ATS Brescia (Brescia Health Protection Agency), Brescia, Italy.
Department of Medical and Surgical Specialties Radiological Sciences and Public Health, Unit of Hygiene, Epidemiology, and Public Health, University of Brescia, Italy.
Environ Int. 2018 Nov;120:215-222. doi: 10.1016/j.envint.2018.08.022. Epub 2018 Aug 10.
Exposure to polychlorinated biphenyls (PCBs) has been linked to the onset of cardiovascular, endocrine, and metabolic diseases, but no conclusive evidence has been provided so far. A chemical factory produced PCBs from 1938 to 1984 in Brescia (North Italy) resulting in environmental contamination and human exposure. We aimed to evaluate the association between PCB serum levels and subsequent incidence of chronic diseases through a prospective cohort study design.
Based on surveys conducted in Brescia province between 2001 and 2013, a cohort of 1331 subjects with at least one measure of PCB serum levels during the period was selected and followed longitudinally. Serum concentration of total PCBs was computed summing up the levels of 24 PCB congeners determined by gas chromatography. The data on incidence of hypertension, cardiovascular diseases, and endocrine and metabolic chronic diseases were retrieved from the Brescia Health Protection Agency database. Poisson regression models adjusted for age, level of education, BMI, cholesterol level, tobacco smoking and alcohol drinking were employed to calculate rate ratios (RRs).
1331 subjects were enrolled (45.7% males, mean age 50.6 years) contributing to 10,006 person-years of follow-up. A dose-response relationship was observed between PCB serum levels and the onset of hypertension (RR for 2nd and 3rd tertiles of serum PCB distribution: 2.07, 95% CI 1.18-3.63, and 2.41, 1.30-4.47, respectively). A possible, though not statistically significant, increase of the risk of cardiovascular disease was also found (RR for 2nd and 3rd tertiles of serum PCB distribution: 1.61, 0.72-3.64, and 1.96, 0.86-4.48, respectively). The results based on lipid-standardized PCBs were slightly attenuated. No association was found between PCB serum levels and occurrence of diabetes and endocrine disorders. Stratified analysis by body mass index showed an increased risk of hypertension in subjects at 2nd and 3rd tertile of serum PCB distribution in overweight/obese subjects only.
These results suggest that PCBs might play a role in the development of hypertension and possibly cardiovascular disease, though alternative explanations are to be considered too.
接触多氯联苯（PCBs）与心血管、内分泌和代谢疾病的发生有关，但目前尚无确凿证据。一家化工厂于 1938 年至 1984 年在意大利北部的布雷西亚生产 PCB，导致环境污染和人体接触。我们旨在通过前瞻性队列研究设计评估血清 PCB 水平与随后发生慢性疾病的相关性。
基于 2001 年至 2013 年在布雷西亚省进行的调查，选择了一个至少在该期间内有一次血清 PCB 水平测量的 1331 名受试者队列，并进行了纵向随访。通过气相色谱法测定 24 种 PCB 同系物的水平，计算出总 PCB 的血清浓度。高血压、心血管疾病以及内分泌和代谢性慢性疾病的发病数据从布雷西亚卫生保护局数据库中检索。采用泊松回归模型，根据年龄、教育水平、BMI、胆固醇水平、吸烟和饮酒情况进行调整，计算发病率比（RR）。
共纳入 1331 名受试者（45.7%为男性，平均年龄为 50.6 岁），随访 10006 人年。观察到血清 PCB 水平与高血压发病之间存在剂量-反应关系（血清 PCB 分布第 2 和第 3 三分位的 RR：2.07，95%CI 1.18-3.63 和 2.41，1.30-4.47）。也发现心血管疾病风险可能增加，但无统计学意义（血清 PCB 分布第 2 和第 3 三分位的 RR：2.07，95%CI 1.18-3.63 和 2.41，1.30-4.47）。基于脂质标准化 PCB 的结果略有减弱。血清 PCB 水平与糖尿病和内分泌紊乱的发生无关。按体重指数分层分析显示，仅在超重/肥胖受试者中，血清 PCB 分布第 2 和第 3 三分位的受试者发生高血压的风险增加。
这些结果表明，PCBs 可能在高血压的发展中起作用，并且可能在心血管疾病中起作用，但也需要考虑其他解释。
