尿中多环芳烃和金属的联合暴露对肺功能的影响：系统性炎症的介导作用

Co-exposure effects of urinary polycyclic aromatic hydrocarbons and metals on lung function: mediating role of systematic inflammation   

尿中多环芳烃和金属的联合暴露对肺功能的影响：系统性炎症的介导作用

Authors: Wu L, Lu X, Zhang S, Zhong Y, Gao H, Tao FB, Wu X.

Source：BMC Pulm Med. 2024 Aug 11;24(1):386. doi: 10.1186/s12890-024-03173-9.

Abstract

Background: Polycyclic aromatic hydrocarbons (PAHs) and metals were associated with decreased lung function, but co-exposure effects and underlying mechanism remained unknown.

Methods: Among 1,123 adults from National Health and Nutrition Examination Survey 2011-2012, 10 urinary PAHs, 11 urinary metals, and peripheral white blood cell (WBC) count were determined, and 5 lung function indices were measured. Least absolute shrinkage and selection operator, Bayesian kernel machine regression, and quantile-based g-computation were used to estimate co-exposure effects on lung function. Mediation analysis was used to explore mediating role of WBC.

Results: These models demonstrated that PAHs and metals were significantly associated with lung function impairment. Bayesian kernel machine regression models showed that comparing to all chemicals fixed at median level, forced expiratory volume in 1 s (FEV₁)/forced vital capacity, peak expiratory flow, and forced expiratory flow between 25 and 75% decreased by 1.31% (95% CI: 0.72%, 1.91%), 231.62 (43.45, 419.78) mL/s, and 131.64 (37.54, 225.74) mL/s respectively, when all chemicals were at 75th percentile. In the quantile-based g-computation, each quartile increase in mixture was associated with 104.35 (95% CI: 40.67, 168.02) mL, 1.16% (2.11%, 22.40%), 294.90 (78.37, 511.43) mL/s, 168.44 (41.66, 295.22) mL/s decrease in the FEV₁, FEV₁/forced vital capacity, peak expiratory flow, and forced expiratory flow between 25% and 75%, respectively. 2-Hydroxyphenanthrene, 3-Hydroxyfluorene, and cadmium were leading contributors to the above associations. WBC mediated 8.22%-23.90% of association between PAHs and lung function.

Conclusions: Co-exposure of PAHs and metals impairs lung function, and WBC could partially mediate this relationship. Our findings elucidate co-exposure effects of environmental mixtures on respiratory health and underlying mechanisms, suggesting that focusing on highly prioritized toxicants would effectively attenuate adverse effects.

Keywords: Lung function; Metals; Mixture effect; Polycyclic aromatic hydrocarbons; White blood cell.

摘要

背景资料：多环芳烃（PAHs）和金属与肺功能下降，但共同暴露的影响和潜在的机制仍然未知。

研究方法：对2011-2012年全国健康与营养调查的1,123名成年人进行了10项尿多环芳烃、11项尿金属、外周血白色细胞（WBC）计数和5项肺功能指标的测定。使用最小绝对收缩和选择算子、贝叶斯核机器回归和基于分位数的g计算来估计联合暴露对肺功能的影响。采用中介作用分析探讨白细胞的中介作用。

结果：这些模型显示多环芳烃和金属与肺功能损害显著相关。贝叶斯核机器回归模型显示，与固定在中位数水平的所有化学物质相比，当所有化学物质均处于第75百分位时，1秒用力呼气量（FEV₁）/用力肺活量、呼气峰流量和25 - 75%之间的用力呼气流量分别下降了1.31%（95%CI：0.72%，1.91%）、231.62（43.45，419.78）mL/s和131.64（37.54，225.74）mL/s。在基于分位数的g计算中，混合物中每增加一个四分位数，FEV₁、FEV₁/用力肺活量、呼气峰流速和用力呼气流速在25%和75%之间分别降低104.35（95%CI：40.67，168.02）mL、1.16%（2.11%，22.40%）、294.90（78.37，511.43）mL/s、168.44（41.66，295.22）mL/s。2-羟基菲、3-羟基芴和镉是上述关联的主要贡献者。白细胞介导了8.22%~ 23.90%的多环芳烃与肺功能的相关性。

结论：多环芳烃和金属污染物联合暴露可损害肺功能，白细胞可部分介导这种关系。我们的研究结果阐明了环境混合物对呼吸系统健康和潜在机制的共同暴露效应，表明专注于高度优先的有毒物质将有效地减轻不良影响。

关键词：肺功能;金属;混合效应;多环芳烃;白色血细胞。