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采用冠状动脉计算机断层血管造影术测量的血铅水平与冠状动脉狭窄的相关性。

Associations between Blood Lead Levels and Coronary Artery Stenosis Measured Using Coronary Computed Tomography Angiography.

机构信息

Department of Occupational and Environmental Medicine, Chonnam National University (CNU) Medical School and CNU Hwasun Hospital, Hwasun, Republic of Korea.

Institute of Occupational and Environmental Health, Korea Workers' Compensation & Welfare Service, Incheon, Republic of Korea.

出版信息

Environ Health Perspect. 2021 Feb;129(2):27006. doi: 10.1289/EHP7351. Epub 2021 Feb 23.

Abstract

BACKGROUND

Lead exposure is a risk factor for increased blood pressure and cardiovascular disease, even when blood lead levels (BLLs) are within the normal range.

OBJECTIVE

This study aimed to investigate the association between BLL and coronary artery stenosis (CAS) in asymptomatic adults using 128-slice dual-source coronary computed tomography (CT) angiography.

METHODS

We analyzed medical records data from 2,193 adults (1,461 men and 732 women) who elected to complete a screening health examination, coronary CT angiography, and BLL measurement during 2011-2018 and had no history of CAS symptoms, cardiovascular disease, or occupational exposure to lead. Logistic regression models were used to estimate associations between moderate-to-severe CAS ( stenosis) and a increase in blood lead, with and without adjustment for age, sex, hypertension, diabetes mellitus, dyslipidemia, body mass index, regular exercise, smoking status, and alcohol drinking.

RESULTS

BLLs ranged from , with an arithmetic mean of . The arithmetic mean was higher for men than for women ( vs. , ) and higher in the moderate-to-severe CAS group than in the no-CAS or stenosis group ( vs. , ). Moderate-to-severe CAS was significantly associated with BLL before and after adjustment, with an adjusted odds ratio for a increase in BLL of 1.14 (95% CI: 1.02, 1.26), .

CONCLUSIONS

BLL was positively associated with the prevalence of moderate-to-severe CAS in Korean adults who completed an elective screening examination for early cardiovascular disease, 94% of whom had a BLL of . More efforts and a strict health policy are needed to further reduce BLLs in the general population. https://doi.org/10.1289/EHP7351.

摘要

背景

即使血铅水平(BLL)处于正常范围内,铅暴露也是血压升高和心血管疾病的一个风险因素。

目的

本研究旨在使用 128 层双源冠状动脉计算机断层扫描(CT)血管造影术,调查无症状成年人的 BLL 与冠状动脉狭窄(CAS)之间的关系。

方法

我们分析了 2193 名成年人(1461 名男性和 732 名女性)的病历数据,这些人选择在 2011-2018 年期间进行筛查健康检查、冠状动脉 CT 血管造影和 BLL 测量,并且没有 CAS 症状、心血管疾病或职业性铅接触史。使用逻辑回归模型来估计中度至重度 CAS(狭窄)与 BLL 增加之间的关联,并在不调整和调整年龄、性别、高血压、糖尿病、血脂异常、体重指数、规律运动、吸烟状况和饮酒状况的情况下进行估计。

结果

BLL 范围从 ,算术平均值为 。男性的算术平均值高于女性( ),并且在中度至重度 CAS 组中高于无 CAS 或 狭窄组( )。中度至重度 CAS 与 BLL 之间存在显著关联,在未调整和调整后,BLL 增加 1 的调整比值比分别为 1.14(95%CI:1.02,1.26)和 1.14。

结论

在完成早期心血管疾病选择性筛查检查的韩国成年人中,BLL 与中度至重度 CAS 的患病率呈正相关,其中 94%的人 BLL 。需要进一步努力并制定严格的健康政策,以进一步降低普通人群中的 BLL。https://doi.org/10.1289/EHP7351.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fa0/7901725/a5c94f969cfd/ehp7351_f1.jpg

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