Annals of Occupational and Environmental Medicine

The Korean Society of Occupational & Environmental Medicine (대한직업환경의학회)
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Association between Cadmium and Cognitive Function in the Elderly

노인인구에서 카드뮴과 인지기능의 상관성

  • Kang, Mo-Yeol (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Cho, Soo-Hun (Institute of Environmental Medicine, Seoul National University Medical Research Center) ;
  • Leem, Youn-Hee (Department of Epidemiology and Biostatistics, School of Public Health, Seoul National University) ;
  • Kim, Jin-Hee (Institute of Environmental Medicine, Seoul National University Medical Research Center) ;
  • Bae, Sang-Hyuk (Institute of Environmental Medicine, Seoul National University Medical Research Center) ;
  • Hong, Yun-Chul (Institute of Environmental Medicine, Seoul National University Medical Research Center)
  • 강모열 (서울대학교 의과대학 예방의학교실) ;
  • 조수헌 (서울대학교 의과대학 환경의학 연구소) ;
  • 임연희 (서울대학교 보건대학원) ;
  • 김진희 (서울대학교 의과대학 환경의학 연구소) ;
  • 배상혁 (서울대학교 의과대학 환경의학 연구소) ;
  • 홍윤철 (서울대학교 의과대학 환경의학 연구소)
  • Published : 2011.09.30
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Abstract

Objectives: We conducted this study to investigate the relationship between the blood concentration of cadmium and cognitive function in elderly Koreans. Methods: This research is a part of the Korean Elderly Environmental Panel Study (KEEPS). A total of 403 subjects were enrolled and analyzed from August 2008 through August 2010. Demographic information and medical histories were obtained using a questionnaire. Blood concentration of cadmium and Mini-Mental State Examination (MMSE) with Functional Activities Questionnaire (FAQ) were evaluated for each subject. Results: The mean age of subjects was 70.67 (SD 5.18, n=403) and 72% were female. The mean blood cadmium level was 1.22 ${\mu}g$/dl (SD 0.56), mean MMSE score was 25.12 out of 30 and mean FAQ score was 2.03 out of 30. Using linear regression analysis to estimate the relationship between blood cadmium concentration and MMSE and FAQ, we observed a significant association between log transformed values of blood cadmium levels and MMSE (p<0.002) or FAQ (p=0.005) scores. After adjusting for age, sex, level of education, alcohol consumption and smoking habits, the relationship between blood cadmium concentration and MMSE and FAQ scores ramained statistically significant (p=0.033 and 0.029, respectively). Conclusions: These results suggest that blood cadmium concentration is strongly associated with cognitive function and functional activity in the elderly.1.1

목적: 최근 중금속과 인지기능 혹은 치매에 관련된 연구가 많이 늘었지만 아직까지 카드뮴이 인지기능에 미치 는 영향에 대해서는 연구 결과가 일관되지 못하고 생물학적 기전도 명확하게 밝혀져 있지 않아 확정적인 결론을 내기에는 어려운 수준이다. 그래서 저자들은 노령인구에서 카드뮴이 인지기능에 미치는 영향에 대한 보다 명확한 근거를 제시하고자 본 연구를 수행하였다. 방법: 본 연구는 노령인구의 환경노출에 의한 건강영향 조사 (Korean Elderly Environmental Panel Study, KEEPS)의 일부분으로 2008년 8월 26일부터 2010년 8월 20일 까지 서울시 성북구 치매지원센터와 길음 복지관에 방문하여 환경오염노출 조사와 건강검진을 받은 403명을 대상으로 혈중 카드뮴 농도 측정, MMSE-KC, K-FAQ등을 측정, 평가하였다. 성별, 나이, 학력, 흡연습관과 음주습관을 보정하여 다중회귀분석을 실시하였다. 또한 성별, 교육수준, 흡연습관, 음주습관에 따른 혈중 카드뮴 농도의 인지기능 저하와의 관련성에 대하여 층화 분석을 시행하여 관련성의 크기를 살펴보았다. 결과: 연구 대상자 403명의 평균연령은 70.68세였으며, 그 중 여성은290명(71.96%)이었다. 혈중 카드뮴 농도의 평균은 남성에서 1.02 ${\mu}g$/l, 여성에서 1.30 ${\mu}g$/l로 측정되었다. 성별, 나이, 학력, 흡연습관과 음주습관을 보정하여 다중회귀분석을 실시한 결과 통계적으로 유의하게 혈중 카드뮴 농도가 증가함에 따라 MMSE-KC점수(p=0.033)와 K-FAQ점수(p=0.030)가 악화되는 것으로 관찰되었다. 성별, 교육수준, 흡연습관, 음주습관에 따른 혈중 카드뮴 농도의 인지기능 저하와의 관련성에 대하여 층화 분석한 결과, 남성에 비하여 여성의 경우 상관성이 보다 뚜렷하게 관찰되었고, 교육수준별로는 교육수준이 3 년 이하로 낮은 경우에 유의한 상관성을 보이는 것으로 나타났다. 흡연습관과 음주습관에 대하여 살펴보면 흡연을 하지 않는 군과 음주를 하지 않는 군에서 통계적으로 유의하게 혈중 카드뮴 농도와 MMSE-KC 및 K-FAQ 간에 관련성이 있는 것으로 관찰되었다. 결론: 노인 인구에서 혈중 카드뮴 농도의 증가는 인지기능의 저하뿐만 아니라 생활능력의 저하와도 관련성이 있으며, 특히 여성과 저학력군에서 더욱 두드러진 관련성이 있다는 것을 확인할 수 있었다.

Keywords

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