混合二恶英暴露与美国成年人高尿酸血症的关联：三种统计模型的比较。
Association between mixed dioxin exposure and hyperuricemia in U.S. adults: A comparison of three statistical models.
机构信息
Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, Qingdao, 266071, China.
Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, Qingdao, 266071, China.
出版信息
Chemosphere. 2022 Sep;303(Pt 3):135134. doi: 10.1016/j.chemosphere.2022.135134. Epub 2022 May 26.
BACKGROUND
Previous studies on the relationship between dioxin exposures and hyperuricemia have usually been based on multi-chemical linear models. However, the complex nonlinear relationship and interaction between mixed dioxin exposures and hyperuricemia have seldom been studied. In this study, we applied three different statistical models to assess the joint effect of 12 dioxins on hyperuricemia.
METHODS
A total of 7 dioxin-like polychlorinated biphenyls (DL-PCBs), 3 polychlorinated dibenzo-p-dioxins (PCDDs), and 2 polychlorinated dibenzofurans (PCDFs) were measured in the serum of adults by the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2004. We fitted multivariable logistic regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) models to estimate the association of individual and mixed dioxin exposures with hyperuricemia.
RESULTS
Among the 1008 individuals included in our analysis, 20.04% had hyperuricemia. In the multivariable logistic regression established for each single dioxin, PCB28, PCB74, PCB105, PCB118, and 1,2,3,4,6,7,8-HPCDD were positively associated with hyperuricemia. With including all dioxins in the multivariable logistic regression model simultaneously, only PCB28 and 1,2,3,4,6,7,8-HPCDD were positively associated with hyperuricemia. In the WQS regression model, the WQS index was significantly associated (OR (95% CI): 2.32 (1.26, 4.28)) with hyperuricemia, and 1,2,3,4,6,7,8-HPCDD (weighted 0.22) had the largest contribution. In BKMR analysis, a significant positive association was found between mixed dioxin exposure and hyperuricemia when all dioxins were at their 60th percentile or above, compared to their 50th percentile. The univariate exposure-response function showed that PCB105 and PCB118 were positively associated with hyperuricemia.
CONCLUSION
By comparing the three statistical models, we concluded that the whole-body burden of 12 dioxins was significantly positively associated with hyperuricemia. PCB105, PCB118, and 1,2,3,4,6,7,8-HPCDD played the most important roles in hyperuricemia.
背景
以往关于二噁英暴露与高尿酸血症之间关系的研究通常基于多化学线性模型。然而，混合二噁英暴露与高尿酸血症之间复杂的非线性关系和相互作用很少被研究。在这项研究中，我们应用了三种不同的统计模型来评估 12 种二噁英对高尿酸血症的联合作用。
方法
我们通过 2003 年至 2004 年全国健康与营养调查（NHANES）测量了成年人血清中的 7 种二噁英类多氯联苯（DL-PCBs）、3 种多氯二苯并对二恶英（PCDDs）和 2 种多氯二苯并呋喃（PCDFs）。我们使用多变量逻辑回归、加权分位数总和（WQS）回归和贝叶斯核机器回归（BKMR）模型来估计个体和混合二噁英暴露与高尿酸血症的关联。
结果
在我们分析的 1008 名个体中，20.04%患有高尿酸血症。在为每种单一二噁英建立的多变量逻辑回归中，PCB28、PCB74、PCB105、PCB118 和 1,2,3,4,6,7,8-HPCDD 与高尿酸血症呈正相关。在同时包含所有二噁英的多变量逻辑回归模型中，只有 PCB28 和 1,2,3,4,6,7,8-HPCDD 与高尿酸血症呈正相关。在 WQS 回归模型中，WQS 指数与高尿酸血症显著相关（OR（95%CI）：2.32（1.26，4.28）），1,2,3,4,6,7,8-HPCDD（权重 0.22）的贡献最大。在 BKMR 分析中，当所有二噁英处于第 60 百分位或以上时，与处于第 50 百分位相比，混合二噁英暴露与高尿酸血症之间存在显著的正相关关系。单变量暴露-反应函数显示 PCB105 和 PCB118 与高尿酸血症呈正相关。
结论
通过比较三种统计模型，我们得出结论，12 种二噁英的全身负荷与高尿酸血症呈显著正相关。PCB105、PCB118 和 1,2,3,4,6,7,8-HPCDD 在高尿酸血症中发挥最重要的作用。
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