安徽医科大学学报2026，Vol.61Issue(7)：1237-1244,8.DOI:10.19405/j.cnki.issn1000-1492.2026.07.011
砷、汞和镉联合暴露与成年人听力损失关联的病例对照分析
A case-control analysis on the effects of combined exposure to heavy metals arsenic,mercury,and cadmium on hearing function in adults
摘要
Abstract
Objective To investigate the association between single and combined exposure to arsenic(As),mer-cury(Hg),and cadmium(Cd)in urine and hearing loss in adults.Methods A total of 400 adult patients were re-cruited for the study,comprising 200 participants in the normal hearing group and 200 in the hearing loss group.General demographic information of the study subjects was collected by a self-administered questionnaire,morning urine samples were tested for As,Hg,and Cd concentrations,and hearing status was assessed by Pure Tone Audi-ometry.A binary Logistic regression model was used to explore the association between the concentrations of the three metals in urine and hearing loss,and a Bayesian kernel-machine regression(BKMR)model was used to fur-ther explore the association between the concentrations of the three metal mixtures and hearing loss.Results After correction for urinary creatinine,As,Hg,and Cd concentrations were higher in the hearing loss group than those in the normal hearing group(P＜0.05).Binary Logistic regression indicated that concentrations of As,Hg,and Cd were positively associated with hearing loss,and the risk of hearing loss was significantly higher in the second quar-tile of Cd concentration compared to the first quartile(OR=2.000,95％CI:1.009-3.964).BKMR modeling analysis showed that the combined exposure levels of As,Hg,and Cd significantly increased the risk of hearing loss,with Cd being the most important contributor(posterior inclusion probability=0.412),and that there were po-tential interactions between As and Cd,and Cd and Hg.Conclusion Combined exposure to As,Hg,and Cd in urine is significantly associated with adult hearing loss,with Cd being the primary contributor in the exposure com-bination.The interactions between As and Cd,as well as Cd and Hg,may have adverse effects on hearing loss.关键词
听力损失/重金属/贝叶斯核机器回归/联合暴露/交互作用/尿液生物标志物Key words
hearing loss/heavy metals/bayesian kernel machine regression/mixed exposure/interaction/uri-nary biomarkers分类
医药卫生引用本文复制引用
聂欢欢,张淑媛,杨林胜,孟相龙,王宏利,王媛,杨洁,徐东升..砷、汞和镉联合暴露与成年人听力损失关联的病例对照分析[J].安徽医科大学学报,2026,61(7):1237-1244,8.基金项目
国家自然科学基金项目(编号:82201295) National Natural Science Foundation of China(No.82201295) （编号:82201295）
