Occupational and Environmental Medicine, Department of Medicine, Uppsala University, Uppsala, Sweden.
Environ Health Perspect. 2012 Jan;120(1):38-43. doi: 10.1289/ehp.1103563.
Increased circulating levels of persistent organic pollutants (POPs) have been associated with myocardial infarction. Because myocardial infarction is an atherosclerotic disease, we investigated, in a cross-sectional study, whether POP levels are related to atherosclerosis.
In the population-based Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study (n = 1,016 participants 70 years of age), the prevalence of carotid artery plaques was determined by ultrasound. The number of carotid arteries with plaques (0, 1, or 2) was recorded. Also, the intima-media thickness (IMT) and gray scale median of the intima-media complex (IM-GSM) were measured. Twenty-three POPs, comprising 16 polychlorinated biphenyls (PCBs), 5 pesticides, 1 dioxin, and 1 brominated compound (brominated diphenyl ether congener BDE-47), were analyzed by high-resolution chromatography coupled to high-resolution mass spectrometry.
Seven of the POPs (PCB congeners 153, 156, 157, 170, 180, 206, and 209) were significantly associated with the number of carotid arteries with plaques even after adjusting for multiple risk factors (sex, waist circumference, body mass index, fasting blood glucose, systolic and diastolic blood pressure, high-density lipoprotein and low-density lipoprotein cholesterol, serum triglycerides, smoking, antihypertensive treatment, and statin use; p = 0.002-0.0001). Highly chlorinated PCBs (congeners 194, 206, and 209) were associated with an echolucent IM-GSM (p < 0.0001 after adjustment), whereas associations between POPs and IMT were modest.
Circulating levels of PCBs were associated with atherosclerotic plaques and echogenicity of the intima-media complex independent of cardiovascular risk factors, including lipids. This suggests that POPs may be a risk factor for myocardial infarction, but associations need to be confirmed in prospective studies.
循环中持久性有机污染物（POPs）水平的升高与心肌梗死有关。由于心肌梗死是一种动脉粥样硬化性疾病，我们在一项横断面研究中调查了 POP 水平是否与动脉粥样硬化有关。
在基于人群的乌普萨拉老年人血管前瞻性研究（PIVUS）中（n = 1016 名 70 岁的参与者），通过超声确定颈动脉斑块的患病率。记录有斑块的颈动脉数量（0、1 或 2）。此外，还测量了内膜-中膜厚度（IMT）和内膜-中膜复合层的灰度中位数（IM-GSM）。使用高分辨率色谱法结合高分辨率质谱法分析了 23 种 POP，包括 16 种多氯联苯（PCBs）、5 种农药、1 种二恶英和 1 种溴化化合物（溴化二苯醚同系物 BDE-47）。
即使在调整了多种危险因素（性别、腰围、体重指数、空腹血糖、收缩压和舒张压、高密度脂蛋白和低密度脂蛋白胆固醇、血清甘油三酯、吸烟、降压治疗和他汀类药物使用）后，仍有 7 种 POP（PCB 同系物 153、156、157、170、180、206 和 209）与颈动脉斑块数量显著相关（p = 0.002-0.0001）。高度氯化的 PCBs（同系物 194、206 和 209）与回声减弱的 IM-GSM 相关（调整后 p < 0.0001），而 POP 与 IMT 的关联则较为温和。
PCBs 的循环水平与动脉粥样硬化斑块以及内膜-中膜复合层的回声强度独立于心血管危险因素（包括脂质）相关。这表明 POP 可能是心肌梗死的一个危险因素，但需要在前瞻性研究中进一步证实。
