain reaction (qPCR) methodology. No significant difference was observed between exposed individuals (6227 ± 2884 bp) when compared to the unexposed group (5638 ± 2452 bp). Nevertheless, TL decrease was associated with age and risk for cardiovascular disease; and longer TL was found to be linked with increased concentrations of silicon and phosphorus in blood samples. No correlations were observed between TL with comet assay (visual score), micronucleus test, oxidative stress, and inflammatory results. Additional research is required to ascertain the potential correlation between these changes and the onset of diseases and premature mortality.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    目的:实验和急性暴露研究表明锰影响红细胞生成。然而,环境暴露与红细胞分布宽度(RDW)之间的关系尚待探索。这项研究旨在评估美国普通人群中血锰水平与RDW之间的相关性。
    方法:采用加权多元线性回归模型,我们利用2011-2018年全国健康和营养检查调查(NHANES)的数据评估了血液中锰水平与RDW之间的相关性.还采用了受限制的三次样条图和两分段线性回归模型。
    结果:该分析共包括15882名参与者,我们确定了参与者之间血锰水平与RDW之间的独立正相关关系(β=0.079,P<0.001)。此外,我们在总参与者(血锰拐点:7.32ug/L)和校正协变量后的不同亚组中发现了血锰水平与RDW之间的J形关联.女性表现出更明显的联想,即使在控制了调整后的协变量之后。
    结论:我们确定了血锰水平与RDW之间的J形关系,血锰的拐点为7.32ug/L。然而,需要基础研究和大样本前瞻性研究来确定血锰水平与RDW的相关程度.
    OBJECTIVE: Experimental and acute exposure studies imply that manganese affects red blood cell production. Nevertheless, the association between environmental exposure and red blood cell distribution width (RDW) has yet to be explored. This research sought to assess the correlation between blood manganese levels and RDW within the general population of the United States.
    METHODS: Employing weighted multiple linear regression models, data from the 2011-2018 National Health and Nutrition Examination Survey (NHANES) were utilized to assess the correlation between manganese levels in the blood and RDW. Restricted cubic spline plots and two-piecewise linear regression models were also employed.
    RESULTS: The analysis included a total of 15882 participants in which we determined an independent positive relationship between blood manganese levels and RDW among participants(β = 0.079, P<0.001). Moreover, we identified a J-shaped association between blood manganese levels and RDW in total participants (inflection point for blood manganese: 7.32 ug/L) and distinct subgroups following adjusted covariates. Women exhibited a more pronounced association, even after controlling for adjusted covariates.
    CONCLUSIONS: We determined a J-shaped relationship between blood manganese levels and RDW with an inflection point at 7.32 ug/L for blood manganese. Nevertheless, fundamental research and large sample prospective studies are needed to determine the extent to which blood manganese levels correlate with RDW.
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