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目的了解某地农村居民自然生活环境中镉、铅暴露对人体骨密度(BMD)的影响。方法以系统随机抽样的方法在开平市远离工业区的3个村镇选择本地居住超过15年、以当地自产大米和蔬菜为主要膳食来源的30～80岁村民为调查对象,采集居民晨尿和空腹静脉血,ICP-MS测定尿液和全血中镉、铅、磷和钙浓度,尿元素均采用尿肌酐校正;DTX-200骨密度仪测定受试者左前臂尺桡骨远端的BMD值,并进行Z评分,One-way ANOVA、卡方检验、Spearman秩相关和多元回归分析等统计方法初步探讨铅、镉水平与BMD的关系。结果 Spearman秩相关显示男性和女性尿镉与BMD呈负相关,其相关系数分别为-0.21和-0.22,尿铅和BMD未见显著相关。经方差分析和卡方检验,5个不同尿镉水平下,男性BMD不同,但其Z评分水平T-SD构成比未见明显差别;女性BMD未见显著差别,而不同T-SD水平人群构成比不同,随着女性尿镉水平增加,骨量减少和骨质疏松构成情况上升,其等级相关系数为0.22。多元回归分析显示女性BMD与年龄、体重有线性关系,男性BMD与年龄和BMI存在线性关系。结论本研究认为尿镉与BMD间存在简单相关关系,但未观察到线性关系,生活环境镉、铅暴露人群暴露指标对骨密度间的影响有待进一步研究。
Objective To understand the effects of cadmium and lead exposure on the body’s bone mineral density (BMD) in rural areas. Methods A random sampling method was used to select the 30 to 80-year-old villagers who lived in Kaiping City far away from the industrial area for more than 15 years. The residents aged 30-80 were selected as the main source of rice and vegetables, Fasting venous blood, urinary cadmium, lead, phosphorus and calcium concentrations in urine and whole blood were determined by ICP-MS. Urinary creatinine was corrected by urinary creatinine. The BMD of the distal radius and ulna was measured by DTX-200 bone densitometry , And Z-score, One-way ANOVA, chi-square test, Spearman rank correlation and multiple regression analysis were used to investigate the relationship between lead and cadmium levels and BMD. Results Spearman rank correlation showed that there was a negative correlation between urinary cadmium and BMD in male and female patients. The correlation coefficients were -0.21 and -0.22, respectively. There was no significant correlation between urinary lead and BMD. By means of analysis of variance and Chi-square test, BMD of male under different urine cadmium levels was different, but no significant difference was found in the T-SD ratio of Z score. There was no significant difference between female BMD and T-SD In contrast, with the increase of urinary cadmium levels in females, osteopenia and osteoporosis constituted a rise with a rank correlation coefficient of 0.22. Multivariate regression analysis showed that female BMD had a linear relationship with age and weight, and there was a linear relationship between male BMD and age and BMI. Conclusions This study suggests that there is a simple correlation between urinary cadmium and BMD. However, no linear relationship was observed. The influence of cadmium and lead exposure on bone mineral density in living environment needs to be further studied.