Fu Xihang, Li Huiru, Song Lingling, Cen Manqiu, Wu Jing
Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, Hubei 430030, People's Republic of China.
Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, Hubei 430030, People's Republic of China.
Neurotoxicology. 2023 Mar;95:117-126. doi: 10.1016/j.neuro.2023.01.008. Epub 2023 Jan 22.
This study aimed to evaluate the association between urinary heavy metal mixture exposure and depression, and the modifying role of physical activity in the effects of heavy metal mixture on depression risk was also considered.
Data of this study were derived from the National Health and Nutrition Examination Survey 2011-2016. Depression was measured by the Patient Health Questionnaire. We first selected 6 (cadmium, cobalt, tin, antimony, thallium, and mercury) from 14 heavy metals through elastic net regression for further analysis. Then binomial logistic regression, generalized additive model, environment risk score (ERS), and weighted quantile sum (WQS) regression were adopted to assess the effects of six metals individual and cumulative exposure on depression risk. Finally, we also examined whether physical activity could mitigate the effects of heavy metal co-exposure on depression risk.
Totally, 4212 participants were included and 7.40% of subjects were with depression. We found urinary tin and antimony were separately associated with increased odds of depression (Sb: OR = 1.285, 95% CI: 1.064-1.553; Sn: OR = 1.281, 95% CI: 1.097-1.495), and a linear dose-response relationship between tin and depression was also noticed (P < 0.05). Meanwhile, urinary heavy metals co-exposure was positively related to depression risk (ERS: OR = 2.691, 95% CI: 1.399-5.174; WQS: OR = 1.465, 95% CI: 1.063-2.021), in which tin, antimony, and cadmium were identified with greater contributions to the overall mixture effect. In both ERS and WQS models, the significant positive association between the metal mixture and depression risk remained only in those who were inactive in physical activity.
Our study concluded the detrimental effect of heavy metals in combined exposure on the risk of depression, which might be attenuated by physical activity.
本研究旨在评估尿中重金属混合物暴露与抑郁症之间的关联，并考虑身体活动在重金属混合物对抑郁症风险影响中的调节作用。
本研究数据来源于2011 - 2016年美国国家健康与营养检查调查。采用患者健康问卷来测量抑郁症。我们首先通过弹性网络回归从14种重金属中筛选出6种（镉、钴、锡、锑、铊和汞）进行进一步分析。然后采用二项逻辑回归、广义相加模型、环境风险评分（ERS）和加权分位数和（WQS）回归来评估这六种金属的单独暴露和累积暴露对抑郁症风险的影响。最后，我们还研究了身体活动是否可以减轻重金属共同暴露对抑郁症风险的影响。
共纳入4212名参与者，7.40%的受试者患有抑郁症。我们发现尿中锡和锑分别与抑郁症患病几率增加相关（锑：比值比[OR]=1.285，95%置信区间[CI]：1.064 - 1.553；锡：OR = 1.281，95% CI：1.097 - 1.495），并且还注意到锡与抑郁症之间存在线性剂量反应关系（P < 0.05）。同时，尿中重金属共同暴露与抑郁症风险呈正相关（ERS：OR = 2.691，95% CI：1.399 - 5.174；WQS：OR = 1.465，95% CI：1.063 - 2.021），其中锡、锑和镉对总体混合物效应的贡献更大。在ERS和WQS模型中，金属混合物与抑郁症风险之间的显著正相关仅在身体活动不活跃的人群中存在。
我们的研究得出结论，重金属联合暴露对抑郁症风险有有害影响，而身体活动可能会减弱这种影响。
