焦炉工人多环芳烃暴露与代谢综合征的关联研究

Association between occupational exposure to polycyclic aromatic hydrocarbons and metabolic syndrome in coke oven workers

目的通过研究焦炉工人尿中多环芳烃代谢物水平与代谢综合征发病的关系,旨在评价职业环境中多环芳烃暴露是否会成为代谢综合征发生的重要危险因素之一。方法选取符合要求的1 157名男性焦炉工人为研究对象,测定其尿中12种多环芳烃水平,运用logistic回归分析它们与代谢综合征及其各组分的关联。结果焦炉工人中代谢综合征的发生率为26.5%,尿4-羟基菲水平与代谢综合征的发生风险以及增高的甘油三酯和空腹血糖呈明显的剂量—反应关系。与尿4-羟基菲最低四分位数相比,最高四分位数代谢综合征发生风险增加了97%(P<0.01)。分层分析发现,在工龄≥20a、吸烟和超重的工人中,4-羟基菲与代谢综合征以及高甘油三脂和高血糖的关联更加明显。另外,高水平的4-羟基菲分别与工龄≥20a和超重对代谢综合征的发生存在联合作用。结论焦炉工人尿中4-羟基菲与代谢综合征的发生呈明显的剂量—反应关系,并且4-羟基菲分别与工龄≥20a和超重对代谢综合征的发生存在联合作用。

Objective To examine whether occupational exposure to polycyclic aromatic hydrocarbons（PAHs）would be one of the important risk factors for metabolic syndrome（MetS）in the coke oven workers.Methods A total of 1157 male coke oven workers with complete data were qualified for the present study.12 urinary PAHs metabolites were measured by gas chromatography- mass spectrometry. Multiple logistic regression was used to evaluate the associations between urinary PAHs metabolites and risk of MetS and its individual components,with adjustments for the potential covariates.Results The prevalence of MetS in coke oven workers was 26.5%.Urinary 4-OHPh was associated,in a dose-dependent manner,with elevated risk of MetS and elevated levels of triglycerides and fasting glucose.Compared with the lowest quartile,the adjusted OR of having MetS in the highest quartile was 1.97（1.29-3.00）（P〈0.01）.In stratified analysis,the association between urinary 4-OHPh and risk of MetS and elevated levels of triglycerides and fasting glucose was more evident in subjects who worked longer than 20 years,smokers,and overweight.Joint effects of urinary 4-OHPh with working years and BMI,respectively,on the risk of MetS were also observed.Conclusions Elevated urinary 4-OHPh was associated with a dose-response increased risk of MetS in coke oven workers.High levels of 4-OHPh combined with longer working years and overweight had a joint effect on the risk of MetS.