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中国2017年成人膳食来源铅暴露所致心血管疾病疾病负担分析

李依玲 闫贻忠 刘佳琳 王彝白纳 魏晟

李依玲, 闫贻忠, 刘佳琳, 王彝白纳, 魏晟. 中国2017年成人膳食来源铅暴露所致心血管疾病疾病负担分析[J]. 中国公共卫生, 2022, 38(5): 557-562. doi: 10.11847/zgggws1137343
引用本文: 李依玲, 闫贻忠, 刘佳琳, 王彝白纳, 魏晟. 中国2017年成人膳食来源铅暴露所致心血管疾病疾病负担分析[J]. 中国公共卫生, 2022, 38(5): 557-562. doi: 10.11847/zgggws1137343
LI Yi-ling, YAN Yi-zhong, LIU Jia-lin, . Burden of cardiovascular disease attributable to dietary lead exposure among adults in China, 2017[J]. Chinese Journal of Public Health, 2022, 38(5): 557-562. doi: 10.11847/zgggws1137343
Citation: LI Yi-ling, YAN Yi-zhong, LIU Jia-lin, . Burden of cardiovascular disease attributable to dietary lead exposure among adults in China, 2017[J]. Chinese Journal of Public Health, 2022, 38(5): 557-562. doi: 10.11847/zgggws1137343

中国2017年成人膳食来源铅暴露所致心血管疾病疾病负担分析

doi: 10.11847/zgggws1137343
基金项目: 国家重点研究发展计划(2018YFC1603105)
详细信息
    作者简介:

    李依玲(1997 – ),女,湖北武汉人,硕士在读,研究方向:流行病与卫生统计学

    通信作者:

    王彝白纳,E-mail:wangyibaina@cfsa.net.cn

    魏晟,E-mail:shengwei@hust.edu.cn

  • 中图分类号: R 195.4;R 54

Burden of cardiovascular disease attributable to dietary lead exposure among adults in China, 2017

  • 摘要:   目的  分析中国2017年成人膳食来源铅暴露所致心血管疾病(CVD)的疾病负担,为评估食品中铅暴露导致的健康危害提供参考依据。  方法  收集2000年1月 — 2020年7月万方数据知识服务平台、中国知网数据库、中国生物医学文献数据库、PubMed数据库和Web of Science数据库中公开发表的关于中国成人血铅的相关文献,2017年全球疾病负担研究(GBD 2017)中2017年CVD的疾病负担数据以及食物、空气、饮用水的铅浓度和经消化道、呼吸道摄入铅的生物利用度相关数据,采用比较风险评估法计算人群归因分值(PAF)估算铅暴露导致CVD的疾病负担,并参考整合暴露吸收生物动力学模型(IEUBK)的原理计算膳食铅暴露途径对血铅的贡献率。  结果  中国成人血铅水平为5.23 μg/dL,男性和女性成人血铅水平分别为5.96 和4.90 μg/dL;2017年中国成人由于铅暴露导致CVD的疾病负担为323.96万人年,四川省、云南省和湖南省的总CVD标化归因DALY率较高,每10万人中分别可造成635.00、633.62和547.36个健康寿命年的损失;膳食是铅暴露的主要途径,对男性和女性成人的贡献率分别为57.01 %和58.60 %,导致CVD的总DALYs为186.34万人年,包括缺血性心脏病60.23万人年、脑卒中99.70万人年和高血压心脏病19.37万人年。  结论  铅暴露对中国成人造成了较大的CVD疾病负担,其中膳食途径是铅暴露的主要来源。
  • 表  1  中国各省(自治区、直辖市)成人的血铅水平(μg/dL)

    行政区样本量几何均值(μg/dL)几何标准差(μg/dL)
    北京市11674.872.89
    天津市254.781.41
    陕西省406.373.97
    辽宁省12224.083.93
    吉林省4533.033.20
    黑龙江省8926.72NR a
    上海市368.954.66
    江苏省2607.153.09
    浙江省9766.814.57
    安徽省10982.883.75
    山东省3128.135.79
    河南省22095.493.77
    湖北省10484.396.22
    湖南省21207.893.13
    广东省1095.100.75
    广西壮族自治区659.862.41
    重庆市14867.732.74
    四川省837.614.77
    贵州省1577.440.98
    云南省2338.296.70
      注:a NR表示文献中未报道。
    下载: 导出CSV

    表  2  中国2017年成人铅暴露所致CVD的PAF和疾病负担

    行政区缺血性心脏病脑卒中高血压心脏病总CVD
    PAFDALY
    (万人年)
    DALY率
    (1/10万)
    PAFDALY
    (万人年)
    DALY率
    (1/10万)
    PAFDALY
    (万人年)
    DALY率
    (1/10万)
    DALY
    (万人年)
    DALY率
    (1/10万)
    北京市2.710.9153.113.051.2673.315.450.095.172.37138.20
    天津市0.920.3730.231.040.4940.121.830.021.740.9274.29
    陕西省4.043.39115.904.545.04172.238.050.7826.519.57326.85
    辽宁省2.824.68135.413.176.63191.965.670.3911.1912.03348.29
    吉林省1.711.6375.671.932.1198.043.470.3114.344.16193.61
    上海市5.131.2062.545.772.17113.6710.140.2211.353.84200.99
    江苏省4.094.1765.734.6010.49165.188.141.5925.1116.94266.85
    浙江省4.372.0746.224.915.41120.848.701.3530.139.30208.00
    安徽省1.942.2946.252.184.4890.543.931.0120.418.04162.55
    山东省4.9713.83174.745.5917.83225.329.852.6333.2435.41539.39
    河南省3.549.95131.653.9815.62206.637.092.0827.4728.34358.14
    湖北省3.634.5497.204.088.86189.917.282.1846.6316.10213.02
    湖南省4.458.01147.665.0011.70215.738.824.7787.9925.55547.36
    广东省1.552.5528.861.753.4138.593.100.637.096.87242.84
    广西壮族自治区5.085.00129.565.708.49219.819.991.7846.0216.10296.87
    重庆市4.231.7572.084.763.77154.968.400.8635.226.7476.26
    四川省4.706.4498.175.2914.49220.689.332.3535.8324.53635.00
    贵州省4.002.1576.114.506.35224.227.950.8128.669.83258.96
    云南省5.104.41116.295.738.60226.5910.101.5741.2515.41633.62
    下载: 导出CSV

    表  3  中国2017年成人膳食来源铅暴露所致CVD的疾病负担

    暴露途径性别缺血性心脏病脑卒中高血压心脏病总CVD
    DALY
    (万人年)
    DALY率
    (1/10万)
    DALY
    (万人年)
    DALY率
    (1/10万)
    DALY
    (万人年)
    DALY率
    (1/10万)
    DALY
    (万人年)
    DALY率
    (1/10万)
    食物男性40.6372.2367.25119.5713.0623.22125.69223.46
    女性19.6036.5232.4560.466.3111.7660.66113.01
    合计60.23108.7699.70180.0319.3734.97186.34336.48
    空气男性30.4854.1950.4589.709.8017.4294.29167.65
    女性13.7725.6622.8042.484.438.2642.6279.41
    合计44.2579.8573.26132.1914.2325.68136.91247.06
    饮用水男性0.150.270.250.450.050.090.470.84
    女性0.070.140.120.230.020.040.230.42
    合计0.230.410.370.680.070.130.701.26
    合计男性71.26126.70117.96209.7222.9040.72220.45391.95
    女性33.4562.3255.38103.1710.7720.06103.50192.84
    合计104.7195.26173.33157.6933.6730.63323.96294.73
    下载: 导出CSV
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  • 接收日期:  2021-11-03
  • 网络出版日期:  2022-04-29
  • 刊出日期:  2022-05-20

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