农村居民血清中23种元素与代谢综合征关系

靳雅男; 付海龙; 廖沙; 樊学敏; 赵燚; 许红霞; 刘秀英; 张毓洪

doi:10.11847/zgggws2013-29-12-37

摘要: 目的了解农村居民血清中23种微量元素与代谢综合征（MS）的关系，为采取相应的干预措施提供参考依据。方法采用分层整群抽样结合系统抽样方法对在宁夏回族自治区吴忠市和固原市抽取的1 493名25~74岁农村居民进行问卷调查和体格检查，并测定各项生化指标及血清中23种微量元素含量。结果1 493名农村居民中，MS患者142例（9.51%），正常人群1 351人（90.49%）；2组人群比较，MS组血清中Cu、Se、P、Cd含量和Zn/Cd比值分别为（1.05±0.26）μg/mL、（0.48±0.46）μg/mL、（1.54±0.43）mg/mL、（17.16±6.82）ng/mL、（1 991.55±288.21），均高于正常组的（0.99±0.21）μg/mL、（0.34±0.39）μg/mL、（1.43±0.33）mg/mL、（14.49±6.74）ng/mL、（619.05±214.12）（P<0.05），B和Cr的含量分别（2.30±1.57）μg/mL和（5.32±2.49）μg/mL，均低于正常组的（2.84±2.15）μg/mL和（6.30±2.71）μg/mL（P<0.05）；控制年龄和文化程度后，偏相关分析结果显示，血清中Li与空腹血糖（FPG）、甘油三酯（TG）均呈正相关，与高密度脂蛋白胆固醇（HDL-C）呈负相关（均P<0.05），Cu与收缩压（SBP）、舒张压（DBP）均呈正相关（均P<0.05），Ca与HDL-C 呈负相关（r=-0.095，P=0.022），T1与TG呈正相关，与SBP、DBP、HDL-C均呈负相关（均P<0.05），Pb与FPG呈正相关，与HDL-C呈负相关（均P<0.05），P与SBP、DBP、FPG、TG、HDL-C均呈正相关（均P<0.05），Cr与HDL-C呈正相关，与体质指数（BMI）呈负相关（均P<0.05），Ba与DBP呈负相关（r=-0.087，P=0.035），Sr与HDL-C呈正相关（r=0.153，P=0.000）；Logistic回归分析结果显示，血清Cu（OR=1.543，95%CI=1.195~1.992）、Ga（OR=1.361，95%CI=1.017~1.822）、Cd（OR=1.605，95%CI=1.148~2.243）是MS患病的危险因素，Cr（OR=0.754，95%CI=0.603~0.942）是MS患病的保护因素。结论血清Li、Cu、Ga、Tl、Pb、P、Cr、Ba、Sr与MS均相关，Cu、Ga、Cd、Cr是MS患病的独立影响因素。

Abstract: Objective To analyse the relationship between serum mineral elements and metabolic syndrome among rural residents and to provide reference for taking relevant intervention.Methods A cross-sectional survey was carried out among 3 391 people selected from four villages in Guyuan and Wuzhong city in Ningxia.After physical checking,1 612 blood samples were collected using stratified cluster sampling combined with systematic sampling.Inductively coupled plasma atomic emission spectrometry(ICP-AES)was used to determine the serum levels of 23 elements in 1 493 participants.Results The concentrations of serum copper,selenium,phosphorus and cadmium in metabolic syndrome group were higher than those of the normal group(P<0.05 for all);the serum boron and chromium contents in normal group were higher than those of the participants with metabolic syndrome(P<0.05 for all).Zn/Cd ratio for metabolic syndrome group was higher than that of normal group(P<0.05).Partial correlation analyses showed that there were positive correlations between systolic blood pressure and serum copper and phosphorus and serum thallium was negatively correlated with systolic blood pressure.Serum copper and phosphorus were positively correlated with diastolic blood pressure;serum thallium and barium were negatively correlated with diastolic pressure.There were positive correlations between blood sugar and serum lithium,gallium,lead,and phosphorus.Serum lithium,thallium and phosphorus were positively correlated with triglycerides.Serum phosphorus,chromium,and strontium were positively correlated with high-density lipoprotein cholesterol;serum lithium,gallium,thallium,and lead were negatively correlated with high-density lipoprotein cholesterol.Serum chromium was negatively correlated with body mass index.Logistic regression showed that serum copper,gallium,and cadmium were independent impact factors of metabolic syndrome.Conclusion Serum copper,phosphorus,gallium,barium,lithium,thallium,lead,chromium and strontium are closely associated with metabolic syndrome.Serum copper,cadmium and gallium are the risk factors for metabolic syndrome,while with the increases of the concentration of the elements,the metabolic syndrome risk will increase.Serum chromium is a protective factor for metabolic syndrome,the risk of metabolic syndrome could decrease with the increment of serum chromium concentration.

农村居民血清中23种元素与代谢综合征关系

Relationship between 23 serum elements and metabolic syndrome among rural residents