Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
Gannan Medical University, No.1 Harmonious Road, RongJiang District, Ganzhou, Jiangxi, 341000, China.
Chemosphere. 2021 May;270:129443. doi: 10.1016/j.chemosphere.2020.129443. Epub 2020 Dec 28.
To investigate the cross-sectional and longitudinal associations between aluminum exposure and lung function and the risk of chronic obstructive pulmonary disease (COPD).
The repeated-measure study was developed with 3917 adults from the Wuhan-Zhuhai cohort and they were followed-up after 3 years and 6 years. Urinary aluminum and lung function were measured at each period. Linear mixed models were used to estimate the exposure-response relationship between urinary aluminum and lung function. COX regression models were used to evaluate the association of urinary aluminum with the risk of COPD.
A total of 6996 observations including 2251 (32.2%) males with a mean age of 54.8 years were included. In the cross-sectional analyses, each 1-unit increase in log-transformed urinary aluminum was associated with a -33.34 mL (95% confidence interval (CI) -45.71 to -20.96) change in forced vital capacity (FVC) and a -17.89 mL (-27.80 to -7.97) change in forced expiratory volume in 1 s (FEV1). The follow-up analyses detected a negative association between urinary aluminum and the annual change of FVC (-6.73 mL/year, 95% CI -10.92 to -2.54), while the association of annual decline of FEV1 with urinary aluminum was statistically insignificant (-2.26 mL/year, -5.76 to 1.23). In the adjusted COX regression model, each 1-unit increase in log-transformed urinary aluminum was associated with a 29% increase in the incident risk of COPD (hazard ratio 1.29, 95% CI 1.04-1.62).
Increased urinary aluminum was associated with lung function reduction and the increased risk of COPD in a general urban population.
研究铝暴露与肺功能和慢性阻塞性肺疾病（COPD）风险之间的横断面和纵向关联。
本重复测量研究纳入了来自武汉-珠海队列的 3917 名成年人，他们在 3 年和 6 年后进行了随访。在每个时期测量尿铝和肺功能。使用线性混合模型来估计尿铝与肺功能之间的暴露-反应关系。使用 COX 回归模型来评估尿铝与 COPD 风险的关联。
共有 6996 次观察结果，其中包括 2251 名（32.2%）男性，平均年龄为 54.8 岁。在横断面分析中，尿铝的自然对数值每增加 1 个单位，与用力肺活量（FVC）的-33.34ml（95%置信区间（CI）：-45.71 至-20.96）变化和 1 秒用力呼气量（FEV1）的-17.89ml（-27.80 至-7.97）变化相关。随访分析发现，尿铝与 FVC 的年变化量呈负相关（-6.73ml/年，95%CI：-10.92 至-2.54），而尿铝与 FEV1 年下降量之间的关联无统计学意义（-2.26ml/年，-5.76 至 1.23）。在调整后的 COX 回归模型中，尿铝的自然对数值每增加 1 个单位，COPD 的发病风险增加 29%（风险比 1.29，95%CI：1.04-1.62）。
在一般城市人群中，尿铝升高与肺功能下降和 COPD 风险增加相关。
