摘要
目的探讨职业人群噪声性听力损失（NIHL）易感性与原钙黏蛋白15（PCDH15）基因单核苷酸多态性（SNPs）之间的关联。方法采用巢式病例．对照研究方法，从2006年1月1日起，以中国河南省某钢铁企业炼钢和轧钢车间的7445名接触噪声作业工人为队列研究的源人群，随访至2015年12月31日，筛选其中双耳高频平均听阈≥40dB（A）定义为病例组，共394例；双耳高频平均听阈〈35dB（A）且双耳平均语频425dB（A）定义为对照组，共721名。对所有研究对象进行健康检查和问卷调查。采用SNPscan^TM多重SNP分型试剂盒对单核苷酸多态性位点进行分型，采用多元非条件logistic回归模型分析加性模型下病例、对照组不同单个位点与NIHL发病的相关性。采用多因素非条件logistic回归模型分析病例组、对照组人群中PCDH15基因不同位点SNP与NIHL发病之间的相关性。结果纳入调查对象的年龄为（40．5±8.3）岁，接噪工龄肘（P25，P75）为[21．1（9．1，27．3）1年，接触噪声的范围最小值．最大值为80．1—98．8dB（A），累计噪声暴露量（CNE）的最小值～最大值为86．6—111．2dB（A）·年。研究发现，PCDH15基因rs11004085位点的TT、CT和CC基因型分布在病例组和对照组的差异有统计学意义（P=0．049），病例组分别为370例（93．9％）、24例（6．1％）和0例（0），对照组分别为694例（96．3％）、26例（3．6％）和1例（0．1％）。在调整吸烟、饮酒、高血压、身高和CNE后，与1TT基因型相比，个体携带CC／CT基因型发生NIHL的0R（95％CI）为1．90（1．06—3．40）。分别按噪声暴露水平和CNE分层分析后发现，当噪声暴露水平〉85dB（A）时，与AA基因型相比，rs10825113位点的GA／GG基因型发生NIHL的0R（95％CI）为2．63（1．12～6．14）。以CNE分层后，发现在CNE≤98dB（A）·年时，与TT基因型相比，rs11004085位点的CC／
Objective The aim of this study was to investigate whether genetic variability in the protocadherin 15 （PCDH15） gene may correspond with increased susceptibility to noise-induced hearing loss （NIHL） in a Chinese population. Methods A nested case-control study was performed that followed a cohort of 7 445 noise-exposed workers in a steel factory of Henan province in China from January 1, 2006 to December 31, 2015. In this study, 394 cases who had an average hearing threshold of more than 40 dB （A） in high frequency were defined as the case group, and 721 controls who had an average hearing threshold of less than 35 dB （A） in high frequency and less than 25 dB （A） in speech frequency were defined as the control group. A questionnaire was completed by participants and a physical test was also conducted. SNP genotyping was performed using the SNPscanTM Kit. Multivariate unconditional logistic regression additive models were used to analyze the genotypes in different groups, and the association with NIHL. Unconditional logistic regression models were used to assess the associations between the genotypes and NIHL. Results The average age of study participants was （40.5±8.3） years and the median number of noise-exposed working years M （P25, P75） was 21.1 （9.1, 27.3）. The range of noise exposed levels and the levels of cumulative noise exposure （CNE） were 80.1-98.8 dB（A） and 86.6-111.2 dB（A）, respectively. Only the distribution of the genotypes （TT/CC/CT） of rs 11004085 in the PCDH 15 gene showed a significant difference between the case and control groups （P=0.049）. In the case group, the distribution was 370 （93.9%）, 24 （6.1%） and O; in the control group, the distribution was 694 （96.3%）, 23 （3.2%） and 1 （0.1%）. After smoking, drinking, hypertension, height and CNE adjustment, compared with the TT genotype individuals with the CC/CT genotype had a 1.90-fold increased risk of NIHL （95% CI： 1.06-3.40）. After stratified these data by the noise
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2017年第1期20-26,共7页
Chinese Journal of Preventive Medicine
基金
国家自然科学基金（81372940）
国家科技支撑计划（2014BA112803）
