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
Tan Yulong,E-mail:yulong_tan2014@163.com
Received:15 May 2026,
Revised:2026-07-21,
Accepted:03 August 2026,
Published:15 September 2026
移动端阅览
罗珍,何根林,罗雪,等.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[J].陆军军医大学学报,2026,48(17):2465-2475.DOI:10.16016/j.2097-0927.202605046.
Luo Z,He G L,Luo X,et al.Lifestyle behaviors and serum biochemical indicators jointly influence heat tolerance in young adult males: a cross-sectional study in Hainan region[J].J Army Med Univ,2026,48(17):2465-2475.DOI:10.16016/j.2097-0927.202605046.
罗珍,何根林,罗雪,等.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[J].陆军军医大学学报,2026,48(17):2465-2475.DOI:10.16016/j.2097-0927.202605046. DOI:
Luo Z,He G L,Luo X,et al.Lifestyle behaviors and serum biochemical indicators jointly influence heat tolerance in young adult males: a cross-sectional study in Hainan region[J].J Army Med Univ,2026,48(17):2465-2475.DOI:10.16016/j.2097-0927.202605046. DOI:
目的
2
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
2
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
2
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
2
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
2
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
2
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
2
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
2
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.
Rodrigues Júnior J F C , Mckenna Z , Amorim F T , et al . Thermoregulatory and metabolic responses to a half-marathon run in hot, humid conditions [J]. J Therm Biol , 2020 , 93 : 102734 . DOI: 10.1016/j.jtherbio.2020.102734 http://dx.doi.org/10.1016/j.jtherbio.2020.102734 .
Schlader Z J , Schwob J , Hostler D , et al . Simultaneous assessment of motor and cognitive tasks reveals reductions in working memory performance following exercise in the heat [J]. Temperature (Austin) , 2022 , 9 ( 4 ): 344 - 356 . DOI: 10.1080/23328940.2021.1992239 http://dx.doi.org/10.1080/23328940.2021.1992239 .
Lee J K W , Tan B , Ogden H B , et al . Exertional heat stroke: nutritional considerations [J]. Exp Physiol , 2022 , 107 ( 10 ): 1122 - 1135 . DOI: 10.1113/EP090149 http://dx.doi.org/10.1113/EP090149 .
Bouchama A , Abuyassin B , Lehe C , et al . Classic and exertional heatstroke [J]. Nat Rev Dis Primers , 2022 , 8 ( 1 ): 8 . DOI: 10.1038/s41572-021-00334-6 http://dx.doi.org/10.1038/s41572-021-00334-6 .
胡明 , 李萍 , 刘吉洛 , 等 . 热习服分子机制、特异性标志物及遗传差异研究进展 [J]. 解放军医学杂志 , 2022 , 47 ( 10 ): 1034 - 1041 . DOI: 10.11855/j.issn.0577-7402.2022.10.1034 http://dx.doi.org/10.11855/j.issn.0577-7402.2022.10.1034 .
Hu M , Li P , Liu J L , et al . Research progress on molecular mechanism, specific markers and genetic differences of heat acclimatization [J]. Med J Chin PLA , 2022 , 47 ( 10 ): 1034 - 1041 . DOI: 10.11855/j.issn.0577-7402.2022.10.1034 http://dx.doi.org/10.11855/j.issn.0577-7402.2022.10.1034 .
Lisman P , Kazman J B , O’Connor F G , et al . Heat tolerance testing: association between heat intolerance and anthropometric and fitness measurements [J]. Mil Med , 2014 , 179 ( 11 ): 1339 - 1346 . DOI: 10.7205/milmed-d-14-00169 http://dx.doi.org/10.7205/milmed-d-14-00169 .
Kazman J B , Purvis D L , Heled Y , et al . Women and exertional heat illness: identification of gender specific risk factors [J]. US Army Med Dep J , 2015 : 58 - 66 .
Alele F O , Malau-Aduli B S , Malau-Aduli A E O , et al . Haematological, biochemical and hormonal biomarkers of heat intolerance in military personnel [J]. Biology , 2021 , 10 ( 10 ): 1068 . DOI: 10.3390/biology10101068 http://dx.doi.org/10.3390/biology10101068 .
Schermann H , Craig E , Yanovich E , et al . Probability of heat intolerance: standardized interpretation of heat-tolerance testing results versus specialist judgment [J]. J Athletic Train , 2018 , 53 ( 4 ): 423 - 430 . DOI: 10.4085/1062-6050-519-16 http://dx.doi.org/10.4085/1062-6050-519-16 .
Moran D S , Shitzer A , Pandolf K B . A physiological strain index to evaluate heat stress [J]. Am J Physiol , 1998 , 275 ( 1 ): R129 - R134 . DOI: 10.1152/ajpregu.1998.275.1.R129 http://dx.doi.org/10.1152/ajpregu.1998.275.1.R129 .
Pandolf K B . Aging and human heat tolerance [J]. Exp Aging Res , 1997 , 23 ( 1 ): 69 - 105 . DOI: 10.1080/03610739708254027 http://dx.doi.org/10.1080/03610739708254027 .
Havenith G , Inoue Y , Luttikholt V , et al . Age predicts cardiovascular, but not thermoregulatory, responses to humid heat stress [J]. Eur J Appl Physiol Occup Physiol , 1995 , 70 ( 1 ): 88 - 96 . DOI: 10.1007/BF00601814 http://dx.doi.org/10.1007/BF00601814 .
Alele F O , Malau-Aduli B S , Malau-Aduli A E O , et al . Individual anthropometric, aerobic capacity and demographic characteristics as predictors of heat intolerance in military populations [J]. Medicina (Kaunas) , 2021 , 57 ( 2 ): 173 . DOI: 10.3390/medicina57020173 http://dx.doi.org/10.3390/medicina57020173 .
Druyan A , Makranz C , Moran D , et al . Heat tolerance in women—reconsidering the criteria [J]. Aviat Space Environ Med , 2012 , 83 ( 1 ): 58 - 60 . DOI: 10.3357/asem.3130.2012 http://dx.doi.org/10.3357/asem.3130.2012 .
Brazelton S C , Charkoudian N , Bradbury K E , et al . Inter-individual variability in physiological adaptations during heat acclimation in adults: Contributions of body mass index and body size [J]. Physiol Rep , 2026 , 14 ( 2 ): e70713 . DOI: 10.14814/phy2.70713 http://dx.doi.org/10.14814/phy2.70713 .
Selkirk G A , McLellan T M . Influence of aerobic fitness and body fatness on tolerance to uncompensable heat stress [J]. J Appl Physiol (1985), 2001 , 91 ( 5 ): 2055 - 2063 . DOI: 10.1152/jappl.2001.91.5.2055 http://dx.doi.org/10.1152/jappl.2001.91.5.2055 .
Gardner J W , Kark J A , Karnei K , et al . Risk factors predicting exertional heat illness in male Marine Corps recruits [J]. Med Sci Sports Exerc , 1996 , 28 ( 8 ): 939 - 944 . DOI: 10.1097/00005768-199608000-00001 http://dx.doi.org/10.1097/00005768-199608000-00001 .
Wallace R F , Kriebel D , Punnett L , et al . Risk factors for recruit exertional heat illness by gender and training period [J]. Aviat Space Environ Med , 2006 , 77 ( 4 ): 415 - 421 .
Bedno S A , Urban N , Boivin M R , et al . Fitness, obesity and risk of heat illness among army trainees [J]. Occup Med (Lond) , 2014 , 64 ( 6 ): 461 - 467 . DOI: 10.1093/occmed/kqu062 http://dx.doi.org/10.1093/occmed/kqu062 .
Zlatar T , Mendes F , Vasconcelos B , et al . Lifestyle factors influencing heat stress response: a review [J]. CESET , 2018 : 22 - 31 .
Moyen N E , Ganio M S , Burchfield J M , et al . Effect of passive heat stress on arterial stiffness in smokers versus non-smokers [J]. Int J Biometeorol , 2016 , 60 ( 4 ): 499 - 506 . DOI: 10.1007/s00484-015-1046-2 http://dx.doi.org/10.1007/s00484-015-1046-2 .
宁波 , 宋青 . 《部队热习服指南》解读 [J]. 空军医学杂志 , 2018 , 34 ( 4 ): 276 - 278, 289 . DOI: 10.3969/j.issn.2095-3402.2018.04.018 http://dx.doi.org/10.3969/j.issn.2095-3402.2018.04.018 .
Ning B , Song Q . Interpretation of “Military Heat Acclimatization Guidelines” [J]. Med J Air Force , 2018 , 34 ( 4 ): 276 - 278, 289 . DOI: 10.3969/j.issn.2095-3402.2018.04.018 http://dx.doi.org/10.3969/j.issn.2095-3402.2018.04.018 .
Park J , Kim Y , Oh I . Factors affecting heat-related diseases in outdoor workers exposed to extreme heat [J]. Ann Occup Environ Med , 2017 , 29 ( 1 ): 30 . DOI: 10.1186/s40557-017-0183-y http://dx.doi.org/10.1186/s40557-017-0183-y .
Périard J D , Eijsvogels T M H , Daanen H A M . Exercise under heat stress: thermoregulation, hydration, performance implications, and mitigation strategies [J]. Physiol Rev , 2021 , 101 ( 4 ): 1873 - 1979 . DOI: 10.1152/physrev.00038. 2020 http://dx.doi.org/10.1152/physrev.00038.2020 .
Foster J , Hodder S G , Lloyd A B , et al . Individual responses to heat stress: implications for hyperthermia and physical work capacity [J]. Front Physiol , 2020 , 11 : 541483 . DOI: 10.3389/fphys.2020.541483 http://dx.doi.org/10.3389/fphys.2020.541483 .
Sanchis-Gomar F , Lippi G . Physical activity—an important preanalytical variable [J]. Biochem Med , 2014 , 24 ( 1 ): 68 - 79 . DOI: 10.11613/BM.2014.009 http://dx.doi.org/10.11613/BM.2014.009 .
Mitchell K M , Cheuvront S N , King M A , et al . Use of the heat tolerance test to assess recovery from exertional heat stroke [J]. Temperature (Austin) , 2019 , 6 ( 2 ): 106 - 119 . DOI: 10.1080/23328940.2019.1574199 http://dx.doi.org/10.1080/23328940.2019.1574199 .
Alele F O , Malau-Aduli B S , Malau-Aduli A E O , et al . Epidemiology of exertional heat illness in the military: a systematic review of observational studies [J]. Int J Environ Res Public Health , 2020 , 17 ( 19 ): 7037 . DOI: 10.3390/ijerph17197037 http://dx.doi.org/10.3390/ijerph17197037 .
Peake J . Heat, athletes, and immunity [J]. Am J Lifestyle Med , 2010 , 4 ( 4 ): 320 - 326 . DOI: 10.1177/1559827610362969 http://dx.doi.org/10.1177/1559827610362969 .
Brenner I , Shek P , Zamecnik J , et al . Stress hormones and the immunological responses to heat and exercise [J]. Int J Sports Med , 1998 , 19 ( 2 ): 130 - 143 . DOI: 10.1055/s-2007-971895 http://dx.doi.org/10.1055/s-2007-971895 .
Brooks K , Carter J . Overtraining, exercise, and adrenal insufficiency [J]. J Nov Physiother , 2013 , 3 ( 125 ): 11717 . DOI: 10.4172/2165-7025.1000125 http://dx.doi.org/10.4172/2165-7025.1000125 .
Brandenberger G , Candas V , Follenius M , et al . Vascular fluid shifts and endocrine responses to exercise in the heat [J]. Eur J Appl Physiol Occup Physiol , 1986 , 55 ( 2 ): 123 - 129 . DOI: 10.1007/BF00714993 http://dx.doi.org/10.1007/BF00714993 .
Costello J T , Rendell R A , Furber M , et al . Effects of acute or chronic heat exposure, exercise and dehydration on plasma cortisol, IL-6 and CRP levels in trained males [J]. Cytokine , 2018 , 110 : 277 - 283 . DOI: 10.1016/j.cyto.2018. 01.018 http://dx.doi.org/10.1016/j.cyto.2018.01.018 .
Cramer M N , Jay O . Biophysical aspects of human thermoregulation during heat stress [J]. Auton Neurosci , 2016 , 196 : 3 - 13 . DOI: 10.1016/j.autneu.2016.03.001 http://dx.doi.org/10.1016/j.autneu.2016.03.001 .
van den Bos R , Harteveld M , Stoop H . Stress and decision-making in humans: Performance is related to cortisol reactivity, albeit differently in men and women [J]. Psychoneuroendocrinology , 2009 , 34 ( 10 ): 1449 - 1458 . DOI: 10.1016/j.psyneuen.2009.04.016 http://dx.doi.org/10.1016/j.psyneuen.2009.04.016 .
Hill E E , Zack E , Battaglini C , et al . Exercise and circulating cortisol levels: the intensity threshold effect [J]. J Endocrinol Invest , 2008 , 31 ( 7 ): 587 - 591 . DOI: 10.1007/BF03345606 http://dx.doi.org/10.1007/BF03345606 .
Chen Y F , Yu T Z . Testosterone mediates hyperthermic response of mice to heat exposure [J]. Life Sci , 2018 , 214 : 34 - 40 . DOI: 10.1016/j.lfs.2018.10.058 http://dx.doi.org/10.1016/j.lfs.2018.10.058 .
Bartman N E , Vargas N T , Cavuoto L A , et al . Heat strain differences walking in hot-dry and warm-wet environments of equivalent wet bulb globe temperature [J]. Temperature , 2024 , 11 ( 4 ): 333 - 349 . DOI: 10.1080/23328940.2024. 2384185 http://dx.doi.org/10.1080/23328940.2024.2384185 .
Weitz C A . Coping with extreme heat: current exposure and implications for the future [J]. Evol Med Public Heal , 2024 , 12 ( 1 ): 156 - 168 . DOI: 10.1093/emph/eoae015 http://dx.doi.org/10.1093/emph/eoae015 .
Daanen H A M , Racinais S , Périard J D . Heat acclimation decay and re-induction: a systematic review and meta-analysis [J]. Sports Med , 2018 , 48 ( 2 ): 409 - 430 . DOI: 10.1007/s40279-017-0808-x http://dx.doi.org/10.1007/s40279-017-0808-x .
0
Views
9
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010802024621
