Telisman Spomenka, Pizent Alica, Jurasović Jasna, Cvitković Petar
Department of Occupational and Environmental Health, Institute for Medical Research and Occupational Health, Zagreb, Croatia.
Am J Ind Med. 2004 May;45(5):446-54. doi: 10.1002/ajim.20006.
The effect of lead (Pb) and potential confounding variables on blood pressure was examined in healthy male industrial workers 20-43 years of age.
In 100 Pb workers and 51 reference subjects, the following variables were measured: blood Pb (BPb), activity of delta-aminolevulinic acid dehydratase (ALAD), erythrocyte protoporphyrin (EP), blood cadmium (BCd), serum zinc (SZn), serum copper (SCu), hematocrit (Hct), body mass index (BMI), and blood pressure. The inter-relationship of biomarkers of Pb (BPb, ALAD, EP) and BCd, SZn, SCu, Hct, BMI, age, smoking, and alcohol to systolic and diastolic blood pressure was calculated by forward stepwise multiple regression.
There was no significant difference in blood pressure between the two groups, possibly because the reference subjects had relatively high BPb levels and significantly higher BMI (P < 0.05) as compared to the Pb workers. According to the multiple regression results in Pb workers, an increase in systolic blood pressure was significantly associated with increasing EP (P = 0.001) and BMI (P < 0.002), or alternatively with increasing BMI (P < 0.004) and decreasing ALAD (P < 0.04) and BCd (P < 0.05). An increase in diastolic blood pressure was significantly associated with increasing BMI (P < 0.009) and EP (P = 0.05) and decreasing BCd (P < 0.04). With respect to the EP range of 0.73-13.94 micromol/l erythrocytes in 100 Pb workers, an increase of 17 mm Hg in systolic and 6 mm Hg in diastolic blood pressure was found.
Long-term cumulative Pb exposure, which is better reflected by EP than by ALAD or current BPb level, can significantly increase blood pressure in moderately Pb-exposed male workers (long-term average BPb <400 microg/l; exposure duration 2-21 years).
在20至43岁的健康男性产业工人中，研究了铅（Pb）及潜在混杂变量对血压的影响。
对100名铅作业工人和51名对照对象测量了以下变量：血铅（BPb）、δ-氨基-γ-酮戊酸脱水酶（ALAD）活性、红细胞原卟啉（EP）、血镉（BCd）、血清锌（SZn）、血清铜（SCu）、血细胞比容（Hct）、体重指数（BMI）和血压。通过向前逐步多元回归分析计算铅（BPb、ALAD、EP）生物标志物与BCd、SZn、SCu、Hct、BMI、年龄、吸烟和饮酒与收缩压和舒张压之间的相互关系。
两组之间血压无显著差异，可能是因为对照对象的血铅水平相对较高，且体重指数显著高于铅作业工人（P < 0.05）。根据铅作业工人的多元回归结果，收缩压升高与EP升高（P = 0.001）和BMI升高（P < 0.002）显著相关，或者与BMI升高（P < 0.004）、ALAD降低（P < 0.04）和BCd降低（P < 0.05）显著相关。舒张压升高与BMI升高（P < 0.009）、EP升高（P = 0.05）和BCd降低（P < 0.04）显著相关。在100名铅作业工人红细胞EP范围为0.73 - 13.94 μmol/l时，收缩压升高17 mmHg，舒张压升高6 mmHg。
长期累积铅暴露（用EP比用ALAD或当前BPb水平能更好地反映）可使中度铅暴露男性工人（长期平均BPb < 400 μg/l；暴露时间2 - 21年）血压显著升高。
