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台灣地區國中學童黃麴毒素暴露量的生物測定

Biological Monitoring of Aflatoxin Exposures among Junior High School Students in Taiwan

Abstracts


臺灣地區為B型肝炎以及肝癌高盛行的地區,為評估臺灣地區居民黃麴毒素的暴露量,自20個鄉鎮區選取501名國中學童,每名收集隔夜的尿液,以酵素聯結免疫吸附法來分析個體黃麴毒素的暴露狀況。此研完對象的黃麴毒素的陽性率為10.6%。根據對數複迴歸分析,黃麴毒素陽性率與尿液採集月份、都市發展程度、居住地肝癌的年齡標準化死亡率以及是否攝食帶殼花生、花生醬、花生粉或花生糖等任一種花生製品有顯著相關。在四、五月收集的尿液檢體相對於一、三月的尿液有較高的陽性率,相對危險性為1.9(P=0.03);高肝癌死亡率地區相對於低肝癌死亡率地區有較高的陽性率,相對危險性為2.1(P=0.07);中度都市發展程度地區相對於都市發展低度或高度地區也有較高的陽性率,相對危險性為2.2(P=0.01):如果攝食帶殼花生、花生醬、花生粉或花生糖等任一種花生製品,相對於未吃上述四種花生製品的相對危險性為2.7(P=0.001)。雖然問卷調查可粗略評估個體黃麴毒素的暴露量,但是仍必須考慮季節性差異、個人及個體間的差異、食物型態及來源。因此要反應個人層次的黃麴毒素的暴露量及代謝的差異,有必要進行生物監測。

Keywords

黃麴毒素 肝癌 尿液測定

Parallel abstracts


In order to assess aflatoxin exposure among residents in Taiwan where hepatitis B virus infection and hepatocellular carcinoma are hyperendemic, a total of 501 junior high school students were recruited from 20 townships and precincts. Overnight urine samples were collected from study subjects and analyzed for the presence of aflatoxins by an enzyme-linked immunosorbent assay. The overall aflatoxin positive rate was 10.6%. Based on multiple logistic regression analysis, the aflatoxin positive rate was significantly associated with the season of sample collection. urbanizational level, and age-adjusted liver cancer mortality of residential area, and intake of peanut products, including shelled peanut, peanut butter, peanut powder or peanut candy. Urine samples collected in April and May had a higher positive rate than those collected in January and March with an odds ratio of 1.9 (P=0.03); the positive rate was also higher in areas of higher liver cancer mortality than in areas of low liver cancer mortality with an odds ratio of 2.1(P=0.07); the positive rate was also higher in areas of moderate urbanizational level than in areas of high or low urbanizational levels with an odds ratio of 2.2 (p=0.01); intake of any peanut products including shelled peanut , peanut butter, peanut powder or peanut candy had an odds ratio of 2.7(P=0.001). Although questionnaire interview may be useful to estimate roughly aflatoxin exposure, cautions have to be paid on seasonal variation, intra- or inter-individual variability, and varieties and sources of food items. It is necessary to conduct the biologic monitoring to assess aflatoxin exposure and its metabolism at the individual level.

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