Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48824, United States.
Department of Internal Medicine, Division of Gastroenterology, University of Michigan, Ann Arbor, MI 48109, United States.
Environ Int. 2016 Apr-May;89-90:174-8. doi: 10.1016/j.envint.2016.02.006. Epub 2016 Feb 13.
Polycyclic aromatic hydrocarbons (PAHs) are potent atmospheric pollutants produced by incomplete combustion of organic materials. Pre-clinical and occupational studies have reported a positive association of PAHs with oxidative stress, inflammation and subsequent development of atherosclerosis, a major underlying risk factor for cardiovascular disease (CVD). The aim of the current study is to estimate the association between levels of PAH biomarkers and CVD in a national representative sample of United States (US) adults.
We examined adult participants (≥20years of age) from the merged US National Health and Nutrition Examination Survey 2001-2010. Logistic regression models were used to estimate the associations of each urinary PAH biomarker and CVD. Post-exploratory structural equation modeling was then used to address the interdependent response variables (angina, heart attack, stroke and coronary heart disease) as well as the interdependencies of PAH biomarkers.
PAH biomarkers were positively associated with cardiovascular disease in multiple logistic regression models, although some associations were not statistically robust. Using structural equation modeling, latent PAH exposure variable was positively associated with latent CVD level variable in the multivariable adjusted model (β=0.12; 95% CI: 0.03, 0.20).
A modest association between levels of PAH biomarkers and CVD was detected in US adults. Further prospective studies with adequate sample size are needed to replicate or refute our findings.
多环芳烃（PAHs）是有机物质不完全燃烧产生的强效大气污染物。临床前和职业研究报告称，PAHs 与氧化应激、炎症以及随后的动脉粥样硬化发生呈正相关，动脉粥样硬化是心血管疾病（CVD）的一个主要潜在风险因素。本研究旨在估计美国（US）成年人全国代表性样本中 PAH 生物标志物与 CVD 之间的关联。
我们检查了来自美国国家健康和营养调查 2001-2010 年合并数据的成年参与者（≥20 岁）。使用逻辑回归模型估计每个尿液 PAH 生物标志物与 CVD 的关联。然后使用探索性结构方程模型来解决依赖响应变量（心绞痛、心脏病发作、中风和冠心病）以及 PAH 生物标志物的相互依存关系。
PAH 生物标志物与多种逻辑回归模型中的心血管疾病呈正相关，尽管有些关联不具有统计学意义。使用结构方程模型，在多变量调整模型中，潜在的 PAH 暴露变量与潜在的 CVD 水平变量呈正相关（β=0.12；95%CI：0.03，0.20）。
在美国成年人中检测到 PAH 生物标志物水平与 CVD 之间存在适度关联。需要进一步进行具有足够样本量的前瞻性研究，以复制或反驳我们的发现。
