| Objective: Oxidative stress was confirmed to be an important pathogenesis of fluorosis.Carotenoids have been shown to contribute to the body’s defense against free radicals.In vitro and vivo experiments have showed that carotenoids can antagonize body damage caused by fluorosis.However,no epidemiological studies on the relationship between carotenoids and fluorosis have been reported.Therefore,the present study aims to explore the associations between the dietary and serum carotenoids(α-carotene,β-carotene,lutein/zeaxanthin,lycopene,β-cryptoxanthin and total carotenoids)and coal-burning fluorosis.Furthermore,screening out carotenoids with strong effects for fluorosis,and providing a new scientific evidence for the prevention and control of fluorosis.Methods: This 1:1 matched case-control study was conducted in Zhijin County,Guizhou Province,in which coal-burning fluorosis is endemic.Two hundred and forty six adult patients with endemic fluorosis were recruited,and 246 control subjects were individually matched by sex and age(±3 years).Structured questionnaires were conducted to collect general sociodemographic characteristics,coal burning related conditions,and various disease history through face-to-face survey.A 75-item food frequency questionnaire(FFQ)was conducted to assess habitual dietary intake in the year.Urinary fluoride was measured using an ion-selective electrode method.Serum carotenoids were examined by reversed-phase high-performance liquid chromatography(HPLC).Dietary and serum carotenoids were categorized into Quartiles(Quartile 1~Quartile 4)according to the cutoffs of carotenoids among the control group.The lowest group(Quartile 1)as the reference group,univariate and multivariable Logistic regression was used to assess the relationships between the Quartiles(Quartile 2~Quartile 4)of carotenoids and risk of coal-burning fluorosis,and Odd ratios(ORs)and 95% confidence intervals(95% CIs)were calculated.Results: Compared with the case group,control group had a higher intake of β-carotene,α-carotene,lycopene,lutein/zeaxanthin,and total carotenoids(all P <0.05)expect for β-cryptoxanthin.In addition,compared with the case group,control group had higher serum levels of α-carotene,β-cryptoxanthin,lutein/zeaxanthin,lycopene and total carotenoids(all P<0.05),but there was no significance for β-carotene in both groups.After adjustment for potential confounders,a significant inverse association was observed between the dietary intake of α-carotene,β-carotene,lutein/zeaxanthin,lycopene and total carotenoids and the risk of coal-burning fluorosis(all P for trend <0.05),whereas β-cryptoxanthin intakes were not found to be related to coal-burning fluorosis.The ORs and 95% CIs of coal-burning fluorosis for the highest(Quartile 4)versus lowest(Quartile 1)of intake were 0.44(0.24,0.80)for β-carotene,0.45(0.24,0.86)for α-carotene,0.46(0.26,0.82)for lycopene,0.43(0.23,0.79)for lutein/zeaxanthin and 0.49(0.26,0.93)for total carotenoids.We also found significant inverse associations between serum levels of lutein/zeaxanthin,lycopene,α-carotene,and total carotenoids and coal-burning fluorosis(all P for trend <0.05).No significant associations were found between the β-cryptoxanthin,β-carotene and coal-burning fluorosis.The ORs and 95% CIs of fluorosis for the top versus bottom quartile were 0.46(0.24,0.91)for α-carotene,0.44(0.23,0.83)for lycopene,0.52(0.29,0.93)for lutein/zeaxanthin,and 0.42(0.21,0.84)for total carotenoids.Conclusion: Greater dietary intake of β-carotene,α-carotene,lutein/zeaxanthin,lycopene,and total carotenoids,as well as higher circulating levels of α-carotene,lutein/zeaxanthin,lycopene,and total carotenoids are negatively correlated with the risk of coal-burning fluorosis.Greater intake of fruit and vegetables rich in carotenoids might are beneficial to risk of coal-burning fluorosis. |
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