台湾南部成年人的面板研究：真皮邻苯二甲酸二乙酯水平与绝对嗜酸性粒细胞计数介导的肺功能试验值变化的关联。
Associations of dermal diethyl phthalate level with changes in lung function test value mediated by absolute eosinophil count: A panel study of adults in southern Taiwan.
机构信息
Division of Hepatobiliary, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
出版信息
Environ Res. 2021 Mar;194:110613. doi: 10.1016/j.envres.2020.110613. Epub 2020 Dec 24.
Phthalate concentrations in indoor and outdoor dust are associated with respiratory disease. Both immunoglobulin E (IgE) and eosinophil count are associated with airway inflammation from exposure to environmental allergens. Dermal phthalate level can be used as a matrix for assessing personal exposure through direct absorption from the air, particle deposition, or contact with contaminated products. However, the association between dermal phthalate level and changes in lung function test values, as mediated by immunological response, remains unclear. In total, 237 adults in southern Taiwan were recruited. Spirometry measurements (in L) of forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were taken on visits 1 (2016-2018) and 2 (2019). Dermal phthalate level, absolute eosinophil count, and IgE level were recorded on visit 1. Mean changes in FVC and FEV1 decrease pear year, as determined through pairwise comparisons, were significant (FVC: -0.46, 95% CI: -0.51, -0.41; p < 0.001; FEV1: -0.37, 95% confidence interval [CI]: -0.41, -0.34; p < 0.001). For FEV1 decrease, log-unit increases in dermal diethyl phthalate (DEP) were positively associated with FEV1 (β = 0.096; 95% CI: 0.042, 0.150; p = 0.001) and negatively associated with absolute eosinophil count (β= -0.201; 95% CI: -0.380, -0.023; p= 0.027). Log-unit increases in absolute eosinophil count were negatively associated with FEV1 (β= -0.109; 95% CI: -0.150, -0.068; p < 0.001). Absolute eosinophil count mediated 19.70% of the association between dermal DEP level and FEV1. For FVC decrease, log-unit increases in dermal DEP were positively associated with FVC (β = 0.095; 95% CI: 0.035, 0.155; p = 0.002) and negatively associated with absolute eosinophil count (β = -0.243; 95% CI: -0.427, -0.060; p = 0.010). Log-unit increases in absolute eosinophil count were negatively associated with FVC (β= -0.122; 95% CI: -0.168, -0.076; p < 0.001). Absolute eosinophil count mediated 29.98% of the association between dermal DEP level and FVC. The results suggest that dermal DEP level is positively associated with changes in lung function test values and is mediated by absolute eosinophil count.
室内和室外灰尘中的邻苯二甲酸酯浓度与呼吸道疾病有关。免疫球蛋白 E（IgE）和嗜酸性粒细胞计数都与暴露于环境过敏原引起的气道炎症有关。皮肤中的邻苯二甲酸酯水平可以用作评估个人通过直接从空气中吸收、颗粒沉积或接触受污染产品而暴露的基质。然而，皮肤邻苯二甲酸酯水平与免疫反应介导的肺功能测试值变化之间的关联仍不清楚。在台湾南部共招募了 237 名成年人。在第 1 次就诊（2016-2018 年）和第 2 次就诊（2019 年）时测量了用力呼气量 1 秒（FEV1）和用力肺活量（FVC）的肺活量测量值（以升为单位）。在第 1 次就诊时记录了皮肤邻苯二甲酸酯水平、绝对嗜酸性粒细胞计数和 IgE 水平。通过两两比较确定 FVC 和 FEV1 的平均年下降量具有显著意义（FVC：-0.46，95%置信区间：-0.51，-0.41；p<0.001；FEV1：-0.37，95%置信区间：-0.41，-0.34；p<0.001）。对于 FEV1 的下降，皮肤中邻苯二甲酸二乙酯（DEP）的对数单位增加与 FEV1 呈正相关（β=0.096；95%置信区间：0.042，0.150；p=0.001），与绝对嗜酸性粒细胞计数呈负相关（β=-0.201；95%置信区间：-0.380，-0.023；p=0.027）。绝对嗜酸性粒细胞计数的对数单位减少与 FEV1 呈负相关（β=-0.109；95%置信区间：-0.150，-0.068；p<0.001）。绝对嗜酸性粒细胞计数介导了皮肤 DEP 水平与 FEV1 之间 19.70%的关联。对于 FVC 的下降，皮肤中邻苯二甲酸二乙酯的对数单位增加与 FVC 呈正相关（β=0.095；95%置信区间：0.035，0.155；p=0.002），与绝对嗜酸性粒细胞计数呈负相关（β=-0.243；95%置信区间：-0.427，-0.060；p=0.010）。绝对嗜酸性粒细胞计数的对数单位减少与 FVC 呈负相关（β=-0.122；95%置信区间：-0.168，-0.076；p<0.001）。绝对嗜酸性粒细胞计数介导了皮肤 DEP 水平与 FVC 之间 29.98%的关联。结果表明，皮肤 DEP 水平与肺功能测试值的变化呈正相关，由绝对嗜酸性粒细胞计数介导。
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