3rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
Department of Occupational Medicine, 1st Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
Basic Clin Pharmacol Toxicol. 2018 Sep;123(3):356-359. doi: 10.1111/bcpt.13013. Epub 2018 May 7.
The correlation between 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) intoxication and the parameters of metabolic impairment was examined in the last eight male survivors of 80 workers exposed to TCDD during the production of herbicides in a chemical factory in 1965-1967. Their median TCDD blood level was 112 (46-390) pg/g lipids, and the median TCDD body deposit was 3.9 (0.8-11.7) μg. This puts these patients into the most severely intoxicated group of subjects, according to back-calculated levels of TCDD. The median TCDD blood level in eight controls was 12 pg/g (<0.10 to 22.2 pg/g). Markers of metabolic impairment - diabetes, dyslipidaemia, arterial hypertension, carotid artery plaque, skin microvascular reactivity, eye fundus hypertensive angiopathy and history of coronary heart disease - were assessed and compared to a general male population of comparable age. Measured parameters compared with a population of comparable age were as follows: prevalence of diabetes (62.5% versus 17.6%), arterial hypertension (87.5% versus 71.8%), dyslipidaemia (87.5% versus 88.8%), history of coronary heart disease (62.5% versus 26.0%) and eye fundus hypertension angiopathy (50% versus 14%). All eight patients (100% versus 43%) developed plaques in carotid arteries, six had stenosis >50% and two had a carotid intervention (stenting or endarterectomy). Total cholesterol levels decreased compared to the earlier study this patient group in 2008, most likely due to a more intensive use of lipid-lowering drugs. Several metabolic parameters were higher (diabetes as much as 3.5-fold) in the group of severely TCDD-intoxicated subjects than in a general population of comparable age. This suggests that TCDD plays a role in the development of metabolic impairment and vascular changes.
研究人员检查了 8 名男性幸存者，他们是在 1965 年至 1967 年期间，一家化工厂生产除草剂时暴露于 2,3,7,8-四氯二苯并对二恶英（TCDD）的 80 名工人中的最后 8 名幸存者，评估了 TCDD 中毒与代谢损伤参数之间的相关性。他们的 TCDD 血液中位浓度为 112（46-390）pg/g 脂质，TCDD 体内中位蓄积量为 3.9（0.8-11.7）μg。根据 TCDD 的回溯水平，这些患者被归入最严重中毒组。8 名对照组的 TCDD 血液中位浓度为 12 pg/g（<0.10-22.2 pg/g）。代谢损伤标志物 - 糖尿病、血脂异常、动脉高血压、颈动脉斑块、皮肤微血管反应性、眼底高血压性血管病变和冠心病史 - 进行了评估，并与年龄相当的一般男性人群进行了比较。与年龄相当的人群相比，测量的参数如下：糖尿病患病率（62.5%对 17.6%）、动脉高血压（87.5%对 71.8%）、血脂异常（87.5%对 88.8%）、冠心病史（62.5%对 26.0%）和眼底高血压血管病变（50%对 14%）。所有 8 名患者（100%对 43%）颈动脉出现斑块，6 名患者狭窄程度>50%，2 名患者进行了颈动脉介入治疗（支架置入或内膜切除术）。与 2008 年该患者组的早期研究相比，总胆固醇水平下降，这可能是由于更密集地使用降脂药物。与年龄相当的一般人群相比，TCDD 严重中毒组的几个代谢参数（如糖尿病高达 3.5 倍）更高。这表明 TCDD 在代谢损伤和血管变化的发展中起作用。
