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成人汞暴露与肝功能下降的关联:一项纵向研究。

Mercury Exposure in Association With Decrease of Liver Function in Adults: A Longitudinal Study.

作者信息

Choi Jonghyuk, Bae Sanghyuk, Lim Hyungryul, Lim Ji-Ae, Lee Yong-Han, Ha Mina, Kwon Ho-Jang

机构信息

Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea.

出版信息

J Prev Med Public Health. 2017 Nov;50(6):377-385. doi: 10.3961/jpmph.17.099.

Abstract

OBJECTIVES

Although mercury (Hg) exposure is known to be neurotoxic in humans, its effects on liver function have been less often reported. The aim of this study was to investigate whether total Hg exposure in Korean adults was associated with elevated serum levels of the liver enzymes aspartate aminotransferase (AST), alanine transaminase (ALT), and gamma-glutamyltransferase (GGT).

METHODS

We repeatedly examined the levels of total Hg and liver enzymes in the blood of 508 adults during 2010-2011 and 2014-2015. Cross-sectional associations between levels of blood Hg and liver enzymes were analyzed using a generalized linear model, and nonlinear relationships were analyzed using a generalized additive mixed model. Generalized estimating equations were applied to examine longitudinal associations, considering the correlations of individuals measured repeatedly.

RESULTS

GGT increased by 11.0% (95% confidence interval [CI], 4.5 to 18.0%) in women and 8.1% (95% CI, -0.5 to 17.4%) in men per doubling of Hg levels, but AST and ALT were not significantly associated with Hg in either men or women. In women who drank more than 2 or 3 times per week, AST, ALT, and GGT levels increased by 10.6% (95% CI, 4.2 to 17.5%), 7.7% (95% CI, 1.1 to 14.7%), and 37.5% (95% CI,15.2 to 64.3%) per doubling of Hg levels, respectively, showing an interaction between blood Hg levels and drinking.

CONCLUSIONS

Hg exposure was associated with an elevated serum concentration of GGT. Especially in women who were frequent drinkers, AST, ALT, and GGT showed a significant increase, with a significant synergistic effect of Hg and alcohol consumption.

摘要

目的

虽然已知汞(Hg)暴露对人类具有神经毒性,但其对肝功能的影响报道较少。本研究旨在调查韩国成年人的总汞暴露是否与血清中谷丙转氨酶(AST)、谷草转氨酶(ALT)和γ-谷氨酰转移酶(GGT)水平升高有关。

方法

我们在2010 - 2011年和2014 - 2015年期间对508名成年人的血液中总汞和肝酶水平进行了重复检测。使用广义线性模型分析血液汞水平与肝酶水平之间的横断面关联,并使用广义相加混合模型分析非线性关系。考虑到重复测量个体的相关性,应用广义估计方程来检验纵向关联。

结果

汞水平每增加一倍,女性的GGT升高11.0%(95%置信区间[CI],4.5%至18.0%),男性升高8.1%(95% CI,-0.5%至17.4%),但男性和女性的AST和ALT与汞均无显著关联。在每周饮酒超过2或3次的女性中,汞水平每增加一倍,AST、ALT和GGT水平分别升高10.6%(95% CI,4.2%至17.5%)、7.7%(95% CI,1.1%至14.7%)和37.5%(95% CI,15.2%至64.3%),表明血液汞水平与饮酒之间存在相互作用。

结论

汞暴露与血清GGT浓度升高有关。特别是在经常饮酒的女性中,AST、ALT和GGT显著升高,汞和酒精消费具有显著的协同作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51f9/5717329/41ac3f188266/jpmph-50-6-377f1.jpg

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