采用冠状动脉计算机断层血管造影术检测血铅水平与冠状动脉钙评分的相关性。
The Association Between Blood Lead Levels and Coronary Artery Calcium Score Determined by Using Coronary Computed Tomography Angiography.
机构信息
Department of Occupational and Environmental Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea.
Department of Occupational and Environmental Medicine, Chonnam National University Hospital, Gwangju, Korea.
出版信息
J Korean Med Sci. 2023 Jul 3;38(26):e203. doi: 10.3346/jkms.2023.38.e203.
BACKGROUND
Lead exposure is a known risk factor for cardiovascular disease (CVD), and coronary artery calcification (CAC) is a biomarker for diagnosing atherosclerotic CVD. This study investigated the association between blood lead level (BLL) and CAC using coronary computed tomography (CT) angiography.
METHODS
This study enrolled 2,189 participants from the general population with no history or symptoms of CVD. All participants underwent coronary CT angiography, health examination, and BLL testing. The association between coronary artery calcium score (CACS) and BLL was analyzed.
RESULTS
The arithmetic mean of BLL was 2.71 ± 1.26 μg/dL, and the geometric mean was 2.42 (1.64) μg/dL, ranging from 0.12 to 10.14 μg/dL. There was a statistically significant positive correlation between CACS and BLL ( = 0.073, < 0.001). Mean BLLs among predefined CACS categories were as follows: absent grade (CACS = 0), 2.67 ± 1.23 μg/dL; minimal grade (> 0, < 10), 2.81 ± 1.25 μg/dL; mild grade (≥ 10, < 100), 2.74 ± 1.29 μg/dL; moderate grade (≥ 100, < 400), 2.88 ± 1.38 μg/dL; severe grade (≥ 400): 3.22 ± 1.68 μg/dL. The odds ratio for severe CAC was 1.242 in association with an 1 μg/dL increase in BLL ( = 0.042).
CONCLUSION
Using coronary CT angiography, we determined a positive correlation between BLL and CAC among participants without CVD from the general population. To reduce the burden of CVD, efforts and policies should be geared toward minimizing environmental lead exposure.
背景
铅暴露是心血管疾病（CVD）的已知危险因素，冠状动脉钙化（CAC）是诊断动脉粥样硬化性 CVD 的生物标志物。本研究使用冠状动脉计算机断层扫描（CT）血管造影来研究血铅水平（BLL）与 CAC 之间的关系。
方法
本研究纳入了 2189 名来自普通人群且无 CVD 病史或症状的参与者。所有参与者均接受了冠状动脉 CT 血管造影、健康检查和 BLL 检测。分析了冠状动脉钙评分（CACS）与 BLL 之间的关系。
结果
BLL 的算术平均值为 2.71±1.26μg/dL，几何平均值为 2.42（1.64）μg/dL，范围为 0.12-10.14μg/dL。CACS 与 BLL 呈显著正相关（ = 0.073， < 0.001）。在预先设定的 CACS 分类中，BLL 的平均值如下：无等级（CACS = 0），2.67±1.23μg/dL；微量等级（>0，<10），2.81±1.25μg/dL；轻度等级（≥10，<100），2.74±1.29μg/dL；中度等级（≥100，<400），2.88±1.38μg/dL；严重等级（≥400），3.22±1.68μg/dL。BLL 每增加 1μg/dL，严重 CAC 的比值比为 1.242（ = 0.042）。
结论
使用冠状动脉 CT 血管造影，我们确定了普通人群中无 CVD 参与者的 BLL 与 CAC 之间存在正相关关系。为了降低 CVD 的负担，应努力制定政策，最大限度地减少环境铅暴露。
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