The relationship between fluoride exposure, basal metabolic rate, body fat percentage, and grip strength among adults in rural areas with fluorosis of China
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目的 探讨我国农村氟中毒地区成人氟暴露与握力的关系以及基础代谢率（BMR）和身体脂肪率（BFP）在氟暴露与握力关联中的作用。 方法 2017年4 - 5月，采用整群抽样方法，以河南省开封市饮水型地方性氟中毒流行地区通许县的18 ~ 60岁居民作为调查对象，进行问卷调查、体格检查和生物样本采集。共纳入调查对象1 168人，其中男性427人、女性741人。采用氟离子选择电极法、苦味酸法分别测定尿氟和尿肌酐浓度，并计算尿肌酐调整后尿氟浓度（CUF）；生物电阻抗法测定BMR和BFP；Jamar测力计测量握力。采用广义线性模型分析CUF、BMR、BFP和握力之间的关系，使用中介效应模型分析BMR、BFP在CUF与握力关联中的中介效应。 结果 CUF每升高1.00 mg/L，女性握力降低0.28 kg（P = 0.043），在男性中二者关联无统计学意义（P = 0.744）。无论性别分层与否，BMR与握力均呈正向关联（均P < 0.001）。BFP每升高1.00%，女性握力降低0.18 kg（ P = 0.043）。中介效应模型分析结果显示，BMR、BFP在CUF与女性握力关联中的中介效应比分别为65.1%（P < 0.001）和8.4%（ P = 0.111）。 结论 氟暴露与女性握力改变有关，且BMR改变在氟暴露与女性握力的关联中发挥部分中介作用。 Objective To study the relationship between adult fluoride exposure and grip strength in rural areas of China with fluorosis, as well as the roles of basal metabolic rate (BMR) and body fat percentage (BFP) in the association between fluoride exposure and grip strength. Methods From April to May 2017, a cluster sampling method was used to conduct a questionnaire survey, physical examination, and biological sample collection on residents aged 18 - 60 in Tongxu County, Kaifeng City, Henan Province (epidemic areas of drinking-water-borne fluorosis). A total of 1 168 subjects were included in the study, including 427 males and 741 females. The fluoride ion selective electrode method and the picric acid method were used to determine the concentrations of urine fluoride and urine creatinine, and the adjusted urine fluoride concentration (CUF) was calculated. BMR and BFP were measured by a bioelectrical impendence method, and the grip strength was measured by a Jamar grip dynamometer. The relationship between CUF, BMR, BFP and grip strength were analyzed using a generalized linear model regression. The mediation effect model was used to assess the mediating effect of BMR and BFP on the association between CUF and grip strength. Results Female grip strength decreased by 0.28 kg (P = 0.043) for every 1.00 mg/L increment in CUF. No similar association was found between the two in males (P = 0.744). Regardless of gender stratification, BMR was positively correlated with grip strength (P < 0.001). For every 1.00% increase in BFP, female grip strength decreased by 0.18 kg ( P = 0.043). The mediation effect model analysis results showed that the mediation effect ratios of BMR and BFP in the association between CUF and grip strength in female were 65.1% (P < 0.001) and 8.4% ( P = 0.111), respectively. Conclusion Fluoride exposure is associated with changes in female grip strength, and BMR changes play a partial mediating role in the association between fluoride exposure and female grip strength.
Objective To study the relationship between adult fluoride exposure and grip strength in rural areas of China with fluorosis, as well as the roles of basal metabolic rate (BMR) and body fat percentage (BFP) in the association between fluoride exposure and grip strength. Methods From April to May 2017, a cluster sampling method was used to conduct a questionnaire survey, physical examination, and biological sample collection on residents aged 18 - 60 in Tongxu County, Kaifeng City, Henan Province (epidemic areas of drinking-water-borne fluorosis). A total of 1 168 subjects were included in the study, including 427 males and 741 females. The fluoride ion selective electrode method and the picric acid method were used to determine the concentrations of urine fluoride and urine creatinine, and the adjusted urine fluoride concentration (CUF) was calculated. BMR and BFP were measured by a bioelectrical impendence method, and the grip strength was measured by a Jamar grip dynamometer. The relationship between CUF, BMR, BFP and grip strength were analyzed using a generalized linear model regression. The mediation effect model was used to assess the mediating effect of BMR and BFP on the association between CUF and grip strength. Results Female grip strength decreased by 0.28 kg (P = 0.043) for every 1.00 mg/L increment in CUF. No similar association was found between the two in males (P = 0.744). Regardless of gender stratification, BMR was positively correlated with grip strength (P < 0.001). For every 1.00% increase in BFP, female grip strength decreased by 0.18 kg ( P = 0.043). The mediation effect model analysis results showed that the mediation effect ratios of BMR and BFP in the association between CUF and grip strength in female were 65.1% (P < 0.001) and 8.4% ( P = 0.111), respectively. Conclusion Fluoride exposure is associated with changes in female grip strength, and BMR changes play a partial mediating role in the association between fluoride exposure and female grip strength.
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