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手持振动工具暴露与血浆神经损伤生物标志物:基于人群的观察性研究。

Exposure to hand-held vibrating tools and biomarkers of nerve injury in plasma: a population-based, observational study.

机构信息

Department of Translational Medicine, Lund University, Malmö, Sweden.

Department of Orthopedics, Helsingborg's Hospital, Helsingborg, Sweden.

出版信息

BMJ Open. 2023 Jun 30;13(6):e070450. doi: 10.1136/bmjopen-2022-070450.

Abstract

OBJECTIVES

To analyse potential biomarkers for vibration-induced nerve damage in a population-based, observational study.

DESIGN

Prospective cohort study.

SETTING

Malmö Diet Cancer Study (MDCS), Malmö, Sweden.

PARTICIPANTS

In a subcohort of 3898 individuals (recruited 1991-1996) from MDCS (baseline examination in 28 449 individuals; collection of fasting blood samples in a cardiovascular subcohort of MDCS of 5540 subjects), neuropathy-relevant plasma biomarkers were analysed during follow-up after filling out questionnaires, including a question whether work involved hand-held vibrating tools, graded as 'not at all', 'some' or 'much'.

PRIMARY OUTCOME MEASURES

The neuropathy-relevant plasma biomarkers vascular endothelial growth factor (VEGF)-A, VEGF-D, VEGF receptor 2, galanin, galectin-3, HSP27, ß-nerve growth factor, caspase-3, caspase-8, transforming growth factor-α and tumour necrosis factor were analysed. Data were analysed by conventional statistics (Kruskal-Wallis test; post hoc test Mann-Whitney U test; Bonferroni correction for multiple testing) and in a subanalysis for galanin using two linear regression models (unadjusted and adjusted).

RESULTS

Among participants, 3361 of 3898 (86%) reported no work with hand-held vibrating tools, 351 of 3898 (9%) reported some and 186 of 3898 (5%) much work. There were more men and smokers in vibration-exposed groups. Galanin levels were higher after much vibration exposure (arbitrary units 5.16±0.71) compared with no vibration exposure (5.01±0.76; p=0.015) with no other observed differences.

CONCLUSIONS

Higher plasma levels of galanin, possibly related to magnitude, frequency, acceleration and duration, as well as to severity of symptoms of vibration exposure, may be found in individuals working with hand-held vibrating tools.

摘要

目的

在一项基于人群的观察性研究中分析与振动诱导神经损伤相关的潜在生物标志物。

设计

前瞻性队列研究。

地点

瑞典马尔默饮食癌症研究(MDCS)。

参与者

在 MDCS 的一个子队列中(1991-1996 年招募),共有 3898 人(在 28449 人中进行了基线检查;在 MDCS 的心血管子队列中对 5540 名受试者进行了空腹血样采集),在随访期间分析了与神经病变相关的血浆生物标志物,包括工作是否涉及手持式振动工具的问题,分为“根本没有”、“有些”或“很多”。

主要观察指标

与神经病变相关的血浆生物标志物血管内皮生长因子(VEGF)-A、VEGF-D、VEGF 受体 2、甘丙肽、半乳糖凝集素-3、HSP27、β-神经生长因子、半胱天冬酶-3、半胱天冬酶-8、转化生长因子-α和肿瘤坏死因子。数据采用常规统计学方法(Kruskal-Wallis 检验;事后检验 Mann-Whitney U 检验;Bonferroni 多重检验校正)和甘丙肽的亚分析(未调整和调整的两个线性回归模型)进行分析。

结果

在参与者中,3898 人中 3361 人(86%)报告没有使用手持式振动工具,3898 人中 351 人(9%)报告有些使用,3898 人中 186 人(5%)报告大量使用。暴露于振动的组中男性和吸烟者更多。与无振动暴露相比,大量振动暴露后甘丙肽水平更高(任意单位 5.16±0.71),差异有统计学意义(5.01±0.76;p=0.015),没有观察到其他差异。

结论

可能与振动暴露的幅度、频率、加速度和持续时间以及症状严重程度有关的甘丙肽血浆水平升高,可能存在于使用手持式振动工具的个体中。

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