| Objective:The purpose was to find out some suspectable influencing factors of Endemic Arsenic Poisoning in Shanxi Province.Meanwhile,it was explored that the meanings of biomarkers of exposure and biomarkers of effect;it was also explored that the effect of biomarkers of susceptibility--gene polymorphisms of arsenic transport proteins MRP1 and MRP2 in Endemic Arsenic Poisoning's happening to the aim of the strategies preventing and curing Endemic Arsenic Poisoning.Methods:(1)In a case-control study,239 rural residents in 3 villages of Shuocheng Region were interviewed and examined by simple random sampling.All the objects were divided into two groups on the basis of clinical examination:objects with skin lesion(depigmentation,pigmentation or hyperkeratosis)as a case group and objects without skin lesion as a control group.Urine and blood samples were collected from each participant.(2)Age,gender,smoking, drinking,nutritional level and exposure of pesticide were analysed by Logistic regression model. (3)Adjusted age and gender by multivariate Logistic regression,total arsenic in blood and urine were compared between case group and control group.(4)Adjusted age and gender by multivariate Logistic regression,detection rates of myasthenia and acra sensory disability were compared between case group and control group.(5)75 cases and 118 controls were detected the gene mutations in the 2,17,23 exons of Multidrug Resistance Proteinl and the 10,18,31 exons of Multidrug Resistance Protein 2 by Polymerase Chain Reaction—Single Strand Conformation Polymorphism(PCR-SSCP)method and compared after adjusted age and gender by multivariate Logistic regression.(6)Total arsenic in the 30 well waters from 3 villages were determined for the sake of arsenic exposure level.Results:(1)Multiple influencing factors analysis:In univariate analysis,age,gender, smoking and exposure of pesticide increased the risk of arsenic poisoning.In multivariate analysis,age(OR=13.062,＞57 years old)and gender(OR=3.553,male)was significantly associated with Endemic Arsenic Poisoning.(2)Biomarkers of exposure:The average total arsenic in the 30 well waters was 5.99μg/L and lower than China national arsenic standards for drinking water;after adjusted age and gender,the total arsenic in blood in case group was higher than that in control group,the total arsenic in urine was equal between case group and control group.(3)Biomarkers of effect:Detection rate of myasthenia in case group was higher than that in control group.Detection rate of acra sensory disability was equal between case group and control group.(4)Biomarkers of susceptibility:There was no gene mutation detected in the 23 exon of Multidrug Resistance Proteinl and the 18 exon of Multidrug Resistance Protein 2.It was showed that the gene mutations frequencies of the 2,17 exons of Multidrug Resistance Protein 1 and the 10,31 exons of Multidrug Resistance Protein 2 were 6.74%,10.36%,20.21%,3.63 %respectively.There was no significant difference between two groups;after adjusted age and gender by multivariate Logistic regression,there was no significant correlation between gene mutations of multidrug resistance protein1/2 and Endemic Arsenic Poisoning's happening.Conclusions:(1)Older age and male would be the independent risk factors of Endemic Arsenic Poisoning.(2)Exposed in the arsenic in drinking water which was higher than the current arsenic criterion of drinking water in China,there were some arsenicalism patients. Further exploration is needed to discuss for the current total arsenic criterion of drinking water in China.The more total arsenic in blood,the more possibility the skin lesion' happening;the total arsenic in blood may be more sensitive than the total arsenic in urine for estimation of Endemic Arsenic Poisoning.(3)Acra sensory disability may be the earlier period manifestation of Endemic Arsenic Poisoning.Further exploration is needed to discuss for the current diagnosis criterion of Endemic Arsenic Poisoning in China.(4)The gene mutations in the 2,17,23 exons of Multidrug Resistance Protein1 and the 10,18,31 exons of Multidrug Resistance Protein 2 may have no influence on Endemic Arsenic Poisoning's happening. |
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