Nadir Karakulak Ugur, Okutucu Sercan, Lokman Utku, Bilgin Ovunc, Tutkun Engin, Hinc Yilmaz Omer, Oto Ali
Department of Cardiology, Occupational Diseases Hospital.
Department of Cardiology, Memorial Ankara Hospital.
Acta Cardiol Sin. 2019 Jan;35(1):75-84. doi: 10.6515/ACS.201901_35(1).20180716A.
Lead exposure causes a wide range of vascular diseases through oxidative stress, sympathetic hyperactivity and impairment in nitric oxide bioavailability. In this study, the association between the effects of lead exposure on left ventricular diastolic indices and erectile function were assessed.
A total of 94 lead-exposed workers without known cardiovascular diseases or risk factors and 30 healthy subjects were enrolled. Systolic and diastolic functions were measured using transthoracic echocardiography. All participants were non-smokers. The International Index of Erectile Function Questionnaire (IIEF-5) was used to diagnose and grade erectile dysfunction (ED). Echocardiographic parameters, IIEF-5 score and blood lead level (BLL) were analyzed.
The mean age and median BLL were 32.3 ± 6.4 years and 19 μg/dL in the workers, respectively. Sixty-five (69.1%) workers and 9 control subjects (30%) had ED. The IIEF-5 score was lower in the workers (17.0 ± 6.1) than in the controls (22.7 ± 2.1). In the workers, E and e' waves and E/A ratio were lower, and A wave, E/e' ratio, and left atrial volume index (LAVI) were higher than in the controls. Additionally, BLL was correlated with IIEF-5 score, e' wave, and E/e' ratio. IIEF-5 score was correlated with e' wave, E/e' ratio and LAVI. BLL was an independent risk factor for a decreased e' wave and IIEF-5 score and increased E/e' ratio in the lead-exposed workers.
Impairment of diastolic and erectile functions, despite a younger age and in the absence of accompanying risk factors, was correlated with increased BLL.
铅暴露通过氧化应激、交感神经过度活跃和一氧化氮生物利用度受损导致多种血管疾病。在本研究中,评估了铅暴露对左心室舒张指标和勃起功能影响之间的关联。
共纳入94名无已知心血管疾病或危险因素的铅暴露工人和30名健康受试者。使用经胸超声心动图测量收缩和舒张功能。所有参与者均不吸烟。采用国际勃起功能指数问卷(IIEF-5)诊断和分级勃起功能障碍(ED)。分析超声心动图参数、IIEF-5评分和血铅水平(BLL)。
工人的平均年龄和BLL中位数分别为32.3±6.4岁和19μg/dL。65名(69.1%)工人和9名对照受试者(30%)患有ED。工人的IIEF-5评分(17.0±6.1)低于对照组(22.7±2.1)。与对照组相比,工人的E波和e'波以及E/A比值较低,A波、E/e'比值和左心房容积指数(LAVI)较高。此外,BLL与IIEF-5评分、e'波和E/e'比值相关。IIEF-5评分与e'波、E/e'比值和LAVI相关。BLL是铅暴露工人e'波降低、IIEF-5评分降低和E/e'比值升高的独立危险因素。
尽管年龄较轻且无伴随危险因素,但舒张功能和勃起功能受损与BLL升高相关。