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海湾战争退伍军人的动脉粥样硬化性心血管疾病与部署期间暴露因素的关系

Atherosclerotic Cardiovascular Disease in Gulf War Veterans in Relation to Deployment Exposures.

作者信息

Ahmed Sarah T, Li Ruosha, Steele Lea, Richardson Peter, Sims Kellie, Quaden Rachel, Harrington Kelly M, Nambi Vijay, Gaziano John M, Morgan Robert, Delclos George L, Helmer Drew A

机构信息

Center Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA.

Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.

出版信息

Cardiovasc Toxicol. 2025 Jul 5. doi: 10.1007/s12012-025-10013-7.

Abstract

Many 1990-1991 Gulf War Veterans (GWVs) were exposed to toxicants and environmental hazards during deployment, including oil well fire smoke, chemical/biological agents, pyridostigmine bromide (PB) pills, and pesticides. Multiple constituents of smoke are associated with increased risk for atherosclerotic cardiovascular diseases (ASCVD), and other toxic exposures have been associated with autonomic and lipid dysfunction. We used data from the Gulf War Era Cohort and Biorepository Study of veterans deployed to Gulf War in 1990-1991 (n = 942). We evaluated the association of deployment exposures (no, yes (1-6 days), (7-30 days), (31 + days), and not sure) with clinical risk factors (hypertension, diabetes, high cholesterol) and ASCVD using multivariable logistic regression. We adjusted for all clinical risk factors in the models to test the association of military exposures and ASCVD. We found that 7-30 days exposure to oil well fire smoke (OR: 2.95, CI: 1.40, 6.19), PB pills (OR: 2.37, CI: 1.06, 5.32), and chemical/biological agents (OR: 3.60, CI: 1.04, 12.51) were associated with ASCVD. Exposure to chemical/biological agents for 7-30 days was also associated with hypertension (OR: 4.18, CI: 1.48, 11.86) and for 31 + days was associated with ASCVD (OR: 4.24, CI:1.20, 14.94). The associations between oil well fire smoke and chemical/biological agents with ASCVD remained significant in models adjusting for clinical risk factors. For GWVs, exposure to oil well fire smoke, chemical/biological agents, and PB pills were associated with ASCVD. These exposures may represent population-specific risk enhancers for ASCVD and may be considered in individualized clinical risk assessment.

摘要

许多1990 - 1991年海湾战争退伍军人(GWVs)在部署期间接触了有毒物质和环境危害,包括油井火灾烟雾、化学/生物制剂、溴化吡啶斯的明(PB)药丸和杀虫剂。烟雾的多种成分与动脉粥样硬化性心血管疾病(ASCVD)风险增加有关,其他有毒物质暴露与自主神经和脂质功能障碍有关。我们使用了1990 - 1991年部署到海湾战争的退伍军人的海湾战争时代队列和生物样本库研究的数据(n = 942)。我们使用多变量逻辑回归评估部署暴露(无、是(1 - 6天)、(7 - 30天)、(31天及以上)和不确定)与临床风险因素(高血压、糖尿病、高胆固醇)和ASCVD之间的关联。我们在模型中对所有临床风险因素进行了调整,以测试军事暴露与ASCVD之间的关联。我们发现,暴露于油井火灾烟雾7 - 30天(比值比:2.95,置信区间:1.40,6.19)、PB药丸(比值比:2.37,置信区间:1.06,5.32)和化学/生物制剂(比值比:3.60,置信区间:1.04,12.51)与ASCVD有关。暴露于化学/生物制剂7 - 30天也与高血压有关(比值比:4.18,置信区间:1.48,11.86),暴露31天及以上与ASCVD有关(比值比:4.24,置信区间:1.20,14.94)。在调整临床风险因素的模型中,油井火灾烟雾和化学/生物制剂与ASCVD之间的关联仍然显著。对于GWVs,暴露于油井火灾烟雾、化学/生物制剂和PB药丸与ASCVD有关。这些暴露可能代表ASCVD特定人群的风险增强因素,可在个体化临床风险评估中予以考虑。

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