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目的探讨中国汉族人群中钙粘蛋白基因拷贝数多态性(CNPs)与职业性噪声性听力损失(ONHL)的关联。方法采用单纯随机抽样法,以接触稳态噪声1年以上的2 000名噪声作业工人为研究对象,进行职业卫生问卷调查和工作写实,检测其双耳高频平均听阈和工作场所噪声强度,计算累积噪声暴露量(CNE),采用模型法确定易感人群组(201人)和耐受人群组(202人)。实时荧光定量聚合酶链式反应检测2组人群钙粘蛋白23基因(CDH23)与原钙粘蛋白15基因(PCDH15)的CNPs。采用二分类非条件Logistic回归分析分析影响因素,并采用纳入乘积项的方法分析因素间交互作用。结果校正性别、年龄、吸烟、饮酒、CNE、有机溶剂接触、重金属接触、粉尘作业和高温作业等混杂因素影响后,CDH23拷贝数增加是ONHL的保护因素[优势比=0.320,95%可信区间为(0.123~0.835),P=0.020];CDH23拷贝数增加与重金属接触之间存在交互作用(P<0.05);CDH23 CNPs与CNE不存在交互作用(P>0.05)。PCDH15 CNPs与ONHL易感性之间关联无统计学意义(P>0.05)。结论在中国汉族人群中,CDH23 CNPs可能与ONHL易感性有关,其拷贝数增加是ONHL的保护因素。
Objective To investigate the association of cadherin gene copy number polymorphisms (CNPs) with occupational noise-induced hearing loss (ONHL) in Chinese Han population. Methods A simple random sampling method was used to investigate 2 000 noise workers who had been in contact with steady-state noise for more than 1 year. Occupational health questionnaires and realistic work were conducted. The average high-frequency hearing threshold of both ears and workplace noise intensity were measured. Cumulative noise exposure (CNE) was determined using a model approach to identify susceptible (201) and tolerated (202) individuals. The CNPs of cadherin 23 (CDH23) and protocadherin 15 (PCDH15) genes in two groups of people were detected by real-time fluorescence quantitative polymerase chain reaction. The influencing factors were analyzed by two-category non-conditional Logistic regression analysis and the interaction between factors was analyzed using the method of incorporating product terms. RESULTS Correction of CDH23 copy number was a protective factor for ONHL after adjusting for confounders such as gender, age, smoking, drinking, CNE, organic solvent exposure, heavy metal exposure, dusting and high temperature work [odds ratio = 0.320, 95% confidence interval (0.123-0.835), P = 0.020]. There was interaction between CDH23 copy number and heavy metal exposure (P <0.05). There was no interaction between CDH23 CNPs and CNE (P> 0.05). The correlation between PCDH15 CNPs and ONHL susceptibility was not statistically significant (P> 0.05). Conclusion CDH23 CNPs may be related to the ONHL susceptibility in Chinese Han population. Increasing copy number is the protective factor of ONHL.