Department of Clinical Studies, Radiation Effects Research Foundation (RERF), Nagasaki, Japan.
Department of Statistics, RERF, Hiroshima, Japan.
Eur J Epidemiol. 2021 Apr;36(4):401-414. doi: 10.1007/s10654-021-00731-x. Epub 2021 Mar 19.
Past reports indicated that total-body irradiation at low to moderate doses could be responsible for cardiovascular disease risks, but the mechanism remains unclear. The purpose of this study was to investigate the association between radiation exposure and atherosclerosis, an underlying pathology of cardiovascular diseases, in the Japanese atomic bomb survivors. We performed a cross-sectional study measuring 14 clinical-physiological atherosclerosis indicators during clinical exams from 2010 to 2014 in 3274 participants of the Adult Health Study cohort. Multivariable analyses were performed by using a structural equation model with latent factors representing underlying atherosclerotic pathologies: (1) arterial stiffness, (2) calcification, and (3) plaque as measured with indicators chosen a priori on the basis of clinical-physiological knowledge. Radiation was linearly associated with calcification (standardized coefficient per Gy 0.15, 95 % confidence interval: CI [0.070, 0.23]) and plaque (0.11, 95 % CI [0.029, 0.20]), small associations that were comparable to about 2 years of aging per Gy of radiation exposure, but not with arterial stiffness (0.036, 95 % CI [- 0.025, 0.095]). The model fitted better and had narrower confidence intervals than separate ordinary regression models explaining individual indicators independently. The associations were less evident when the dose range was restricted to a maximum of 2 or 1 Gy. By combining individual clinical-physiological indicators that are correlated because of common, underlying atherosclerotic pathologies, we found a small, but significant association of radiation with atherosclerosis.
过去的报告表明，低剂量至中剂量的全身照射可能导致心血管疾病风险，但机制尚不清楚。本研究旨在探讨日本原子弹幸存者的辐射暴露与动脉粥样硬化（心血管疾病的潜在病理学）之间的关系。我们对 2010 年至 2014 年期间参加成人健康研究队列的 3274 名参与者进行了横断面研究，在临床检查中测量了 14 项临床生理动脉粥样硬化指标。通过使用结构方程模型，使用潜在因素来表示潜在的动脉粥样硬化病理：（1）动脉僵硬，（2）钙化，（3）斑块，这些因素是根据临床生理知识预先选择的指标来衡量的。辐射与钙化（每 Gy 标准化系数 0.15，95%置信区间：CI [0.070，0.23]）和斑块（0.11，95%CI [0.029，0.20]）呈线性相关，这些小的关联与每 Gy 辐射暴露约 2 年的衰老相当，但与动脉僵硬（0.036，95%CI [-0.025，0.095]）无关。与单独解释个体指标的普通回归模型相比，该模型拟合更好，置信区间更窄。当剂量范围限制在最大 2 或 1 Gy 时，关联不太明显。通过将与共同潜在动脉粥样硬化病理相关的个体临床生理指标结合起来，我们发现辐射与动脉粥样硬化之间存在较小但显著的关联。
