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重金属对美国 HIV 感染者健康的潜在影响。

Potential health impacts of heavy metals on HIV-infected population in USA.

机构信息

Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida, United States of America.

出版信息

PLoS One. 2013 Sep 2;8(9):e74288. doi: 10.1371/journal.pone.0074288. eCollection 2013.

Abstract

PURPOSE

Noninfectious comorbidities such as cardiovascular diseases have become increasingly prevalent and occur earlier in life in persons with HIV infection. Despite the emerging body of literature linking environmental exposures to chronic disease outcomes in the general population, the impacts of environmental exposures have received little attention in HIV-infected population. The aim of this study is to investigate whether individuals living with HIV have elevated prevalence of heavy metals compared to non-HIV infected individuals in United States.

METHODS

We used the National Health and Nutrition Examination Survey (NHANES) 2003-2010 to compare exposures to heavy metals including cadmium, lead, and total mercury in HIV infected and non-HIV infected subjects.

RESULTS

In this cross-sectional study, we found that HIV-infected individuals had higher concentrations of all heavy metals than the non-HIV infected group. In a multivariate linear regression model, HIV status was significantly associated with increased blood cadmium (p=0.03) after adjusting for age, sex, race, education, poverty income ratio, and smoking. However, HIV status was not statistically associated with lead or mercury levels after adjusting for the same covariates.

CONCLUSIONS

Our findings suggest that HIV-infected patients might be significantly more exposed to cadmium compared to non-HIV infected individuals which could contribute to higher prevalence of chronic diseases among HIV-infected subjects. Further research is warranted to identify sources of exposure and to understand more about specific health outcomes.

摘要

目的

非传染性合并症(如心血管疾病)在 HIV 感染者中变得越来越普遍,且发病年龄更早。尽管越来越多的文献将环境暴露与普通人群的慢性疾病结局联系起来,但在 HIV 感染者中,环境暴露的影响却很少受到关注。本研究旨在调查与未感染 HIV 的个体相比,生活在 HIV 感染者中的个体是否存在重金属暴露水平升高的情况。

方法

我们使用了 2003-2010 年的国家健康和营养检查调查(NHANES)数据,比较了 HIV 感染者和未感染 HIV 的个体对包括镉、铅和总汞在内的重金属的暴露情况。

结果

在这项横断面研究中,我们发现 HIV 感染者的所有重金属浓度均高于未感染 HIV 的群体。在多变量线性回归模型中,在校正了年龄、性别、种族、教育程度、贫困收入比和吸烟状况后,HIV 感染状态与血液中镉浓度升高显著相关(p=0.03)。然而,在校正了相同协变量后,HIV 感染状态与铅或汞水平之间无统计学关联。

结论

我们的研究结果表明,与未感染 HIV 的个体相比,HIV 感染者可能会显著更多地接触到镉,这可能导致 HIV 感染者中慢性疾病的患病率更高。需要进一步的研究来确定暴露源,并深入了解特定的健康结果。

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