职业性锰暴露与饮酒的相互作用加剧了中国横断面研究中肝酶浓度的升高。
Interaction of occupational manganese exposure and alcohol drinking aggravates the increase of liver enzyme concentrations from a cross-sectional study in China.
机构信息
Department of occupational health and environmental health, School of Public Health, Guangxi Medical University, Guangxi, Nanning, China.
出版信息
Environ Health. 2013 Apr 15;12:30. doi: 10.1186/1476-069X-12-30.
BACKGROUND
Over exposure to manganese (Mn) can damage the human central nervous system and potentially cause liver toxicity. Alcohol drinking is also one of the well-known harmful factors to hepatic organism. The interaction between Mn exposure and alcohol consumption to liver function was investigated in this study.
METHODS
A total of 1112 on-the-spot workers were included in the cross-sectional survey from a large scale of manganese exposed workers healthy cohort (MEWHC) in a ferro-manganese refinery company. A questionnaire was used to collect the demographic information, occupational history, and alcohol drinking habits. Occupational health examination was carried out for each worker. The five key serum indices, including total bilirubin (TBILI), direct bilirubin (DBILI), indirect bilirubin (IBILI), alanine transaminase (ALT), and aspartate transaminase (AST), were determined to evaluate the liver function of each subject.
RESULTS
Workers exposed to high levels of Mn had significantly elevated serum concentrations of liver enzymes (DBILI: 3.84±1.20 μmol/L, ALT: 27.04±19.12 IU/L, and AST: 29.96±16.68 IU/L), when compared to those in the low-exposure group (DBIL: 3.54±0.85 μmol/L, ALT: 20.38±10.97 IU/L, and AST: 26.39±8.07 IU/L), all P<0.01. These serum indices had a significantly increasing trend with the elevation of Mn exposure level (Ptrend <0.01). In addition, the workers with alcohol drinking also showed higher concentrations of liver enzymes than those non-drinkers, especially, and there was significant interaction between Mn exposure and alcohol consumption in terms of these three indices (P<0.001).
CONCLUSIONS
Occupational exposure to Mn can lead to a dose-dependent increase of liver enzyme concentrations, and interact with alcohol drinking to potentially aggravate the liver damage. It will be important for Mn exposed workers to control drinking and also assess liver function in the occupational health examination.
背景
过量接触锰（Mn）会损害人体中枢神经系统，并可能导致肝毒性。饮酒也是对肝脏组织有害的因素之一。本研究旨在探讨 Mn 暴露与饮酒对肝功能的相互作用。
方法
本研究采用横断面调查方法，选取某锰铁冶炼厂大型 Mn 暴露工人队列健康研究（MEWHC）中的 1112 名现场工人。采用问卷收集工人的一般人口学信息、职业史和饮酒习惯等资料。对所有工人进行职业健康检查。测定血清总胆红素（TBILI）、直接胆红素（DBILI）、间接胆红素（IBILI）、丙氨酸转氨酶（ALT）和天门冬氨酸转氨酶（AST）等 5 项关键血清指标，以评估各研究对象的肝功能。
结果
与低暴露组相比，高水平 Mn 暴露组工人的血清肝酶浓度显著升高（DBILI：3.84±1.20 μmol/L、ALT：27.04±19.12 IU/L 和 AST：29.96±16.68 IU/L），差异均有统计学意义（均 P<0.01）。这些血清指标随着 Mn 暴露水平的升高呈明显上升趋势（Ptrend<0.01）。此外，饮酒工人的血清肝酶浓度也高于非饮酒工人，尤其是在这三个指标中，Mn 暴露与饮酒之间存在显著的交互作用（P<0.001）。
结论
职业性 Mn 暴露可导致肝酶浓度呈剂量依赖性升高，并与饮酒相互作用，可能加重肝损伤。对于 Mn 暴露工人，控制饮酒和在职业健康检查中评估肝功能非常重要。
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