The Effects of Metal Exposures on Charlson Comorbidity Index Using Zero-Inflated Negative Binomial Regression Model: NHANES 2011-2016
The Effects of Metal Exposures on Charlson Comorbidity Index Using Zero-Inflated Negative Binomial Regression Model: NHANES 2011-2016
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DOI：
10.1007/s12011-020-02331-4
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发表时间：
2020-08-20
影响因子：
3.9
通讯作者：
Li, Bo
中科院分区：
文献类型：
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作者：
Zhao, Hantong;Pan, Yingan;Li, Bo
背景随着慢性病发病率的上升，以及老龄化人口的增多，多发病已成为严重的公共卫生问题。本研究的目的是探讨金属暴露与Charlson共病指数(CCI)之间的关系，为提高生活质量和降低死亡率提供有价值的信息。方法研究样本为连续三个周期(2011-2016)的国民健康与营养状况调查(NHANES)，纳入4901名符合条件的受试者。采用零膨胀负二项(ZINB)模型研究金属暴露对CCI的影响，包括现场尿(砷、汞、镉)、全血(锰、硒、铅)和血清(铜、锌)。结果在计数部分(Cci；=0)，在其他变量不变的情况下，血硒每增加一个单位，Cci的预期变化为0.997(RR=0.997，p=0.017)。在Logit部分(Cci=0)，尿镉(OR=0.659，p=0.007)、血铅(OR=1.073，p=0.023)、血锰(OR=0.963，p=0.025)的对数比数分别增加0.659、1.073和0.963。结论镉、锰均有可能增加死亡率。相反，硒和铅对人的健康可能是积极的。这些发现对于预防疾病和提高生活质量可能是极其必要的。
Background With the rising incidence of chronic diseases, and the increase of aging population has led to multimorbidity a serious public health problem. The aim of this study was to explore the association between metal exposures and Charlson comorbidity index (CCI), which will provide valuable information for improving quality of life and reducing mortality. Methods The study sample consists of three continuous cycles (2011-2016) of the National Health and Nutrition Examination Survey (NHANES), and 4901 eligible subjects were included in the study. Zero-inflated negative binomial (ZINB) model was utilized to investigate the effects in metal exposures on CCI, which includes spot urine (arsenic, mercury, and cadmium), whole blood (manganese, selenium, and lead), and serum (copper and zinc). Results In count part (CCI >= 0), holding other variables constant, the expected change in CCI for a one-unit increase in blood selenium is 0.997 (RR = 0.997,p= 0.017). In logit part (CCI = 0), the log odds of having CCI equals zero would increase by 0.659, 1.073, and 0.963 for every additional urinary cadmium (OR = 0.659,p= 0.007), blood lead (OR = 1.073,p= 0.023), blood manganese (OR = 0.963,p= 0.025), respectively. Conclusions Our findings indicated that cadmium and manganese were likely to increase mortality. Inversely, selenium and lead might be positive on people's health. The findings may be extremely essential for preventing diseases and improving life quality.