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中国成年人铅暴露与心血管危险因素和疾病的关系。

Association of lead exposure with cardiovascular risk factors and diseases in Chinese adults.

机构信息

Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.

出版信息

Environ Sci Pollut Res Int. 2017 Oct;24(28):22275-22283. doi: 10.1007/s11356-017-9884-6. Epub 2017 Aug 10.

Abstract

We aimed to determine whether lead exposure was associated with cardiovascular diseases (CVD) and risk factors in Chinese adults. Five thousand three hundred and forty-eight subjects were enrolled from 16 sites in China. Blood lead level (BLL) was measured by atomic absorption spectrometry. Cardiovascular diseases included coronary heart disease, stroke, and myocardial infarction. Cardiovascular risk factors included body mass index (BMI), fasting plasma glucose (FPG), lipid profile, and blood pressure. We found that 5.9% of the study population had prevalent CVD. Medians (interquartile range) of BLLs were 44.00 μg/L (29.00-62.48) for men and 37.70 μg/L (25.00-54.60) for women. The prevalence of CVD gradually and markedly increased with increasing BLL quartiles in women (P for trend < 0.01), but not in men. After adjustment for age, current smoking, and drinking, BLLs were independently associated with cardiovascular risk factors including BMI, FPG, and blood pressure in women (all P < 0.05), but not in men. Binary logistic regression showed that increased quartiles of BLL were significantly and positively associated with increased odds ratio of prevalent CVD (P for trend < 0.01) in women. This association was independent of age, smoking, drinking, education, diabetes, obesity, hypertension, and lipid profile. In conclusion, BLL in the range currently considered acceptable is independently associated with CVD, which is the leading cause of death in China. Further practical and cost-effective efforts to reduce lead exposure may be warranted.

摘要

我们旨在确定中国成年人的铅暴露是否与心血管疾病(CVD)及其危险因素有关。从中国 16 个地点招募了 5348 名受试者。采用原子吸收光谱法测定血铅水平(BLL)。心血管疾病包括冠心病、中风和心肌梗死。心血管危险因素包括体重指数(BMI)、空腹血糖(FPG)、血脂谱和血压。我们发现,研究人群中有 5.9%患有 CVD。男性 BLL 的中位数(四分位距)为 44.00μg/L(29.00-62.48),女性为 37.70μg/L(25.00-54.60)。女性 CVD 的患病率随着 BLL 四分位数的增加而逐渐显著增加(趋势 P<0.01),但男性则不然。在调整年龄、当前吸烟和饮酒后,BLL 与女性的心血管危险因素(包括 BMI、FPG 和血压)独立相关(均 P<0.05),但与男性无关。二项逻辑回归显示,BLL 四分位数的升高与 CVD 患病率的比值比显著升高(趋势 P<0.01),与年龄、吸烟、饮酒、教育程度、糖尿病、肥胖、高血压和血脂谱无关。总之,目前被认为可接受的 BLL 与 CVD 独立相关,而 CVD 是中国死亡的主要原因。可能需要进一步采取实际且具有成本效益的措施来减少铅暴露。

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