Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China; Peace Hospital Affiliated to Changzhi Medical College, China.
Sixth Hospital of Shanxi Medical University (General hospital of Tisco), China.
Neurotoxicology. 2022 Jul;91:282-289. doi: 10.1016/j.neuro.2022.06.001. Epub 2022 Jun 6.
To explore the effects of occupational aluminum exposure on workers' cognitive function and blood glucose concentration, and to analyze whether blood glucose concentration can mediate the cognitive changes caused by aluminum.
Our study recruited 375 workers from an aluminum factory in northern China. We collected the fasting elbow venous blood of the workers, measured their fasting blood glucose concentration (FBG), and used ICP-MS to determine plasma aluminum concentration (P-Al) as an indicator of internal exposure. The Montreal Cognitive Assessment (MoCA), was used to assess the cognitive function of workers. Generalized linear model was used to analyze the association of P-Al with cognitive function and blood glucose concentration, and the restricted cubic spline model was used to fit the dose-response relationship. We also conducted a mediation effect analysis.
We observed the dose-response relationship, that is, as the P-Al increased, sum of MoCA, visuospatial/executive, naming, language, and abstraction scores decreased, and the blood glucose concentration increased. For every e-fold increase in P-Al, sum of MoCA, visuospatial/executive, naming, language, and abstraction scores decreased by 0.328 points, 0.120 points, 0.059 points, 0.060 points, and 0.083 points, respectively, and FBG rose by 0.109 mmol/L. FBG has a significant mediating effect between P-Al and sum of MoCA (P for mediator=0.042), and it could explain 10.7% of the effect of cognitive level related to P-Al.
Occupational aluminum exposure negatively affected the cognitive function of workers and positively affected FBG. FBG may partially explain the impact of occupational aluminum exposure on workers' cognitive function.
探讨职业性铝暴露对工人认知功能和血糖浓度的影响，并分析血糖浓度是否可以介导铝引起的认知变化。
本研究招募了来自中国北方一家铝厂的 375 名工人。我们采集了工人的空腹肘静脉血，测量了他们的空腹血糖浓度（FBG），并使用电感耦合等离子体质谱法（ICP-MS）测定血浆铝浓度（P-Al）作为内暴露的指标。使用蒙特利尔认知评估（MoCA）评估工人的认知功能。采用广义线性模型分析 P-Al 与认知功能和血糖浓度的关系，采用限制性立方样条模型拟合剂量-反应关系。我们还进行了中介效应分析。
我们观察到剂量-反应关系，即随着 P-Al 的增加，MoCA 总分、视空间/执行、命名、语言和抽象分数降低，血糖浓度升高。P-Al 每增加一个对数，MoCA 总分、视空间/执行、命名、语言和抽象分数分别降低 0.328 分、0.120 分、0.059 分、0.060 分和 0.083 分，FBG 升高 0.109mmol/L。FBG 在 P-Al 与 MoCA 总分之间具有显著的中介作用（P 为中介=0.042），可以解释与 P-Al 相关的认知水平影响的 10.7%。
职业性铝暴露对工人的认知功能产生负面影响，对 FBG 产生正向影响。FBG 可能部分解释了职业性铝暴露对工人认知功能的影响。
