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Article(id=1241522922561532815, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522919977841545, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202307199, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1688918400000, receivedDateStr=2023-07-10, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773931731119, onlineDateStr=2026-03-19, pubDate=1710000000000, pubDateStr=2024-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773931731119, onlineIssueDateStr=2026-03-19, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773931731119, creator=13701087609, updateTime=1773931731119, updator=13701087609, issue=Issue{id=1241522919977841545, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='5', pageStart='769', pageEnd='960', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773931730503, creator=13701087609, updateTime=1773931880386, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241523548695622547, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522919977841545, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241523548695622548, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522919977841545, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=822, endPage=828, ext={EN=ArticleExt(id=1241522923308118946, articleId=1241522922561532815, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis of the relationship between volatile organic compounds and sleep problems in adults, columnId=1228016570660745413, journalTitle=Modern Preventive Medicine, columnName=Environmental and Occupational Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the relationship between volatile organic compounds (VOCs) exposure and sleep problems in adults.

Methods

This study included 5 337 participants from the 2007-2014 National Health and Nutrition Examination Survey (NHANES) database. Weighted logical regression model and weighted quartile sum (WQS) regression model were used to evaluate the association of blood VOCs with short sleep duration (SSD), difficulty in falling asleep, and sleep disorders in adults.

Results

After adjusting the confounding factors, blood benzene (OR = 1.120, 95%CI: 1.019-1.230, P = 0.02), 2,5-dimethylfuran (OR = 1.144, 95%CI: 1.043-1.254, P = 0.005), ethylbenzene (OR = 1.115, 95%CI: 1.025-1.211, P = 0.012), furan (OR =1.271, 95%CI: 1.086-1.489, P = 0.004), and o-xylene (OR = 1.097, 95%CI: 1.006-1.198, P = 0.037) had a significant positive correlation with SDD. Secondly, 2,5-dimethylfuran (OR = 1.082, 95%CI: 1.008-1.161, P = 0.03) and furan (OR = 1.148,95%CI: 1.002-1.315, P = 0.046) were positively correlated with difficulty in falling asleep. Subgroup analysis showed that the positive association between VOCs and SSD was consistent among different groups. WQS results showed that for every unit of increase, SSD risk increased by 25.4% (OR = 1.254, 95%CI: 1.009-1.559, P = 0.041).

Conclusion

There is a positive correlation between VOCs exposure and SSD in American adults.

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目的

探究挥发性有机物(volatile organic compounds, VOCs)暴露与成年人睡眠问题的关联。

方法

本研究合并了来自2007—2014年美国国家健康与营养调查(NHANES)数据库的5 337名参与者，采用加权逻辑回归模型和加权分位数(weighted quantile sum, WQS)回归模型评估血液VOCs与成人睡眠时间短(short sleep duration, SSD)、入睡困难和睡眠障碍的关联。

结果

在调整混杂因素后，血液中苯(OR=1.120, 95%CI:1.019 ~ 1.230, P=0.02)、2,5-二甲基呋喃(OR=1.144,95%CI:1.043 ~ 1.254, P=0.005)、乙苯(OR=1.115, 95%CI:1.025 ~ 1.211, P=0.012)、呋喃(OR=1.271, 95%CI:1.086 ~ 1.489, P=0.004)、邻二甲苯(OR=1.097, 95%CI:1.006 ~ 1.198, P=0.037)与SDD存在显著正向关联。其次，血液中2,5-二甲基呋喃(OR=1.082, 95%CI:1.008 ~ 1.161, P=0.03)、呋喃(OR=1.148, 95%CI:1.002 ~ 1.315, P=0.046)与入睡困难存在显著正向关联。亚组分析显示，VOCs与SSD之间的正向关联在不同组间是一致的。WQS结果显示，每增加1单位，SSD风险增加25.4%(OR=1.254, 95%CI:1.009 ~ 1.559, P=0.041)。

结论

VOCs暴露可能与美国成年人SSD发生呈正向关联。

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鲍蕾蕾，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=XQOIHLMFrQumQaxiSpFVhQ==, magXml=mvFhS0SlGMOEd+qWwp0X4A==, pdfUrl=null, pdf=tr8JMOislFnQNDCtnusgkg==, pdfFileSize=1075327, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=tNx+0Qsn6KdHSvzP+RVHzA==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=4kk4gwaKQxBNFC4J8gXa+A==, mapNumber=null, authorCompany=null, fund=null, authors=

王雅兰（1994—），女，硕士，药师，研究方向：睡眠与环境

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Archives of Environment Health, 2001, 56(2): 157-166., articleTitle=Recent chemical exposures and blood volatile organic compound levels in a large population-based sample, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1241678289853534284, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922561532815, xref=null, ext=[AuthorCompanyExt(id=1241678289870311503, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922561532815, companyId=1241678289853534284, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Medicinal Materials, The Third Affiliated Hospital of Naval Medical University, Shanghai 200438, China), AuthorCompanyExt(id=1241678289887088720, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922561532815, companyId=1241678289853534284, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=海军军医大学第三附属医院药材科，上海 200438)])], figs=[ArticleFig(id=1241678307033403699, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922561532815, language=EN, label=Figure 1, caption=Study population screening process, figureFileSmall=jXUIA+vZYMv479H6xzw5ZQ==, figureFileBig=9/8Ueo5m0GiVFSXD5T3d6g==, tableContent=null), ArticleFig(id=1241678307251507515, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922561532815, language=CN, label=图1, caption=研究人群筛选流程图, figureFileSmall=jXUIA+vZYMv479H6xzw5ZQ==, figureFileBig=9/8Ueo5m0GiVFSXD5T3d6g==, tableContent=null), ArticleFig(id=1241678308342026572, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922561532815, language=EN, label=Figure 2, caption=Correlations among blood VOCs concentrations, figureFileSmall=Eq1heZ58YkHHqPNabByNNw==, figureFileBig=TPtVmppL99OQWDhH5ZceKw==, tableContent=null), ArticleFig(id=1241678310648893783, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922561532815, language=CN, label=图2, caption=血液VOCs浓度之间的相关性, figureFileSmall=Eq1heZ58YkHHqPNabByNNw==, figureFileBig=TPtVmppL99OQWDhH5ZceKw==, tableContent=null), ArticleFig(id=1241678311269650785, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922561532815, language=EN, label=Figure 3, caption=Cubic splines for the associations of VOCs with SSD, figureFileSmall=bbx+x5+EUxF2rk1X64RBNQ==, figureFileBig=JYwLZJ8B+42KGw5LkuftQQ==, tableContent=null), ArticleFig(id=1241678311789744497, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922561532815, language=CN, label=图3, caption=VOCs与SSD关联的立方样条曲线

注：A为苯；B为1,4-二氯苯；C为2,5-二甲基呋喃；D为乙苯；E为呋喃；F为间/对二甲苯；G为邻二甲苯；H为四氯乙烯。

, figureFileSmall=bbx+x5+EUxF2rk1X64RBNQ==, figureFileBig=JYwLZJ8B+42KGw5LkuftQQ==, tableContent=null), ArticleFig(id=1241678315493314947, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922561532815, language=EN, label=Figure 4, caption=The weights of each VOC in positive WQS model regression index for SSD, figureFileSmall=o0cMwghbca2uBh4kkGid3w==, figureFileBig=KzAtHWfbxX3xxBQCeeFn+w==, tableContent=null), ArticleFig(id=1241678316579639693, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922561532815, language=CN, label=图4, caption=VOCs混合暴露与SSD关联中各个VOC分别在WQS回归正向权重, figureFileSmall=o0cMwghbca2uBh4kkGid3w==, figureFileBig=KzAtHWfbxX3xxBQCeeFn+w==, tableContent=null), ArticleFig(id=1241678319440155031, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922561532815, language=EN, label=Table 1, caption=

General demographic characteristics ［n（%），M（P25，P75）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量SSD入睡困难睡眠障碍
否
（n=3 246）		是
（n=2 091）		P值否
（n=4 002）		是
（n=1 335）		P值否
（n=4 895）		是
（n=442）		P值
性别
男性1 601 (49.3)1 069 (51.1)0.2092 121 (53.0)549 (41.1)<0.0012 434 (49.7)236 (53.4)0.153
女性1 645 (50.7)1 022 (48.9)1 881 (47.0)786 (58.9)2 461 (50.3)206 (46.6)
年龄(岁)
<401 056 (32.5)685 (32.8)<0.0011 429 (35.7)312 (23.4)<0.0011 653 (33.8)88 (19.9)<0.001
40～59985 (30.3)791 (37.8)1 246 (31.1)530 (39.7)1 592 (32.5)184 (41.6)
≥601 205 (37.1)615 (29.4)1 327 (33.2)493 (36.9)1 650 (33.7)170 (38.5)
种族
墨西哥裔美国人513 (15.8)307 (14.7)<0.001667 (16.7)153 (11.5)<0.001763 (15.6)57 (12.9)<0.001
其他拉美裔284 (8.7)215 (10.3)389 (9.7)110 (8.2)451 (9.2)48 (10.9)
非西班牙裔白人1 616 (49.8)799 (38.2)1 682 (42.0)733 (54.9)2 181 (44.6)234 (52.9)
非西班牙裔黑人509 (15.7)546 (26.1)810 (20.2)245 (18.4)973 (19.9)82 (18.6)
其他种族324 (10.0)224 (10.7)454 (11.3)94 (7.0)527 (10.8)21 (4.8)
BMI (kg/m2)
<251 014 (31.2)540 (25.8)<0.0011 218 (30.4)336 (25.2)<0.0011 500 (30.6)54 (12.2)<0.001
25～29.91 111 (34.2)688 (32.9)1 385 (34.6)414 (31.0)1 692 (34.6)107 (24.2)
≥301 121 (34.5)863 (41.3)1 399 (35.0)585 (43.8)1 703 (34.8)281 (63.6)
受教育程度
高中以下729 (22.5)507 (24.2)<0.001960 (24.0)276 (20.7)<0.0011 139 (23.3)97 (21.9)0.059
高中1 608 (49.5)1 150 (55.0)2 002 (50.0)756 (56.6)2 507 (51.2)251 (56.8)
高中以上909 (28.0)434 (20.8)1 040 (26.0)303 (22.7)1 249 (25.5)94 (21.3)
婚姻情况
有伴侣2 117 (65.2)1 276 (61.0)0.0082 621 (65.5)772 (57.8)<0.0013 126 (63.9)267 (60.4)0.003
无伴侣722 (22.2)524 (25.1)850 (21.2)396 (29.7)1 116 (22.8)130 (29.4)
未婚407 (12.5)291 (13.9)531 (13.3)167 (12.5)653 (13.3)45 (10.2)
PIR
<1.3949 (29.2)702 (33.6)0.0011 209 (30.2)442 (33.1)0.0511 498 (30.6)153 (34.6)0.09
≥1.32 297 (70.8)1 389 (66.4)2 793 (69.8)893 (66.9)3 397 (69.4)289 (65.4)
吸烟
从不1 813 (55.9)1 107 (52.9)<0.0012 285 (57.1)635 (47.6)<0.0012 719 (55.5)201 (45.5)<0.001
以前867 (26.7)491 (23.5)998 (24.9)360 (27.0)1 216 (24.8)142 (32.1)
现在566 (17.4)493 (23.6)719 (18.0)340 (25.5)960 (19.6)99 (22.4)
饮酒
是2 358 (72.6)1 525 (72.9)0.8422 874 (71.8)1 009 (75.6)0.0083 562 (72.8)321 (72.6)0.993
否888 (27.4)566 (27.1)1 128 (28.2)326 (24.4)1 333 (27.2)121 (27.4)
高血压
否1 582 (48.7)973 (46.5)0.1222 031 (50.7)524 (39.3)<0.0012 417 (49.4)138 (31.2)<0.001
是1 664 (51.3)1 118 (53.5)1 971 (49.3)811 (60.7)2 478 (50.6)304 (68.8)
糖尿病
否2 669 (82.2)1 699 (81.3)0.3893 341 (83.5)1 027 (76.9)<0.0014 060 (82.9)308 (69.7)<0.001
是577 (17.8)392 (18.7)661 (16.5)308 (23.1)835 (17.1)134 (30.3)
癌症
是341 (10.5)171 (8.2)0.006332 (8.3)180 (13.5)<0.001451 (9.2)61 (13.8)0.002
否2 905 (89.5)1 920 (91.8)3 670 (91.7)1 155 (86.5)4 444 (90.8)381 (86.2)
抑郁症
否3 042 (93.7)1 836 (87.8)<0.0013 795 (94.8)1 083 (81.1)<0.0014 543 (92.8)335 (75.8)<0.001
是204 (6.3)255 (12.2)207 (5.2)252 (18.9)352 (7.2)107 (24.2)
CVD
否2 934 (90.4)1 870 (89.4)0.2753 673 (91.8)1 131 (84.7)<0.0014 463 (91.2)341 (77.1)<0.001
是312 (9.6)221 (10.6)329 (8.2)204 (15.3)432 (8.8)101 (22.9)
CKD
否2 607 (80.3)1 690 (80.8)0.6733 273 (81.8)1 024 (76.7)<0.0013 978 (81.3)319 (72.2)<0.001
是639(19.7)401 (19.2)729 (18.2)311 (23.3)917 (18.7)123 (27.8)
VOCs (μg/L)
苯0.02(0.02,0.03)0.02(0.02,0.05)<0.0010.02 (0.02,0.03)0.02 (0.02,0.06)<0.0010.02 (0.02,0.03)0.02 (0.02,0.03)0.718
1,4-二氯苯0.04 (0.03,0.17)0.05 (0.03,0.20)0.0090.05 (0.03,0.19)0.03 (0.03,0.15)0.0010.05 (0.03,0.18)0.03 (0.03,0.16)0.016
2,5-二甲基呋喃0.01 (0.01,0.01)0.01 (0.01,0.01)<0.0010.01 (0.01,0.01)0.01 (0.01,0.02)<0.0010.01 (0.01,0.01)0.01 (0.01,0.01)0.42
乙苯0.02 (0.02,0.03)0.02 (0.02,0.04)<0.0010.02 (0.02,0.03)0.02 (0.02,0.05)<0.0010.02 (0.02,0.04)0.02 (0.02,0.04)0.846
呋喃0.02 (0.02,0.02)0.02 (0.02,0.02)<0.0010.02 (0.02,0.02)0.02 (0.02,0.02)<0.0010.02 (0.02,0.02)0.02 (0.02,0.02)0.078
间/对二甲苯0.06 (0.04,0.11)0.06 (0.04,0.14)0.0040.06 (0.04,0.12)0.07 (0.04,0.14)0.0070.06 (0.04,0.12)0.06 (0.04,0.12)0.885
邻二甲苯0.02 (0.02,0.03)0.02 (0.02,0.04)<0.0010.02 (0.02,0.03)0.02 (0.02,0.04)0.0120.02 (0.02,0.03)0.02 (0.02,0.03)0.812
四氯乙烯0.03 (0.03,0.03)0.03 (0.03,0.03)0.4830.03 (0.03,0.03)0.03 (0.03,0.03)0.4330.03 (0.03,0.03)0.03 (0.03,0.03)0.711
), ArticleFig(id=1241678319897334181, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922561532815, language=CN, label=表1, caption=

研究对象的一般特征分析［n（%），M（P25，P75）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量SSD入睡困难睡眠障碍
否
（n=3 246）		是
（n=2 091）		P值否
（n=4 002）		是
（n=1 335）		P值否
（n=4 895）		是
（n=442）		P值
性别
男性1 601 (49.3)1 069 (51.1)0.2092 121 (53.0)549 (41.1)<0.0012 434 (49.7)236 (53.4)0.153
女性1 645 (50.7)1 022 (48.9)1 881 (47.0)786 (58.9)2 461 (50.3)206 (46.6)
年龄(岁)
<401 056 (32.5)685 (32.8)<0.0011 429 (35.7)312 (23.4)<0.0011 653 (33.8)88 (19.9)<0.001
40～59985 (30.3)791 (37.8)1 246 (31.1)530 (39.7)1 592 (32.5)184 (41.6)
≥601 205 (37.1)615 (29.4)1 327 (33.2)493 (36.9)1 650 (33.7)170 (38.5)
种族
墨西哥裔美国人513 (15.8)307 (14.7)<0.001667 (16.7)153 (11.5)<0.001763 (15.6)57 (12.9)<0.001
其他拉美裔284 (8.7)215 (10.3)389 (9.7)110 (8.2)451 (9.2)48 (10.9)
非西班牙裔白人1 616 (49.8)799 (38.2)1 682 (42.0)733 (54.9)2 181 (44.6)234 (52.9)
非西班牙裔黑人509 (15.7)546 (26.1)810 (20.2)245 (18.4)973 (19.9)82 (18.6)
其他种族324 (10.0)224 (10.7)454 (11.3)94 (7.0)527 (10.8)21 (4.8)
BMI (kg/m2)
<251 014 (31.2)540 (25.8)<0.0011 218 (30.4)336 (25.2)<0.0011 500 (30.6)54 (12.2)<0.001
25～29.91 111 (34.2)688 (32.9)1 385 (34.6)414 (31.0)1 692 (34.6)107 (24.2)
≥301 121 (34.5)863 (41.3)1 399 (35.0)585 (43.8)1 703 (34.8)281 (63.6)
受教育程度
高中以下729 (22.5)507 (24.2)<0.001960 (24.0)276 (20.7)<0.0011 139 (23.3)97 (21.9)0.059
高中1 608 (49.5)1 150 (55.0)2 002 (50.0)756 (56.6)2 507 (51.2)251 (56.8)
高中以上909 (28.0)434 (20.8)1 040 (26.0)303 (22.7)1 249 (25.5)94 (21.3)
婚姻情况
有伴侣2 117 (65.2)1 276 (61.0)0.0082 621 (65.5)772 (57.8)<0.0013 126 (63.9)267 (60.4)0.003
无伴侣722 (22.2)524 (25.1)850 (21.2)396 (29.7)1 116 (22.8)130 (29.4)
未婚407 (12.5)291 (13.9)531 (13.3)167 (12.5)653 (13.3)45 (10.2)
PIR
<1.3949 (29.2)702 (33.6)0.0011 209 (30.2)442 (33.1)0.0511 498 (30.6)153 (34.6)0.09
≥1.32 297 (70.8)1 389 (66.4)2 793 (69.8)893 (66.9)3 397 (69.4)289 (65.4)
吸烟
从不1 813 (55.9)1 107 (52.9)<0.0012 285 (57.1)635 (47.6)<0.0012 719 (55.5)201 (45.5)<0.001
以前867 (26.7)491 (23.5)998 (24.9)360 (27.0)1 216 (24.8)142 (32.1)
现在566 (17.4)493 (23.6)719 (18.0)340 (25.5)960 (19.6)99 (22.4)
饮酒
是2 358 (72.6)1 525 (72.9)0.8422 874 (71.8)1 009 (75.6)0.0083 562 (72.8)321 (72.6)0.993
否888 (27.4)566 (27.1)1 128 (28.2)326 (24.4)1 333 (27.2)121 (27.4)
高血压
否1 582 (48.7)973 (46.5)0.1222 031 (50.7)524 (39.3)<0.0012 417 (49.4)138 (31.2)<0.001
是1 664 (51.3)1 118 (53.5)1 971 (49.3)811 (60.7)2 478 (50.6)304 (68.8)
糖尿病
否2 669 (82.2)1 699 (81.3)0.3893 341 (83.5)1 027 (76.9)<0.0014 060 (82.9)308 (69.7)<0.001
是577 (17.8)392 (18.7)661 (16.5)308 (23.1)835 (17.1)134 (30.3)
癌症
是341 (10.5)171 (8.2)0.006332 (8.3)180 (13.5)<0.001451 (9.2)61 (13.8)0.002
否2 905 (89.5)1 920 (91.8)3 670 (91.7)1 155 (86.5)4 444 (90.8)381 (86.2)
抑郁症
否3 042 (93.7)1 836 (87.8)<0.0013 795 (94.8)1 083 (81.1)<0.0014 543 (92.8)335 (75.8)<0.001
是204 (6.3)255 (12.2)207 (5.2)252 (18.9)352 (7.2)107 (24.2)
CVD
否2 934 (90.4)1 870 (89.4)0.2753 673 (91.8)1 131 (84.7)<0.0014 463 (91.2)341 (77.1)<0.001
是312 (9.6)221 (10.6)329 (8.2)204 (15.3)432 (8.8)101 (22.9)
CKD
否2 607 (80.3)1 690 (80.8)0.6733 273 (81.8)1 024 (76.7)<0.0013 978 (81.3)319 (72.2)<0.001
是639(19.7)401 (19.2)729 (18.2)311 (23.3)917 (18.7)123 (27.8)
VOCs (μg/L)
苯0.02(0.02,0.03)0.02(0.02,0.05)<0.0010.02 (0.02,0.03)0.02 (0.02,0.06)<0.0010.02 (0.02,0.03)0.02 (0.02,0.03)0.718
1,4-二氯苯0.04 (0.03,0.17)0.05 (0.03,0.20)0.0090.05 (0.03,0.19)0.03 (0.03,0.15)0.0010.05 (0.03,0.18)0.03 (0.03,0.16)0.016
2,5-二甲基呋喃0.01 (0.01,0.01)0.01 (0.01,0.01)<0.0010.01 (0.01,0.01)0.01 (0.01,0.02)<0.0010.01 (0.01,0.01)0.01 (0.01,0.01)0.42
乙苯0.02 (0.02,0.03)0.02 (0.02,0.04)<0.0010.02 (0.02,0.03)0.02 (0.02,0.05)<0.0010.02 (0.02,0.04)0.02 (0.02,0.04)0.846
呋喃0.02 (0.02,0.02)0.02 (0.02,0.02)<0.0010.02 (0.02,0.02)0.02 (0.02,0.02)<0.0010.02 (0.02,0.02)0.02 (0.02,0.02)0.078
间/对二甲苯0.06 (0.04,0.11)0.06 (0.04,0.14)0.0040.06 (0.04,0.12)0.07 (0.04,0.14)0.0070.06 (0.04,0.12)0.06 (0.04,0.12)0.885
邻二甲苯0.02 (0.02,0.03)0.02 (0.02,0.04)<0.0010.02 (0.02,0.03)0.02 (0.02,0.04)0.0120.02 (0.02,0.03)0.02 (0.02,0.03)0.812
四氯乙烯0.03 (0.03,0.03)0.03 (0.03,0.03)0.4830.03 (0.03,0.03)0.03 (0.03,0.03)0.4330.03 (0.03,0.03)0.03 (0.03,0.03)0.711
), ArticleFig(id=1241678320333541809, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922561532815, language=EN, label=Table 2, caption=

Associations between VOCs and sleep problems

, figureFileSmall=null, figureFileBig=null, tableContent=
[ln(μg/L)]SSD入睡困难睡眠障碍
OR值(95%CI)P值OR值(95%CI)P值OR值(95%CI)P值
苯1.120(1.019～1.230)0.021.069(0.985～1.16)0.1070.973(0.85～1.115)0.690
1,4-二氯苯1.008(0.895～1.134)0.8951.022(0.863～1.209)0.7980.957(0.744～1.23)0.723
2,5-二甲基呋喃1.144(1.043～1.254)0.0051.082(1.008～1.161)0.0301.004(0.890～1.132)0.946
乙苯1.115(1.025～1.211)0.0121.060(0.960～1.170)0.2420.942(0.794～1.118)0.489
呋喃1.271(1.086～1.489)0.0041.148(1.002～1.315)0.0461.047(0.852～1.286)0.655
间/对二甲苯1.057(0.985～1.133)0.1211.013(0.917～1.119)0.7910.954(0.830～1.096)0.495
邻二甲苯1.097(1.006～1.198)0.0370.999(0.888～1.123)0.9810.908(0.757～1.089)0.290
四氯乙烯1.007(0.951～1.067)0.8011.017(0.947～1.092)0.6650.946(0.855～1.046)0.292
), ArticleFig(id=1241678320799109560, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922561532815, language=CN, label=表2, caption=

VOCs暴露与睡眠问题之间的关联

, figureFileSmall=null, figureFileBig=null, tableContent=
[ln(μg/L)]SSD入睡困难睡眠障碍
OR值(95%CI)P值OR值(95%CI)P值OR值(95%CI)P值
苯1.120(1.019～1.230)0.021.069(0.985～1.16)0.1070.973(0.85～1.115)0.690
1,4-二氯苯1.008(0.895～1.134)0.8951.022(0.863～1.209)0.7980.957(0.744～1.23)0.723
2,5-二甲基呋喃1.144(1.043～1.254)0.0051.082(1.008～1.161)0.0301.004(0.890～1.132)0.946
乙苯1.115(1.025～1.211)0.0121.060(0.960～1.170)0.2420.942(0.794～1.118)0.489
呋喃1.271(1.086～1.489)0.0041.148(1.002～1.315)0.0461.047(0.852～1.286)0.655
间/对二甲苯1.057(0.985～1.133)0.1211.013(0.917～1.119)0.7910.954(0.830～1.096)0.495
邻二甲苯1.097(1.006～1.198)0.0370.999(0.888～1.123)0.9810.908(0.757～1.089)0.290
四氯乙烯1.007(0.951～1.067)0.8011.017(0.947～1.092)0.6650.946(0.855～1.046)0.292
), ArticleFig(id=1241678321554084286, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922561532815, language=EN, label=Table 3, caption=

The OR (95%CI) of associations between VOCs and SSD in different subgroups

, figureFileSmall=null, figureFileBig=null, tableContent=
亚组苯2,5-二甲基呋喃乙苯呋喃邻二甲苯
性别
男1.138(1.016～1.275)1.164(1.047～1.293)1.154(1.044～1.274)1.299(1.067～1.582)1.127(1.003～1.266)
女1.094(0.963～1.243)1.120(0.980～1.280)1.072(0.945～1.216)1.243(0.989～1.562)1.067(0.939～1.212)
年龄(岁)
<401.218(1.050～1.412)1.200(1.032～1.394)1.219(1.035～1.436)1.382(1.032～1.852)1.168(0.984～1.386)
40～591.016(0.899～1.149)1.068(0.946～1.206)1.022(0.899～1.162)1.108(0.907～1.355)1.011(0.872～1.172)
≥601.148(0.972～1.357)1.186(1.003～1.402)1.126(0.945～1.341)1.460(1.075～1.984)1.159(0.957～1.404)
BMI (kg/m2)
<251.111(0.957～1.290)1.116(0.973～1.279)1.104(0.927～1.315)1.229(0.975～1.549)1.050(0.879～1.254)
25～29.91.109(0.969～1.269)1.143(0.983～1.329)1.076(0.933～1.241)1.241(0.991～1.554)1.047(0.893～1.227)
≥301.140(1.001～1.298)1.188(1.022～1.379)1.17(1.018～1.345)1.368(1.024～1.828)1.189(1.008～1.403)
), ArticleFig(id=1241678321977708999, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922561532815, language=CN, label=表3, caption=

不同亚组人群VOCs与SSD的关联［OR (95%CI)］

, figureFileSmall=null, figureFileBig=null, tableContent=
亚组苯2,5-二甲基呋喃乙苯呋喃邻二甲苯
性别
男1.138(1.016～1.275)1.164(1.047～1.293)1.154(1.044～1.274)1.299(1.067～1.582)1.127(1.003～1.266)
女1.094(0.963～1.243)1.120(0.980～1.280)1.072(0.945～1.216)1.243(0.989～1.562)1.067(0.939～1.212)
年龄(岁)
<401.218(1.050～1.412)1.200(1.032～1.394)1.219(1.035～1.436)1.382(1.032～1.852)1.168(0.984～1.386)
40～591.016(0.899～1.149)1.068(0.946～1.206)1.022(0.899～1.162)1.108(0.907～1.355)1.011(0.872～1.172)
≥601.148(0.972～1.357)1.186(1.003～1.402)1.126(0.945～1.341)1.460(1.075～1.984)1.159(0.957～1.404)
BMI (kg/m2)
<251.111(0.957～1.290)1.116(0.973～1.279)1.104(0.927～1.315)1.229(0.975～1.549)1.050(0.879～1.254)
25～29.91.109(0.969～1.269)1.143(0.983～1.329)1.076(0.933～1.241)1.241(0.991～1.554)1.047(0.893～1.227)
≥301.140(1.001～1.298)1.188(1.022～1.379)1.17(1.018～1.345)1.368(1.024～1.828)1.189(1.008～1.403)
), ArticleFig(id=1241678322418110927, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922561532815, language=EN, label=Table 4, caption=

Associations between co-exposure of VOCs and sleep problems

, figureFileSmall=null, figureFileBig=null, tableContent=
模型睡眠问题OR值(95%CI)P值
WQS正向
SSD1.254(1.009～1.559)0.041
入睡困难1.165(0.905～1.501)0.236
睡眠障碍0.911(0.692～1.198)0.504
负向
SSD1.085(0.873～1.349)0.461
入睡困难0.952(0.829～1.094)0.491
睡眠障碍0.890(0.636～1.247)0.499
), ArticleFig(id=1241678323026285012, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922561532815, language=CN, label=表4, caption=

VOCs混合暴露与睡眠问题的关联

, figureFileSmall=null, figureFileBig=null, tableContent=
模型睡眠问题OR值(95%CI)P值
WQS正向
SSD1.254(1.009～1.559)0.041
入睡困难1.165(0.905～1.501)0.236
睡眠障碍0.911(0.692～1.198)0.504
负向
SSD1.085(0.873～1.349)0.461
入睡困难0.952(0.829～1.094)0.491
睡眠障碍0.890(0.636～1.247)0.499
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挥发性有机物与成年人睡眠问题的关联性分析
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王雅兰 , 费扬 , 鲍蕾蕾
现代预防医学 | 环境与职业卫生 2024,51(5): 822-828
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现代预防医学 | 环境与职业卫生 2024, 51(5): 822-828
挥发性有机物与成年人睡眠问题的关联性分析
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王雅兰, 费扬, 鲍蕾蕾
作者信息
  • 海军军医大学第三附属医院药材科，上海 200438

    • 王雅兰（1994—），女，硕士，药师，研究方向：睡眠与环境

通讯作者:

鲍蕾蕾，E-mail:
Analysis of the relationship between volatile organic compounds and sleep problems in adults
Ya-lan WANG, Yang FEI, Lei-lei BAO
Affiliations
  • Department of Medicinal Materials, The Third Affiliated Hospital of Naval Medical University, Shanghai 200438, China
出版时间: 2024-03-10 doi: 10.20043/j.cnki.MPM.202307199
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摘要
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目的

探究挥发性有机物(volatile organic compounds, VOCs)暴露与成年人睡眠问题的关联。

方法

本研究合并了来自2007—2014年美国国家健康与营养调查(NHANES)数据库的5 337名参与者，采用加权逻辑回归模型和加权分位数(weighted quantile sum, WQS)回归模型评估血液VOCs与成人睡眠时间短(short sleep duration, SSD)、入睡困难和睡眠障碍的关联。

结果

在调整混杂因素后，血液中苯(OR=1.120, 95%CI:1.019 ~ 1.230, P=0.02)、2,5-二甲基呋喃(OR=1.144,95%CI:1.043 ~ 1.254, P=0.005)、乙苯(OR=1.115, 95%CI:1.025 ~ 1.211, P=0.012)、呋喃(OR=1.271, 95%CI:1.086 ~ 1.489, P=0.004)、邻二甲苯(OR=1.097, 95%CI:1.006 ~ 1.198, P=0.037)与SDD存在显著正向关联。其次，血液中2,5-二甲基呋喃(OR=1.082, 95%CI:1.008 ~ 1.161, P=0.03)、呋喃(OR=1.148, 95%CI:1.002 ~ 1.315, P=0.046)与入睡困难存在显著正向关联。亚组分析显示，VOCs与SSD之间的正向关联在不同组间是一致的。WQS结果显示，每增加1单位，SSD风险增加25.4%(OR=1.254, 95%CI:1.009 ~ 1.559, P=0.041)。

结论

VOCs暴露可能与美国成年人SSD发生呈正向关联。

挥发性有机物  /  睡眠问题  /  混合暴露
Objective

To explore the relationship between volatile organic compounds (VOCs) exposure and sleep problems in adults.

Methods

This study included 5 337 participants from the 2007-2014 National Health and Nutrition Examination Survey (NHANES) database. Weighted logical regression model and weighted quartile sum (WQS) regression model were used to evaluate the association of blood VOCs with short sleep duration (SSD), difficulty in falling asleep, and sleep disorders in adults.

Results

After adjusting the confounding factors, blood benzene (OR = 1.120, 95%CI: 1.019-1.230, P = 0.02), 2,5-dimethylfuran (OR = 1.144, 95%CI: 1.043-1.254, P = 0.005), ethylbenzene (OR = 1.115, 95%CI: 1.025-1.211, P = 0.012), furan (OR =1.271, 95%CI: 1.086-1.489, P = 0.004), and o-xylene (OR = 1.097, 95%CI: 1.006-1.198, P = 0.037) had a significant positive correlation with SDD. Secondly, 2,5-dimethylfuran (OR = 1.082, 95%CI: 1.008-1.161, P = 0.03) and furan (OR = 1.148,95%CI: 1.002-1.315, P = 0.046) were positively correlated with difficulty in falling asleep. Subgroup analysis showed that the positive association between VOCs and SSD was consistent among different groups. WQS results showed that for every unit of increase, SSD risk increased by 25.4% (OR = 1.254, 95%CI: 1.009-1.559, P = 0.041).

Conclusion

There is a positive correlation between VOCs exposure and SSD in American adults.

Volatile organic compounds  /  Sleep problems  /  Mixed exposure
王雅兰, 费扬, 鲍蕾蕾. 挥发性有机物与成年人睡眠问题的关联性分析. 现代预防医学, 2024 , 51 (5) : 822 -828 . DOI: 10.20043/j.cnki.MPM.202307199
Ya-lan WANG, Yang FEI, Lei-lei BAO. Analysis of the relationship between volatile organic compounds and sleep problems in adults[J]. Modern Preventive Medicine, 2024 , 51 (5) : 822 -828 . DOI: 10.20043/j.cnki.MPM.202307199
正文
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挥发性有机化合物(volatile organic compounds,VOCs)是一种沸点在50～260℃之间的有机气体，是室内空气污染物的重要组成部分[1]。VOCs因其潜在的健康影响而受到高度关注[2-4]。例如，许多VOCs可能会引起呼吸系统、生殖系统和神经系统相关疾病[5-7]，从而对人类健康造成不良影响。
睡眠是大脑独特且必要的功能状态，占据一个人生命中三分之一的时间。睡眠对于心理和身体健康至关重要。然而，许多人遭受睡眠时间短(short sleep duration, SSD)等睡眠问题的困扰[8]。在美国，约有35%的成年人无法得到足够的睡眠时间[9]。SSD是导致肥胖[10]、高血压[11]、慢性肾病[12]和抑郁[13]等疾病的重要因素。许多环境化学物质如砷、杀虫剂、重金属、邻苯二甲酸酯、多芳香烃和多氟烷基化合物与成人的睡眠问题有关[14]。但目前尚未有研究涉及VOCs与睡眠问题的关联性研究。因此，本研究基于2007—2014NHANES数据库，探究睡眠问题与血液VOCs的潜在关联。
1　材料与方法
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1.1　研究人群
本研究数据来自美国国家健康和营养检查调查（National Health and Nutrition Examination Survey, NHANES）数据库。NHANES是由美国疾病控制预防中心（CDC）进行的一项的横断面调查，采用分层多阶段抽样设计，样本从具有全国代表性的美国平民样本中收集。NHANES项目由国家卫生统计中心伦理审查委员会批准，并获得了所有参与者的书面知情同意。在本研究中，我们合并了NHANES数据库中2007—2008年、2009—2010年、2011—2012年和2013—2014年连续8年的人群。
NHANES 2007—2014年数据库中共有40 617个对象，排除VOCs浓度数据缺失的人群后剩下8 408人，继续排除未完成睡眠问卷的人群后剩下7 623人，然后进一步排除了怀孕的女性后剩下7 544人，最后排除了协变量数据缺失的人群后剩下5 337人纳入本研究，筛选流程见图1。
1.2　VOCs浓度测定
所有全血样本均由美国CDC进行分析和质控。采用固相萃取-同位素稀释-超高效液相色谱-串联质谱法定量检测VOCs的含量，包括苯(benzene)、1,4-二氯苯(1,4-dichlorobenzene)、2,5-二甲基呋喃(2,5-dimethylfuran)、乙苯(ethylbenzene)、呋喃(furan)、间/对二甲苯(m-/p-xylene)、邻二甲苯(o-xylene)以及四氯乙烯(tetrachloroethene)。若浓度低于检测限(LOD)，则用LOD/替代。
1.3　睡眠问题
在本项研究中，睡眠时间(sleep duration)是通过回答问题：“你平时在工作日晚上通常睡多少小时？”而获得的。根据美国国立卫生研究院的建议，健康成年人每天需要进行7～8 h的睡眠，睡眠时间小于7 h则会被归类为SSD。是否有入睡困难(trouble sleeping)以曾向医生或其他医疗专业人员反映有入睡困难定义为“是”，反之为“否”。是否有睡眠障碍(sleep disorder)以曾被医生或其他医疗专业人员告知有睡眠障碍定义为“是”，反之为“否”。
1.4　协变量
协变量的选择是基于文献中发现的与睡眠显著相关的因素[15-16]。潜在的混杂因素包括年龄、性别、种族（墨西哥裔美国人、其他西班牙裔、非西班牙裔白人、非西班牙裔黑人及其他种族）、体质量指数(BMI，过轻或正常：<25.0 kg/m2，超重：25.0~29.9 kg/m2，肥胖：≥30.0 kg/m2)、受教育程度（高中以下、高中、高中以上）、婚姻状况（已婚/与伴侣同居、丧偶/离婚/分居、从未结婚）、贫困收入比[17](poverty to income ratio, PIR，低收入:<1.3，中高收入：≥1.3)、吸烟状况(吸烟者、过去吸烟者、不吸烟者)、饮酒状况（一年中饮用过至少12杯酒精饮料）、癌症、抑郁症［根据病人健康问卷抑郁量表（PHQ-9）来定义，总得分≥10分的参与者被认为患有抑郁症[18]］、高血压、糖尿病、心血管疾病（cardiovascular disease, CVD，包括冠心病、心绞痛、充血性心力衰竭、心肌梗死和中风）以及慢性肾病（chronic kidney disease, CKD，定义为eGFR<60 ml/min/1.73m2或尿白蛋白/肌酐≥30mg/g）。eGFR根据IDMS-traceable MDRD方程计算：eGFR=175×(serum creatinine)-1.154×(age)-0.203×(0.742 only if female)×(1.212 only if black)。
1.5　统计分析
连续变量若符合正态分布用（均数±标准差）表示，采用t检验比较，否则采用中位数(四分位数间距)，使用Wilcoxon秩和检验分析；分类变量用频数(百分比)表示，使用Rao-Scott χ2检验比较。
对血液VOCs浓度自然对数转换使其近似正态分布。用Spearman秩相关性分析评估8种VOCs暴露之间的相关性。用多元加权logistic回归模型分析VOCs暴露水平与睡眠问题之间的关联，结果报告为比值比（odds ratio, OR）及其95%置信区间（confidence interval, CI）和P值。为探究关联在不同的性别、年龄组以及BMI之间是否存在差异，按照性别、年龄和BMI进行亚组分析。在调整所有协变量后，使用限制性立方样条来检验每个VOCs和SSD之间的非线性关联。为了验证结果的稳健性，在敏感性分析中使用R软件“mi”包对协变量的缺失数据进行多重插补。所有分析的模型中均调整了年龄、性别、种族、BMI受教育程度、婚姻状况、PIR、饮酒状态、抑郁症、高血压、糖尿病、CKD以及CVD。因吸烟状态与血液VOCs存在严重的共线性，所以未纳入到模型中。
构建加权分位数(weighted quantile sum, WQS)回归模型来评估8种VOCs混合暴露对睡眠问题的影响[19]。本研究基于VOCs的四分位数构建了VOCs暴露的WQS指数，将数据分为训练集（40%）和验证集（60%），共进行1 000次自举；并建立了两组WQS回归模型，分别评估正向关联和负向关联。
本研究使用R version 4.1.2进行所有的统计分析。分别采用“survey”包和“gwqs”包进行加权逻辑回归和WQS回归分析。双侧检验水准α=0.05。
2　结果
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2.1　研究对象一般人口学特征
本研究涉及来自NHANES 2007—2014四个调查周期的人口数据，共计5 337人，包括男性2 670人、女性2 667人，其中2 091人患有SSD。SSD组与非SSD组在年龄、种族、BMI、受教育程度、婚姻状况、PIR、癌症、抑郁症方面存在显著差异。SSD人群的苯、1,4-二氯苯、2,5-二甲基呋喃、乙苯、呋喃、间/对二甲苯、邻二甲苯水平均高于非SSD人群。此外，有1 335人自我报告出现入睡困难，这部分人的苯、2,5-二甲基呋喃、乙苯、呋喃、间/对二甲苯、邻二甲苯水平均高于没有入睡困难的人。研究对象中有289人被定义为睡眠障碍，与非睡眠障碍人群相比，睡眠障碍人群1,4-二氯苯浓度水平较低。见表1。
2.2　血液VOCs之间的相关性
如图2所示，苯、2,5-二甲基呋喃、乙苯、呋喃、间/对二甲苯、邻二甲苯之间存在显著的相关性(r=0.53～0.89)，且均呈正相关。
2.3　VOCs暴露与睡眠问题之间的关联
结果如表2所示，在调整混杂因素后，苯、2,5-二甲基呋喃、乙苯、呋喃、邻二甲苯与SSD存在显著正向关联(均P<0.05)。其次，在调整混杂因素后，血液中2,5-二甲基呋喃、呋喃与入睡困难存在显著正向关联(均P<0.05)。然而，在调整混杂因素后，血液中VOCs与睡眠障碍风险不存在显著关联。敏感性分析的结果显示，血液中苯、2,5-二甲基呋喃、乙苯、呋喃、邻二甲苯与SSD的发生风险之间的显著关联保持不变。
在调整了所有的协变量后，使用受限三次样条曲线（RCS）进一步阐明了VOCs暴露与SSD之间的关系，如图3显示，SSD与血液中苯、2,5-二甲基呋喃、乙苯之间存在非线性关系(均P for nonlinearity <0.05)。亚组分析显示，VOCs与SSD之间的关联在不同组间是一致的，值得注意的是血液中苯、2,5-二甲基呋喃、乙苯、呋喃、邻二甲苯与SDD之间的关联在男性和肥胖人群中更为显著，见表3。
2.4　VOCs混合暴露与睡眠问题之间的关联
WQS结果显示，当限定关联方向为正时，调整混杂因素后，WQS每增加1单位，SSD风险增加25.4%(OR=1.254, 95%CI:1.009～1.559, P=0.041)，其中邻二甲苯权重最大，见表4、图4；然而，VOCs混合暴露和入睡困难、睡眠障碍之间没有显著的关联。当限定关联方向为负时，未观察到VOCs混合暴露与睡眠问题存在显著关联。
3　讨论
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本研究首次评估了美国成年人血液中多种VOCs与睡眠问题的关系。本研究结果显示，大多数VOCs与SSD呈显著正向关联。此外，通过WQS模型分析也进一步证实了VOCs混合暴露与成人SSD发生风险增加存在显著关联。
目前没有研究直接表明VOCs暴露与SSD等睡眠问题的存在显著关联，仅有一些研究间接提示VOCs暴露与睡眠质量存在关联。心率变异性(heart rate variablity, HRV)指数可反映心脏自主神经系统响应外界刺激以适应环境变化的能力[20]。研究表明SSD、睡眠质量差和睡眠效率低与HRV指数降低相关[21-22]。Mizukoshi等[23]通过24小时实时监测VOCs浓度，探讨了VOCs浓度变化与HRV指数的关联，发现VOCs浓度变化较大时受试者的高频功率明显降低。此外，另外两项基于台湾省健康成年人的研究中，同样观察到HRV指数的降低与和VOCs暴露有关[24-25]。最近，一项基于北京市50名18～28周岁年轻女性的研究发现，室内VOCs短期暴露与年轻女性的夜间HRV指数存在负相关[20]。因此，VOCs暴露与SSD等睡眠问题的存在显著关联可能是通过HRV介导的。
亚组分析显示，VOCs暴露与SSD风险在男性中的正向关联更加显著，这可能是因为男性中VOCs的血液暴露水平较高[26]。烟草烟雾中含有众多有毒化学物质，是某些VOCs的主要来源[27]。因此，由于男性吸烟人群较女性多，男性VOCs暴露水平可能会更高。此外，在本研究中，只有2,5-二甲基呋喃与自我报告的入睡困难呈正向关联，VOCs与自我报告的睡眠障碍无显著关联。关于VOCs与睡眠之间关联的机制在体内和体外方面的研究尚缺乏，VOCs的暴露与睡眠问题的关联仍需要进一步探索。
本研究有以下主要优点：采用了多种模型评估VOCs对睡眠问题的单一和联合暴露效应。同时，使用具有较大样本量的全国代表性的NHANES数据，并对多个潜在混杂因素进行了调整，从而提高了研究结果的可靠性。但是，本研究还存在一些缺点。首先，横断面研究难以推断出VOCs与睡眠问题之间的因果关系。其次，尽管我们已经调整了一些潜在的混杂因素，但未纳入的混杂因素仍无法避免。最后，本研究中的一些数据是基于自我报告的，如睡眠问题的评估，这可能会导致潜在的偏倚。此外，这项研究是基于美国成年人数据的，因此是否可以将这些结论推广到其他国家的人群仍不确定。因此，需要在大样本的前瞻性队列研究中进一步验证本研究的结果。
综上所述，本研究表明，VOCs暴露可能会增加美国成年人SSD的患病风险。此外，男性和肥胖人群可能更容易受到VOCs的影响。这对预防VOCs污染和保护睡眠健康具有重要意义。未来需要进行更多的前瞻性流行病学研究，以探索血液VOCs与睡眠问题之间的因果关系。
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2024年第51卷第5期
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doi: 10.20043/j.cnki.MPM.202307199
  • 接收时间：2023-07-10
  • 首发时间：2026-03-19
  • 出版时间：2024-03-10
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    海军军医大学第三附属医院药材科，上海 200438

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鲍蕾蕾，E-mail:
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2种不同金属材料的力学参数
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Number of
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Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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