Telisman S, Jurasović J, Pizent A, Cvitković P
Institute for Medical Research and Occupational Health, Zagreb, Croatia.
Environ Res. 2001 Oct;87(2):57-68. doi: 10.1006/enrs.2001.4292.
The interrelationship of blood lead (BPb), activity of delta-aminolevulinic acid dehydratase (ALAD), erythrocyte protoporphyrin (EP), blood cadmium (BCd), serum copper (SCu), serum zinc (SZn), serum selenium (SSe), hematocrit (Hct), body mass index (BMI), age, smoking habits, and alcohol consumption to blood pressure was examined in 154 Croatian male subjects 19-53 years of age. None of the subjects had been occupationally exposed to metals, or used any medication that could influence blood pressure or metal metabolism. The median and range values were: BPb, 57 (25-254) microg/L; ALAD, 51.9 (22.8-96.4) European units; EP, 0.68 (0.38-1.68) micromol/L erythrocytes; BCd, 0.83 (0.21-11.93) microg/L; SCu, 1113 (763-1662) microg/L; SZn, 961 (734-1213) microg/L; SSe, 73.6 (44.2-106.9) microg/L; systolic blood pressure, 131 (105-165) mm Hg; and diastolic blood pressure, 94 (71-112) mm Hg. Systolic and diastolic blood pressure significantly correlated with an increase in BMI (P<0.0005 and P<0.0001, respectively), EP (P<0.0002 and P<0.002, respectively), and BPb (P<0.005 and P<0.01, respectively). After adjusting for potential confounding variables by multiple regression, an increase in systolic blood pressure was significantly predictive by BMI (P<0.0005) and log BPb (P<0.02) and inversely by log BPbSSe interaction term (P<0.007), or alternatively by EP (P<0.0001), BMI (P<0.001), alcohol (P<0.02), and Hct (P<0.05). An increase in diastolic blood pressure was significantly predictive by BMI (P<10(-5)), log BPb (P<0.04), and alcohol (P=0.05) and inversely by log BPbSSe interaction term (P<0.0007), or alternatively by BMI (P<0.0001), EP (P<0.002), alcohol (P<0.004), and Hct (P<0.04) and inversely by smoking (P<0.04). With respect to the EP range in the study population, an increase of 27 mm Hg in systolic and 14 mm Hg in diastolic blood pressure was found. The study results indicate a significant Pb-related increase in blood pressure, particularly within the low-level Pb exposure range (BPb of 25-75 microg/L, and/or EP of 0.4-1.0 micromol/L erythrocytes).
在154名年龄在19至53岁的克罗地亚男性受试者中,研究了血铅(BPb)、δ-氨基乙酰丙酸脱水酶(ALAD)活性、红细胞原卟啉(EP)、血镉(BCd)、血清铜(SCu)、血清锌(SZn)、血清硒(SSe)、血细胞比容(Hct)、体重指数(BMI)、年龄、吸烟习惯和饮酒量与血压之间的相互关系。所有受试者均未在职业上接触过金属,也未使用过任何可能影响血压或金属代谢的药物。中位数和范围值分别为:BPb,57(25 - 254)μg/L;ALAD,51.9(22.8 - 96.4)欧洲单位;EP,0.68(0.38 - 1.68)μmol/L红细胞;BCd,0.83(0.21 - 11.93)μg/L;SCu,1113(763 - 1662)μg/L;SZn,961(734 - 1213)μg/L;SSe,73.6(44.2 - 106.9)μg/L;收缩压,131(105 - 165)mmHg;舒张压,94(71 - 112)mmHg。收缩压和舒张压与BMI升高(分别为P<0.0005和P<0.0001)、EP升高(分别为P<0.0002和P<0.002)以及BPb升高(分别为P<0.005和P<0.01)显著相关。通过多元回归对潜在混杂变量进行调整后,收缩压升高可由BMI(P<0.0005)和log BPb(P<0.02)显著预测,而与log BPbSSe交互项呈负相关(P<0.007),或者由EP(P<0.0001)、BMI(P<0.001)、饮酒(P<0.02)和Hct(P<0.05)预测。舒张压升高可由BMI(P<10⁻⁵)、log BPb(P<0.04)和饮酒(P = 0.05)显著预测,与log BPbSSe交互项呈负相关(P<0.0007),或者由BMI(P<0.0001)、EP(P<0.002)、饮酒(P<0.004)和Hct(P<0.04)预测,与吸烟呈负相关(P<0.04)。就研究人群中的EP范围而言,收缩压升高了27 mmHg,舒张压升高了14 mmHg。研究结果表明,血压与铅相关的升高显著,特别是在低水平铅暴露范围内(BPb为25 - 75μg/L,和/或红细胞EP为0.4 - 1.0μmol/L)。