Interaction effects between tobacco exposure and overweight on abnormal blood pressure in coking workers
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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。 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. -
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 否(n=516) 是(n=154) 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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