Tseng C H, Chong C K, Chen C J, Tai T Y
Department of Internal Medicine, National Taiwan University Hospital, Taipei.
Angiology. 1997 Apr;48(4):321-35. doi: 10.1177/000331979704800405.
To examine whether lipid abnormalities contributed to the endemic peripheral vascular disease (PVD) in villages where arseniasis was hyperendemic in Taiwan, the authors studied 533 adults with Doppler ultrasound and lipid profiles including total cholesterol, triglyceride, high- and low-density lipoprotein cholesterol, apolipoprotein AI, and apolipoprotein B. Among them, 63 had PVD based on an ankle-brachial index < 0.90. Long-term arsenic exposure indices including cumulative arsenic exposure in mg/L-years, duration of drinking artesian well water in years, and duration of living in arseniasis-hyperendemic villages in years were calculated from detailed history obtained through standardized interviews based on a structured questionnaire and arsenic concentration in well water. Possible confounders including age, sex, body mass index, cigarette smoking, and disease status of diabetes mellitus and hypertension were considered in the analyses. None of the lipid profiles differed significantly between the presence and absence of PVD. The odds ratios for PVD did not differ among different quintiles of lipid profiles with the lowest quintile as the referent. However, a significant dose-response relation was found for the long-term arsenic exposure indices. The multivariate-adjusted odds ratios for cumulative arsenic exposure of 0.1 approximately 19.9 and > or = 20 mg/L-years were 2.77 and 4.68, respectively, compared with the unexposed. These results suggest that the PVD in arseniasis-hyperendemic villages is correlated with ingested inorganic arsenic and not with the lipid profiles.
为了研究脂质异常是否与台湾砷中毒高度流行村庄的地方性周围血管疾病（PVD）有关，作者对533名成年人进行了多普勒超声和脂质谱研究，包括总胆固醇、甘油三酯、高密度和低密度脂蛋白胆固醇、载脂蛋白AI和载脂蛋白B。其中，63人根据踝臂指数<0.90被诊断为患有PVD。通过基于结构化问卷的标准化访谈获得详细病史，并结合井水砷浓度，计算长期砷暴露指数，包括以mg/L-年为单位的累积砷暴露量、饮用自流井水的年数以及在砷中毒高度流行村庄居住的年数。分析中考虑了可能的混杂因素，包括年龄、性别、体重指数、吸烟以及糖尿病和高血压的疾病状态。PVD患者和非PVD患者的脂质谱均无显著差异。以脂质谱最低五分位数为参照，不同五分位数的PVD比值比无差异。然而，长期砷暴露指数存在显著的剂量反应关系。与未暴露者相比，累积砷暴露量为0.1至19.9 mg/L-年和≥20 mg/L-年的多变量调整比值比分别为2.77和4.68。这些结果表明，砷中毒高度流行村庄的PVD与摄入的无机砷有关，而与脂质谱无关。
