烟草暴露和超重对焦化作业工人血压异常的交互作用

王勇; 赵新宇; 刘璐; 冯权; 卫佳俊; 郭岚; 杨瑾

doi:10.16462/j.cnki.zhjbkz.2022.08.009

烟草暴露和超重对焦化作业工人血压异常的交互作用

doi: 10.16462/j.cnki.zhjbkz.2022.08.009

030001 太原，山西医科大学公共卫生学院劳动卫生学教研室，国家卫生健康委尘肺病(山西)重点实验室

基金项目:

国家自然科学基金 81273041

山西省自然科学基金 202103021224230

山西省回国留学基金 HGKY2019053

详细信息

通讯作者:
杨瑾，E-mail: yang_jin@sxmu.edu.cn

中图分类号: R135
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出版历程
- 收稿日期: 2022-03-24
- 修回日期: 2022-06-14
- 网络出版日期: 2022-08-23
- 刊出日期: 2022-08-10

Interaction effects between tobacco exposure and overweight on abnormal blood pressure in coking workers

Department of Occupational Health, School of Public Health, Shanxi Medical University, NHC Key Laboratory of Pneumoconiosis in ShanXi, Taiyuan 030001, China

Funds:

National Natural Science Foundation of China 81273041

Natural Science Foundation of Shanxi Province of China 202103021224230

Shanxi Province Overseas Study Fund Project HGKY2019053

More Information

Corresponding author: YANG Jin, E-mail: yang_jin@sxmu.edu.cn

摘要

摘要: 目的分析焦化作业工人烟草暴露和超重对血压异常的交互作用。方法采用横断面研究方法，于2017年收集山西某焦化厂700名工人的基本信息和尿样。采用高效液相色谱-质谱联用(high performance liquid chromatography-mass spectrometry, HPLC-MS/MS)检测工人尿中8种多环芳烃(polycyclic aromatic hydrocarbons, PAHs)及3种烟草代谢物水平。采用套索回归(least absolute shrinkage and selection operator regression, LASSO)筛选出与高血压相关的最优危险因素。采用修正Poisson回归分析烟草暴露与血压异常之间的关系。采用交互作用分析研究烟草代谢物和超重对焦化作业工人血压异常的交互作用。结果按尿烟草代谢物对数转换值的三分位数(tertiles, T)将研究对象分为三组(T1、T2、T3)，修正Poisson回归分析显示与T1组(< 1.54 ng/mL)相比，T3组(≥36.76 ng/mL)尿尼古丁浓度每增加一个单位，患血压异常的风险增加1.46倍(PR=2.46, 95% CI: 1.17~5.18, P=0.036)；血压异常工人BMI的中位数(25.84 kg/m²)＞血压正常者(24.19 kg/m²)；交互作用分析显示，与尿尼古丁水平低的体重正常人群相比，尿尼古丁水平高的超重人群血压异常的风险更高(PR=5.12, 95% CI: 1.76~14.92, P=0.042)。结论 BMI和尿尼古丁水平对焦炉作业工人血压异常具有交互作用，在焦炉作业工人中采取控烟及控制体重措施对预防高血压具有重要意义。
- BMI /
- 高血压 /
- 烟草代谢物 /
- 套索回归
Abstract: Objective To analyze the interaction effects between tobacco exposure and overweight on abnormal blood pressure in coke-oven workers. Methods In this cross-sectional study, we collected basic information and urine sample of 700 workers in a coking plant in Shanxi Province in 2017. Polycyclic aromatic hydrocarbons (PAHs) and tobacco metabolites in the urine of workers were detected by high performance liquid chromatography-mass spectrometry. Least absolute shrinkage and selection operator regression was used to screen out the optimal risk factors associated with hypertension. Modified poisson regression was used to analyze the association between tobacco exposure and abnormal blood pressure. The interaction effects of tobacco metabolites and overweight on abnormal blood pressure in coke-oven workers was studied by interaction effects analysis. Results The logarithmic value of urine tobacco metabolites were divided into 3 groups according to the tertile (T1, T2 and T3). The modified poisson regression model showed that for each unit increase in urinary nicotine concentration in T3 (≥36.76 ng/mL), compared with T1 (< 1.54 ng/mL), the risk of abnormal blood pressure increased 1.46 (PR=2.46, 95% CI: 1.17-5.18, P=0.036). The median body mass index (BMI) of workers with abnormal blood pressure (25.85 kg/m²) was higher than that of those with normal blood pressure(24.19 kg/m²). Interaction effects analysis showed that overweight people with high nicotine levels had a significantly higher risk of hypertension than non-overweight people with low urinary nicotine levels (PR=5.12, 95% CI: 1.76-14.92, P=0.042). Conclusions BMI and urine-nicotine levels have an interactive effect on abnormal blood pressure in coke-oven workers. Controlling smoking and body weight is important to prevent hypertension in coke oven workers.
- BMI /
- Hypertension /
- Tobacco metabolites /
- Least absolute shrinkage and selection operator regression

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图 1 基于LASSO回归的特征变量选择

注：A：十倍交叉验证图; B：收缩系数图。

Figure 1. Selection of characteristic variables based on LASSO regression

下载: 全尺寸图片幻灯片

图 2 研究人群中尿液烟草代谢物浓度与高血压的关系

注：未调整：未控制混杂因素；调整：控制了年龄、BMI、多环芳烃代谢物和其他烟草代谢物，使用修正Poisson回归分析。

Figure 2. Relationship between urinary tobacco metabolite concentration and hypertension in participants

下载: 全尺寸图片幻灯片

图 3 研究人群中尿尼古丁浓度和超重对高血压的交互作用

Figure 3. Interaction of urinary nicotine concentration and overweight with hypertension in the participants

下载: 全尺寸图片幻灯片

表 1 研究对象基本情况[n(%)]

Table 1. Basic characteristics of participants [n(%)]

变量	总人数(N=670)	血压异常		Z/χ²值	P值
变量	总人数(N=670)	否(n=516)	是(n=154)	Z/χ²值	P值
年龄[M(P₂₅, P₇₅), 岁]	38(31, 48)	33(30, 46)	48(45, 52)	-9.17	< 0.001
性别				20.54	< 0.001
男	447(66.7)	321(62.2)	126(81.8)
女	223(33.3)	195(37.8)	28(18.2)
BMI[M(P₂₅, P₇₅), kg/m²]	24.57(22.31, 26.84)	24.19(21.98, 26.35)	25.84(23.89, 28.71)	-6.16	< 0.001
BMI(kg/m²)					< 0.001
＜24	283(42.2)	244(89.7)	39(25.3)
≥24	387(57.8)	272(10.3)	115(74.7)
教育程度				32.07	< 0.001
低	151(22.5)	97(18.8)	54(35.1)
中	158(23.6)	111(21.5)	47(30.5)
高	361(53.9)	308(59.7)	53(34.4)
吸烟				12.75	< 0.001
非	367(54.8)	302(58.5)	65(42.2)
是	303(45.2)	214(41.5)	89(57.8)
饮酒				10.79	0.001
非	487(72.7)	391(75.8)	96(62.3)
是	183(27.3)	125(24.2)	58(37.7)
多环芳烃及烟草代谢物[M(P₂₅, P₇₅), ng/mL]
Σ-OHNAP	0.31(0.13, 0.71)	0.31(0.14, 0.72)	0.41(0.16, 0.77)	-1.72	0.085
Σ-OHFLU	0.14(0.07, 0.25)	0.17(0.09, 0.32)	0.22(0.10, 0.43)	-2.54	0.011
Σ-OHPHE	0.34(0.21, 0.52)	0.39(0.24, 0.60)	0.39(0.25, 0.66)	-0.37	0.713
1-OHPYP	0.09(0.06, 0.16)	0.09(0.06, 0.15)	0.09(0.06, 0.18)	-0.90	0.367
可替宁	44.06(4.80, 1 322.35)	42.05(4.09, 1 162.99)	72.16(8.66, 1 807.46)	-2.50	0.012
尼古丁	54.91(4.11, 1 225.09)	51.52(2.93, 1 089.35)	91.40(7.91, 1 886.94)	-2.96	0.003
反式-3’-羟基可替宁	37.08(11.05, 2 280.06)	34.23(9.62, 2 034.51)	144.03(16.14, 3 653.37)	-2.49	0.013

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