Zhu Zhuoqi, Li Juanhua, Peng Yang, Qin Ning, Li Jiemei, Wei Ying, Wang Biwen, Liao Yunfei, Zeng Huaicai, Cheng Lu, Li Han
Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning 530021, China; Guangxi Key Laboratory of Environment and Health Research, Guangxi Medical University, Nanning 530021, China.
Guangxi Key Laboratory of Environment and Health Research, Guangxi Medical University, Nanning 530021, China; Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, Nanning 530021, China.
Ecotoxicol Environ Saf. 2025 Jan 15;290:117768. doi: 10.1016/j.ecoenv.2025.117768. Epub 2025 Jan 24.
The existing studies on the association between multi-metal mixture exposure and cognitive function in the older adults are limited and controversial, with no studies considering the mediating effect of thyroid hormones on the connection between them. This study of 441 urban older adults assessed 21 urinary metal levels and cognitive function using the Mini-Mental State Examination (MMSE). Urinary metal levels were measured via inductively coupled plasma mass spectrometry (ICP-MS), and thyroid hormones levels were obtained from medical records. Mediation analysis evaluated the role of thyroid hormones in the link between metals exposure and cognitive function. The General Linear Model (GLM) showed negative correlations between MMSE scores and titanium (Ti), copper (Cu), rubidium (Rb), and molybdenum (Mo), and positive correlations with selenium (Se) and barium (Ba). Nonlinear inverse U-shaped associations between Mo, Rb, and MMSE scores were identified using Restricted Cubic Splines (RCS) and Bayesian Kernel Machine Regression (BKMR). Mediation analysis revealed that Free Thyroxine (FT4) mediated the relationship between Rb and MMSE scores by 29.10 % and between Zinc (Zn) and language performance by 35.00 %. Total thyroxine (TT4) mediated the link between Cu and orientation score by 24.69 %, and Thyroid Stimulating Hormone (TSH) mediated the association between Cu and attention score by 38.96 %. Ti, Se, Rb, Mo, Ba and Cu were significantly associated with cognitive impairment risk. Mixed exposure to Mo and Rb was linked to an increased risk of cognitive impairment. Additionally, levels of TSH, FT4 and TT4 were associated with cognitive function, mediating the effects of Rb, Zn and Cu on cognitive function.
目前关于老年人多金属混合物暴露与认知功能之间关联的研究有限且存在争议，尚无研究考虑甲状腺激素在二者联系中的中介作用。本研究对441名城市老年人进行了评估，使用简易精神状态检查表（MMSE）评估其21种尿金属水平和认知功能。通过电感耦合等离子体质谱法（ICP-MS）测量尿金属水平，并从医疗记录中获取甲状腺激素水平。中介分析评估了甲状腺激素在金属暴露与认知功能之间联系中的作用。广义线性模型（GLM）显示，MMSE评分与钛（Ti）、铜（Cu）、铷（Rb）和钼（Mo）呈负相关，与硒（Se）和钡（Ba）呈正相关。使用受限立方样条（RCS）和贝叶斯核机器回归（BKMR）确定了Mo、Rb与MMSE评分之间的非线性倒U形关联。中介分析显示，游离甲状腺素（FT4）介导了Rb与MMSE评分之间29.10%的关系以及锌（Zn）与语言能力之间35.00%的关系。总甲状腺素（TT4）介导了Cu与定向评分之间24.69%的联系，促甲状腺激素（TSH）介导了Cu与注意力评分之间38.96%的关联。Ti、Se、Rb、Mo、Ba和Cu与认知障碍风险显著相关。Mo和Rb的混合暴露与认知障碍风险增加有关。此外，TSH、FT4和TT4水平与认知功能相关，介导了Rb、Zn和Cu对认知功能的影响。
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