Department of tuberculosis, Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine, No. 208, East Huan Cheng Road, Gongshu District, Hangzhou, 310000, Zhejiang, China.
BMC Pulm Med. 2024 Aug 1;24(1):375. doi: 10.1186/s12890-024-03181-9.
This cross-sectional study aimed to explore the association between methyl mercury (MeHg) level and latent tuberculosis infection (LTBI) risk based on the data from National Health and Nutrition Examination Survey (NHANES 2011-2012).
A total of 5243 participants with 20 variables were enrolled. The importance of these variables on TB infection was first ranked by XGBoost and Random Forest methods. Then the association between MeHg level and infection risk was evaluated by restricted cubic spline, threshold effect, and generalized linear regression analyses. We also explored the factors correlated with the difference in MeHg level and finally conducted a mediation analysis to assess the mediating effect of MeHg in LTBI.
521 participants were experiencing the LTBI, and 12 variables showed the differences between infection and non-infection groups (all P < 0.05). Of them, MeHg presented the highest importance on the LTBI. Restricted cubic spline (RCS) next revealed a significant non-linear correlation of MeHg with LTBI (all P < 0.05). Adjusted regression models further indicated their independent association (all P < 0.05), and infection risk increased with the increase of MeHg (P for trend < 0.05). We also found a significant turning point, and their association was significantly observed when MeHg > 5.75 µg/L (P < 0.05). In addition, asthma history was related to the difference in MeHg levels between LTBI and non-LTBI groups. Mediation analysis found that MeHg level partially mediated the association of asthma and LTBI risk (all P < 0.05).
Our study identified MeHg as an independent risk factor for LTBI risk. Their causal relationship needs more investigation to verify.
本横断面研究旨在基于国家健康和营养调查（NHANES 2011-2012）的数据，探讨甲基汞（MeHg）水平与潜伏性结核感染（LTBI）风险之间的关系。
共纳入 5243 名参与者，共包含 20 个变量。首先使用 XGBoost 和随机森林方法对这些变量对结核感染的重要性进行排序。然后，采用受限立方样条、阈值效应和广义线性回归分析评估 MeHg 水平与感染风险之间的关系。我们还探讨了与 MeHg 水平差异相关的因素，并最终进行了中介分析，以评估 MeHg 在 LTBI 中的中介作用。
521 名参与者患有 LTBI，感染组和非感染组有 12 个变量存在差异（均 P<0.05）。其中，MeHg 对 LTBI 的重要性最高。受限立方样条（RCS）进一步显示 MeHg 与 LTBI 之间存在显著的非线性关系（均 P<0.05）。调整后的回归模型进一步表明它们之间存在独立的关联（均 P<0.05），并且随着 MeHg 的增加，感染风险也随之增加（P 趋势<0.05）。我们还发现了一个显著的转折点，当 MeHg>5.75μg/L 时，两者之间的关联显著（P<0.05）。此外，哮喘病史与 LTBI 和非 LTBI 组之间 MeHg 水平的差异有关。中介分析发现，MeHg 水平部分介导了哮喘与 LTBI 风险之间的关联（均 P<0.05）。
本研究确定 MeHg 是 LTBI 风险的一个独立危险因素。它们之间的因果关系需要进一步调查验证。
