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诊断前血清中有机氯农药浓度与非霍奇金淋巴瘤:挪威扬努斯血清库队列的巢式病例对照研究。

Prediagnostic serum concentrations of organochlorine pesticides and non-Hodgkin lymphoma: A nested case-control study in the Norwegian Janus Serum Bank Cohort.

机构信息

Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, USA.

Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.

出版信息

Environ Res. 2020 Aug;187:109515. doi: 10.1016/j.envres.2020.109515. Epub 2020 Apr 29.

Abstract

BACKGROUND

Much of the marked increase in incidence of non-Hodgkin lymphoma (NHL) over the past few decades remains unexplained. Organochlorines, including organochlorine pesticides (OCPs), have been implicated as possible contributors to the increase, but the evidence is inconsistent.

OBJECTIVES

To investigate the relation between pre-diagnostic levels of OCPs and risk of NHL in a case-control study nested within the population-based Janus Serum Bank Cohort in Norway.

METHODS

Prediagnostic concentrations of 11 OCPs or OCP metabolites were measured in baseline blood samples collected between 1972 and 1978 from 190 cases and 190 controls matched on sex, county, age at blood draw, and date of blood draw. We conducted conditional logistic regression to estimate adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for each quartile of lipid-corrected OCP/metabolite relative to the lowest quartile.

RESULTS

We observed non-significantly elevated ORs across quartiles of β-hexachlorocyclohexane compared to the lowest quartile (OR range: 1.40-1.82) although with no apparent monotonic exposure-response relationship. We also found an inverse association between risk of NHL and o,p'-DDT (OR for Q vs. Q = 0.44, 95% CI: 0.19, 1.01; p-trend = 0.05). In analyses stratified by age at blood collection and duration of follow-up, several other analytes, primarily chlordane-related compounds, showed inverse associations among younger participants or those with longer follow-up time between blood draw and NHL diagnosis.

CONCLUSIONS

We found only limited evidence of positive association between selected OCPs and development of NHL.

摘要

背景

在过去几十年中,非霍奇金淋巴瘤(NHL)的发病率显著上升,但其中大部分原因仍未得到解释。有机氯化合物,包括有机氯杀虫剂(OCPs),被认为是导致这种上升的可能因素之一,但证据并不一致。

目的

在挪威基于人群的扬努斯血清库队列中进行的病例对照研究中,调查 OCP 预诊断水平与 NHL 风险之间的关系。

方法

在 1972 年至 1978 年期间,从 190 例病例和 190 例性别、采血县、采血时年龄和采血日期匹配的对照者的基线血样中测量了 11 种 OCP 或 OCP 代谢物的预诊断浓度。我们采用条件逻辑回归来估计每个四分位数相对于最低四分位数的校正脂质 OCP/代谢物的调整比值比(OR)和 95%置信区间(95%CI)。

结果

与最低四分位数相比,β-六氯环己烷的四分位数观察到非显著升高的 OR(OR 范围:1.40-1.82),尽管没有明显的单调暴露-反应关系。我们还发现 NHL 风险与 o,p'-DDT 呈负相关(Q 与 Q 的比值比=0.44,95%CI:0.19,1.01;p-trend=0.05)。在按采血年龄和随访时间分层的分析中,一些其他分析物,主要是氯丹相关化合物,在年龄较小的参与者或采血和 NHL 诊断之间随访时间较长的参与者中表现出负相关。

结论

我们仅发现有限的证据表明某些 OCP 与 NHL 的发生之间存在正相关。

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