Rosenbaum Paula F, Weinstock Ruth S, Silverstone Allen E, Sjödin Andreas, Pavuk Marian
Department of Public Health & Preventive Medicine, State University of New York (SUNY) Upstate Medical University, Syracuse, NY, United States.
Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States.
Environ Int. 2017 Nov;108:11-21. doi: 10.1016/j.envint.2017.07.017. Epub 2017 Aug 2.
The Anniston Community Health Survey, a cross-sectional study, was undertaken in 2005-2007 to study environmental exposure to polychlorinated biphenyl (PCB) and organochlorine (OC) pesticides and health outcomes among residents of Anniston, AL, United States. The examination of potential risks between these pollutants and metabolic syndrome, a cluster of cardiovascular risk factors (i.e., hypertension, central obesity, dyslipidemia and dysglycemia) was the focus of this analysis. Participants were 548 adults who completed the survey and a clinic visit, were free of diabetes, and had a serum sample for clinical laboratory parameters as well as PCB and OC pesticide concentrations. Associations between summed concentrations of 35 PCB congeners and 9 individual pesticides and metabolic syndrome were examined using generalized linear modeling and logistic regression; odds ratios (OR) and 95% confidence intervals (CI) are reported. Pollutants were evaluated as quintiles and as log transformations of continuous serum concentrations. Participants were mostly female (68%) with a mean age (SD) of 53.6 (16.2) years. The racial distribution was 56% white and 44% African American; 49% met the criteria for metabolic syndrome. In unadjusted logistic regression, statistically significant and positive associations across the majority of quintiles were noted for seven individually modeled pesticides (p,p'-DDT, p,p'-DDE, HCB, β-HCCH, oxychlor, tNONA, Mirex). Following adjustment for covariables (i.e., age, sex, race, education, marital status, current smoking, alcohol consumption, positive family history of diabetes or cardiovascular disease, liver disease, BMI), significant elevations in risk were noted for p,p'-DDT across multiple quintiles (range of ORs 1.61 to 2.36), for tNONA (range of ORs 1.62-2.80) and for p,p'-DDE [OR (95% CI)] of 2.73 (1.09-6.88) in the highest quintile relative to the first. Significant trends were observed in adjusted logistic models for log HCB [OR=6.15 (1.66-22.88)], log oxychlor [OR=2.09 (1.07-4.07)] and log tNONA [3.19 (1.45-7.00)]. Summed PCB concentrations were significantly and positively associated with metabolic syndrome only in unadjusted models; adjustment resulted in attenuation of the ORs in both the quintile and log-transformed models. In conclusion, several OC pesticides were found to have significant associations with metabolic syndrome in the Anniston study population while no association was observed for PCBs.
安尼斯顿社区健康调查是一项横断面研究,于2005年至2007年开展,旨在研究美国阿拉巴马州安尼斯顿居民接触多氯联苯(PCB)和有机氯(OC)农药的环境暴露情况及其健康结果。本分析的重点是研究这些污染物与代谢综合征(一组心血管危险因素,即高血压、中心性肥胖、血脂异常和血糖异常)之间的潜在风险。参与者为548名完成调查和门诊就诊的成年人,他们没有患糖尿病,并且有一份用于临床实验室参数以及PCB和OC农药浓度检测的血清样本。使用广义线性模型和逻辑回归分析了35种PCB同系物和9种单一农药的总浓度与代谢综合征之间的关联;报告了比值比(OR)和95%置信区间(CI)。污染物按五分位数以及连续血清浓度的对数转换进行评估。参与者大多为女性(68%),平均年龄(标准差)为53.6(16.2)岁。种族分布为56%白人,44%非裔美国人;49%符合代谢综合征标准。在未调整的逻辑回归中,七种单独建模的农药(p,p'-滴滴涕、p,p'-滴滴伊、六氯苯、β-六六六、氧氯丹、t-九氯、灭蚁灵)在大多数五分位数中均呈现出具有统计学意义的正相关。在对协变量(即年龄、性别、种族、教育程度、婚姻状况、当前吸烟情况、饮酒情况、糖尿病或心血管疾病家族史阳性、肝病、体重指数)进行调整后,多个五分位数的p,p'-滴滴涕(OR范围为从1.61至2.36)、t-九氯(OR范围为1.62 - 2.80)以及最高五分位数相对于第一五分位数的p,p'-滴滴伊[OR(95%CI)]为2.73(1.09 - 6.88)的风险显著升高。在调整后的逻辑模型中,六氯苯对数[OR = 6.15(1.66 - 22.88)] > 氧氯丹对数[OR = 2.09(1.07 - 4.07)]和t-九氯对数[3.19(1.45 - 7.00)]呈现出显著趋势。仅在未调整模型中,总PCB浓度与代谢综合征呈显著正相关;调整后,五分位数模型和对数转换模型中的OR值均有所衰减。总之,在安尼斯顿研究人群中发现几种OC农药与代谢综合征存在显著关联,而未观察到PCB与代谢综合征有关联。