Wong F L, Yamada M, Sasaki H, Kodama K, Hosoda Y
Department of Statistics, Clinical Studies, Radiation Effects Research Foundation, Hiroshima, Japan.
Radiat Res. 1999 Jun;151(6):736-46.
The effects of radiation on the long-term trends of the total serum cholesterol levels of the Hiroshima and Nagasaki atomic bomb survivors were examined using data collected in the Adult Health Study over a 28-year period (1958-1986). The growth-curve method was used to model the longitudinal age-dependent changes in cholesterol levels. For each sex, temporal trends of cholesterol levels were characterized with respect to age, body mass index, city and birth year. We then examined whether the temporal trends differed by radiation dose. We showed that the mean growth curve of cholesterol levels for the irradiated subjects were significantly higher than that for the unirradiated subjects, and that the increase was greater for women than for men. No difference in dose response was detected between Hiroshima and Nagasaki. An increased mean level of cholesterol was evident for irradiated women in general, but a notable increase was apparent in males only for the youngest birth cohort of 1935-1945. The difference in the mean cholesterol levels between the irradiated and unirradiated subjects diminished past 70 years of age. It is not known whether this is due to natural progression or is an artifact of nonrandom variation in the rate of participation in the examinations. The maximum predicted increase at 1 Gy for women occurred at age 52 years for the 1930 cohort: 2.5 mg/dl (95% CI 1.6-3.3 mg/dl) for Hiroshima and 2.3 mg/dl (95% CI 1.5-3.1 mg/dl) for Nagasaki. The corresponding increase for men occurred at age 29 years for the 1940 cohort: 1.6 mg/dl (95% CI 0.4-2.8) for Hiroshima and 1.4 mg/dl (95% CI 0.3-2.6) for Nagasaki. Controlling for cigarette smoking did not alter the dose-response relationship. Although the difference in the mean growth curves of the irradiated and unirradiated groups was statistically significant, there was a considerable overlap in the individual growth curves of the two groups. The significant sex difference and the greater magnitude of radiation effects in women suggest that hormonal changes resulting from radiation exposure, such as accelerated menopause, is an area worth investigating to delineate the mechanisms underlying the increased cholesterol levels of the irradiated female subjects. This increase may also partially explain the increased rate of coronary heart disease seen in the atomic bomb survivors.
利用成人健康研究在28年期间(1958 - 1986年)收集的数据,研究了辐射对广岛和长崎原子弹爆炸幸存者血清总胆固醇水平长期趋势的影响。采用生长曲线法对胆固醇水平随年龄变化的纵向趋势进行建模。对于每种性别,根据年龄、体重指数、城市和出生年份对胆固醇水平的时间趋势进行了特征描述。然后,我们研究了时间趋势是否因辐射剂量而异。我们发现,受辐射者胆固醇水平的平均生长曲线显著高于未受辐射者,而且女性的增幅大于男性。广岛和长崎之间未检测到剂量反应差异。一般来说,受辐射女性的胆固醇平均水平有所升高,但仅在1935 - 1945年最年轻的出生队列中,男性的胆固醇水平有显著升高。受辐射者和未受辐射者之间的平均胆固醇水平差异在70岁以后逐渐减小。尚不清楚这是由于自然进展还是检查参与率的非随机变化造成的假象。1930年出生队列的女性在1戈瑞辐射剂量下预测的最大增幅出现在52岁时:广岛为2.5毫克/分升(95%可信区间1.6 - 3.3毫克/分升),长崎为2.3毫克/分升(95%可信区间1.5 - 3.1毫克/分升)。1940年出生队列的男性相应增幅出现在29岁时:广岛为1.6毫克/分升(95%可信区间0.4 - 2.8),长崎为1.4毫克/分升(95%可信区间0.3 - 2.6)。控制吸烟并没有改变剂量反应关系。尽管受辐射组和未受辐射组的平均生长曲线差异具有统计学意义,但两组个体生长曲线有相当大的重叠。显著的性别差异以及女性中更大的辐射效应表明,辐射暴露导致的激素变化,如加速绝经,是一个值得研究的领域,以阐明受辐射女性受试者胆固醇水平升高的潜在机制。这种升高也可能部分解释了原子弹爆炸幸存者中冠心病发病率的增加。