在美国60岁及以上成年人的一项横断面研究中血镉水平与认知功能之间的关联。
Associations between blood cadmium levels and cognitive function in a cross-sectional study of US adults aged 60 years or older.
作者信息
Li Hongyu, Wang Zhihui, Fu Zhen, Yan Mingming, Wu Nanjin, Wu Hongyan, Yin Ping
机构信息
Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, Huazhong University of Science and Technology, Wuhan, China.
Department of Nursing, Union Hospital, Huazhong University of Science and Technology, Wuhan, China.
出版信息
BMJ Open. 2018 Apr 12;8(4):e020533. doi: 10.1136/bmjopen-2017-020533.
OBJECTIVES
The relationship between cadmium exposure and cognition has been well studied in children. However, the association between environmental cadmium exposure and cognitive function has not been researched extensively in older adults. Our goal was to evaluate the association between cognitive function and blood cadmium levels in US adults aged 60 years or older.
DESIGN
A cross-sectional study.
SETTING
The US National Health and Nutrition Examination Survey (NHANES).
PARTICIPANTS
A total of 2068 adults aged 60 years or older who completed four cognitive assessment tests and blood cadmium detection in two waves of NHANES (2011-2014).
MAIN OUTCOME MEASURES
Cognitive assessment was conducted by household interview or at a Mobile Examination Center (MEC) using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word List Learning Test, the CERAD Word List Recall Test, the Animal Fluency Test and the Digit Symbol Substitution Test (DSST). We created a composite cognitive z-score to represent global cognitive function.
RESULTS
The median blood cadmium concentration in the study participants was 0.35 µg/L, and the IQR was 0.24-0.56 µg/L. In linear regression analyses, adjusting for demographics, behaviour and medical history, blood cadmium as a continuous variable was inversely associated with the composite z-score (μg/L, β=-0.11, 95% CI -0.20 to -0.03). Similarly, there was a significant association between quartiles of blood cadmium and composite z-score, with somewhat lower scores in the upper quartile of exposure (blood cadmium ≥0.63 µg/L) compared with those in the lower quartile of exposure (blood cadmium <0.25 µg/L) (μg/L, β=-0.14, 95% CI -0.25 to -0.03), and there was a trend by quartiles of blood cadmium (P<0.0001).
CONCLUSIONS
Our findings suggest that increased blood cadmium is associated with worse cognitive function in adults aged 60 years or older in the USA.
目的
镉暴露与儿童认知之间的关系已得到充分研究。然而，环境镉暴露与老年人认知功能之间的关联尚未得到广泛研究。我们的目标是评估60岁及以上美国成年人认知功能与血镉水平之间的关联。
设计
一项横断面研究。
地点
美国国家健康与营养检查调查（NHANES）。
参与者
共有2068名60岁及以上的成年人，他们在NHANES的两波调查（2011 - 2014年）中完成了四项认知评估测试和血镉检测。
主要观察指标
通过家庭访谈或在移动检查中心（MEC）使用阿尔茨海默病注册协会（CERAD）词汇学习测试、CERAD词汇回忆测试、动物流畅性测试和数字符号替换测试（DSST）进行认知评估。我们创建了一个综合认知z分数来代表整体认知功能。
结果
研究参与者的血镉浓度中位数为0.35μg/L，四分位间距为0.24 - 0.56μg/L。在线性回归分析中，在调整人口统计学、行为和病史后，作为连续变量的血镉与综合z分数呈负相关（μg/L，β = -0.11，95%CI -0.20至 -0.03）。同样，血镉四分位数与综合z分数之间存在显著关联，与低暴露四分位数（血镉<0.25μg/L）相比，高暴露四分位数（血镉≥0.63μg/L）的分数略低（μg/L，β = -0.14，95%CI -0.25至 -0.03），并且血镉四分位数存在趋势（P<0.0001）。
结论
我们的研究结果表明，在美国60岁及以上的成年人中，血镉升高与较差的认知功能相关。
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