生活行为与血清生化指标共同影响青年男性热耐受能力:一项海南地区横断面研究OA
Lifestyle behaviors and serum biochemical indicators jointly influence heat tolerance in young adult males:a cross-sectional study in Hainan region
目的 青年男性是高温作业的主要群体,全球气候变化加剧的高温暴露严重威胁其作业效能与生命安全,个体间天然存在热耐受能力差异,但当前对热耐受差异的影响因素缺乏系统认识.本研究旨在通过多维度指标(基本生理特征、生活行为特征、血清生化与激素水平等)系统探究影响青年男性热耐受能力的个体差异因素,为高温作业人群的健康防护、热相关疾病预防及人员选拔与任务部署提供理论依据.方法 采用横断面研究设计方案,于2024年3月25日至4月6日选取常住海南地区青年男性160位,依据热耐受测试的完成情况和结束时体温、心率分为不耐热组(35人)、一般耐热组(81人)和超强耐热组(44人),对比分析3组基本生理特征(年龄、身高、体质量、BMI、体表面积和体脂肪率);利用问卷星调查各组的生活行为特征(吸烟、失眠、饮水、中暑病史、体能水平、环境适应性);检测血清生化指标[天冬氨酸氨基转移酶(aspartate aminotransferase,AST)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、尿素氮(urea nitrogen,UREA)、肌酐(creatinine,Cr)、肌酸激酶(creatine kinase,CK)和肌酸激酶MB同工酶(creatine kinase-MB,CK-MB)]和激素(皮质醇、醛固酮和血睾酮)水平;有序Logistic回归分析影响耐热能力的差异指标,并通过混淆矩阵评价预测准确性.结果 单因素分析显示,BMI(P=0.017)、体脂肪率(P=0.002)、吸烟(P=0.010)、失眠(P=0.024)、既往中暑病史(P=0.019)、体能水平(P=0.002)、环境适应性(P<0.001)、Cr(P<0.001)、ALT(P<0.001)、皮质醇(P=0.002)及血睾酮(P=0.002)水平在3组间差异均有统计学意义.多因素有序Logistic回归分析表明,吸烟(OR=2.958,95%CI:1.379~6.346,P=0.005)、中暑病史(OR=3.872,95%CI:1.451~10.328,P=0.007)、体能差(OR=0.047,95%CI:0.006~0.383,P=0.004)、环境适应性一般(OR=0.280,95%CI:0.107~0.730,P=0.009)、Cr(OR=0.820,95%CI:0.762~0.882,P<0.001)、ALT(OR=0.848,95%CI:0.751~0.957,P=0.008)与血睾酮(OR=0.627,95%CI:0.448~0.875,P=0.006)升高是热耐受能力下降的独立危险因素.整体预测准确率为70.00%,具有良好的区分效能.结论 个人生理生化(Cr、ALT和血睾酮)和生活行为特征(吸烟、中暑病史、体能水平和环境适应性)是影响海南地区青年男性热耐受能力的关键因素,BMI、体脂肪率、皮质醇及失眠与热耐受存在显著关联.
Objective Young adult males constitute the primary workforce in high-temperature operations,and intensified heat exposure driven by global climate change poses a severe threat to their operational efficiency and life safety.Natural individual differences exist in heat tolerance,yet systematic understanding of the influencing factors remains lacking.This study aims to systematically investigate individual difference factors affecting heat tolerance in young males through multidimensional indicators including basic physiological characteristics,lifestyle behaviors,and serum biochemical and hormonal levels,thereby providing a theoretical basis for health management and heat injury prevention of workers exposed to high-temperature environments.Methods A cross-sectional study was conducted among young adult males permanently residing in Hainan.A total of 160 participants were enrolled between March 25 and April 6,2024,and based on the results of heat tolerance tests and terminal body temperature and heart rate,they were divided into a heat-intolerant group(n=35),a moderately heat-tolerant group(n=81),and a superiorly heat-tolerant group(n=44).General physiological indicators including age,height,body weight,body mass index(BMI),body surface area and body fat percentage were compared across groups.Lifestyle behaviors(smoking status,insomnia,water intake,history of heatstroke,physical fitness and adaptability to local living environment)were investigated via Wenjuanxing questionnaire.Serum biochemical indicators[aspartate aminotransferase(AST),alanine aminotransferase(ALT),urea nitrogen(UREA),creatinine(Cr),creatine kinase(CK),and creatine kinase-MB(CK-MB)]and hormones(cortisol,aldosterone,and testosterone)level were detected.Ordinal logistic regression analysis was applied to identify differential indicators influencing heat tolerance,and a confusion matrix was adopted to evaluate the prediction accuracy of the model.Results Univariate analysis showed significant differences among the 3 groups in terms of BMI(P=0.017),body fat percentage(P=0.002),smoking(P=0.010),insomnia(P=0.024),history of heatstroke(P=0.019),physical fitness(P=0.002),environmental adaptability(P<0.001),Cr(P<0.001),ALT(P<0.001),cortisol(P=0.002)and serum testosterone(P=0.002).Multivariate ordinal logistic regression analysis revealed that smoking(OR=2.958,95%CI:1.379 to 6.346,P=0.005),history of heatstroke(OR=3.872,95%CI:1.451 to 10.328,P=0.007),poor physical fitness(OR=0.047,95%CI:0.006 to 0.383,P=0.004),moderate environmental adaptability(OR=0.280,95%CI:0.107 to 0.730,P=0.009),elevated levels of Cr(OR=0.820,95%CI:0.762 to 0.882,P<0.001),ALT(OR=0.848,95%CI:0.751 to 0.957,P=0.008)and testosterone(OR=0.627,95%CI:0.448 to 0.875,P=0.006)were independent risk factors for decreased heat tolerance.The overall prediction accuracy of the model was 70.00%,indicating satisfactory discriminative performance.Conclusion Individual physiological and biochemical indicators(Cr,ALT and testosterone)as well as lifestyle behaviors(smoking,heatstroke history,physical fitness and environmental adaptability)are key influencing factors for heat tolerance in young adult males in Hainan region.BMI,body fat percentage,cortisol and insomnia are also significantly correlated with heat tolerance.
罗珍;何根林;罗雪;李萍;胡啸;杨学森;谭雨龙
陆军军医大学(第三军医大学)军事预防医学系热带医学教研室,重庆陆军军医大学(第三军医大学)军事预防医学系热带医学教研室,重庆陆军军医大学(第三军医大学)军事预防医学系热带医学教研室,重庆陆军军医大学(第三军医大学)军事预防医学系热带医学教研室,重庆陆军军医大学(第三军医大学)军事预防医学系热带医学教研室,重庆陆军军医大学(第三军医大学)军事预防医学系热带医学教研室,重庆陆军军医大学(第三军医大学)军事预防医学系热带医学教研室,重庆
医药卫生
热耐受高温青年危险因素睾酮职业暴露
heat tolerancehigh temperatureyoung adultsrisk factorstestosteroneoccupational exposure
《陆军军医大学学报》 2026 (17)
2465-2475,11
陆军军医大学科技创新能力提升专项项目(2023XQN17) Supported by the Special Project of Science and Technology Innovation Capacity Promotion of Army Medical University(2023XQN17).
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