阳江高本底地区女性居民心-踝血管指数研究
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摘要
目的探讨长期低剂量电离辐射对女性动脉血管弹性的影响。方法采用随机整群抽样方法,以阳江市高本底辐射地区(HBRA)γ射线外照射剂量率较高的2个管区95名女性居民为HBRA组,以恩平市对照地区(CA)96名女性居民为CA组。测量2组人群身高、体质量、腰围、臀围及血压;采集肘静脉血,测量高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯和血糖;采用血压脉搏检查装置测量心-踝血管指数(CAVI)。结果 CA组、HBRA组人群的CAVI分别为(8.09±1.03)和(8.35±1.60)m/s,CAVI异常率分别为25.00%和29.47%。多重线性回归分析结果显示,在调整年龄、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯、高血压、糖代谢异常及腹型肥胖等因素后,CA组、HBRA组人群CAVI的调整均值分别为8.19和8.25 m/s,HBRA组比CA组高0.73%,但2组人群CAVI的调整均值比较,差异无统计学意义(标准化偏回归系数=0.021,P>0.05)。匹配2组人群年龄后,2组人群CAVI调整均值比较,差异无统计学意义(P>0.05)。结论女性动脉血管硬化可能与长期接受低剂量辐射无关。
Objective To explore the effect of long-term low-dose ionizing radiation exposure on arterial vascular elasticity in female residents. Methods A cluster random sampling method was used,95 female residents in 2 regions with high external γ radiation dose rate in the high radiation background area( HBRA) in Yangjiang City were selected as the HBRA group,and 96 female residents from the control area( CA) in Enping City were chosen as the CA group. The height,body mass,waist circumference,hip circumference and blood pressure were measured in individuals of these two groups. The fasting blood samples of elbow vein were collected to measure high-density lipoprotein cholesterol( HDL-C),low-density lipoprotein cholesterol( LDL-C),triglycerides( TG) and blood glucose. The cardio-ankle vascular index( CAVI) was measured using the blood pressure and pulse check device. Results The CAVI of the CA and HBRA groups were( 8. 09 ±1. 03) and( 8. 35 ± 1. 60) m/s,respectively. The abnormal rates of CAVI were 25. 00% and 29. 47%,respectively. The results of multiple linear regression analysis showed that after adjustment for age,HDL-C,LDL-C,TG,hypertension,abnormal glucose metabolism and abdominal obesity,the CAVI adjustment mean values of the CA and HBRA groups were8. 19 and 8. 25 m/s,respectively. The HBRA group was about 0. 73% higher than the CA group,but the difference was not statistically significant( standardized partial regression coefficient = 0. 021,P > 0. 05). After matching age of both groups,the difference of the adjusted mean of CAVI between the two groups was not statistically significant( P > 0. 05).Conclusion Long-term low-dose radiation exposure is not associated with atherosclerosis in female population.
Objective To explore the effect of long-term low-dose ionizing radiation exposure on arterial vascular elasticity in female residents. Methods A cluster random sampling method was used,95 female residents in 2 regions with high external γ radiation dose rate in the high radiation background area( HBRA) in Yangjiang City were selected as the HBRA group,and 96 female residents from the control area( CA) in Enping City were chosen as the CA group. The height,body mass,waist circumference,hip circumference and blood pressure were measured in individuals of these two groups. The fasting blood samples of elbow vein were collected to measure high-density lipoprotein cholesterol( HDL-C),low-density lipoprotein cholesterol( LDL-C),triglycerides( TG) and blood glucose. The cardio-ankle vascular index( CAVI) was measured using the blood pressure and pulse check device. Results The CAVI of the CA and HBRA groups were( 8. 09 ±1. 03) and( 8. 35 ± 1. 60) m/s,respectively. The abnormal rates of CAVI were 25. 00% and 29. 47%,respectively. The results of multiple linear regression analysis showed that after adjustment for age,HDL-C,LDL-C,TG,hypertension,abnormal glucose metabolism and abdominal obesity,the CAVI adjustment mean values of the CA and HBRA groups were8. 19 and 8. 25 m/s,respectively. The HBRA group was about 0. 73% higher than the CA group,but the difference was not statistically significant( standardized partial regression coefficient = 0. 021,P > 0. 05). After matching age of both groups,the difference of the adjusted mean of CAVI between the two groups was not statistically significant( P > 0. 05).Conclusion Long-term low-dose radiation exposure is not associated with atherosclerosis in female population.
引文
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[18]折茂肇,齐藤康,白井厚治,等.新动脉硬化指标CAVI概述——从基础到临床应用[M].北京:北京大学医学出版社,2011:2-22.
[19]宋明强,田海晔,蛭田啓之,等.心-踝血管指数与颈动脉内膜中膜厚度在动脉硬化评价中的诊断效度比较[J].中国动脉硬化杂志,2010,18(2):141-145.
[20]田海晔,宋明强,田啓之,等.心-踝血管指数与颈动脉内膜中膜厚度在动脉硬化疾病评价中的价值[J].中国动脉硬化杂志,2012,20(3):252-256.
[21]VIGILI D K S,TIENGO A,AVOGARO A.Cerebrovascular disease in diabetes mellitus:the role of carotid intima-media thickness[J].Nutr Metab Cardiovasc Dis,2009,19(9):667-673.
[22]BROEDL U C,GEISS H C,PARHOFER K G,et al.Comparison of current guidelines for primary prevention of coronary heart disease[J].J Gen Intern Med,2003,18(3):190-195.
[23]GOFF D C Jr,LLOYD-JONES D M,BENNETT G,et al.2013ACC/AHA guideline on the assessment of cardiovascular risk:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines[J].J Am Coll Cardiol,2014,63(25):2935-2959.
[2]STEWART F A,AKLEYEV A V,HAUER-JENSEN M,et al.ICRP publication 118:ICRP statement on tissue reactions and early and late effects of radiation in normal tissues and organs-threshold doses for tissue reactions in a radiation protection context[J].Ann ICRP,2012,41(1/2):1-322.
[3]BASELET B,ROMBOUTS C,BENOTMANE A M,et al.Cardiovascular diseases related to ionizing radiation:the risk of lowdose exposure(Review)[J].Int J Mol Med,2016,38(6):1623-1641.
[4]AZIZOVA T V,GRIGORYEVA E S,HAYLOCK R G,et al.Ischaemic heart disease incidence and mortality in an extended cohort of Mayak workers first employed in 1948-1982[J].Br J Radiol,2015,88(1054):20150169.
[5]VRIJHEID M,CARDIS E,ASHMORE P,et al.Mortality from diseases other than cancer following low doses of ionizing radiation:results from the 15-Country Study of nuclear industry workers[J].Int J Epidemiol,2007,36(5):1126-1135.
[6]MUIRHEAD C R,O'HAGAN J A,HAYLOCK R G E,et al.Mortality and cancer incidence following occupational radiation exposure:third analysis of the National Registry for Radiation Workers[J].Br J Cancer,2009,100(1):206-212.
[7]袁镛龄,森岛弥重,沈泓,等.天然辐射源致阳江高本底辐射地区居民的剂量估算[J].中国辐射卫生,2004,13(1):1-7.
[8]苏垠平,谭光享,雷淑洁,等.阳江高本底女性居民低剂量辐射照射与颈动脉中内膜厚度关系的初步研究[J].中华放射医学与防护杂志,2016,36(9):682-687.
[9]胡丹,方平.心-踝血管指数的原理方法及临床应用[J].国际心血管病杂志,2009,36(5):296-299.
[10]聂志华,许顶立,郑侨克,等.心踝血管指数对早期动脉粥样硬化诊断的预测价值[J].中华高血压杂志,2014,22(7):671-674.
[11]查永如,邹剑明,林钻轩,等.阳江高本底地区放射流行病学调查中混淆因素及对照人群可比性研究[J].中华放射医学与防护杂志,1997,17(12):395-398.
[12]何耀.我国超重/肥胖流行趋势及其对公共卫生的挑战[J].中华流行病学杂志,2014,35(4):345-348.
[13]CARR D B,UTZSCHNEIDER K M,HULL R L,et al.Intraabdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome[J].Diabetes,2004,53(8):2087-2094.
[14]SANNE A E,SOPHIE H,MARK WOODWARD,et al.Sex differences in the association between measures of general and central adiposity and the risk of myocardial infarction:results from the UK Biobank[J].J Am Heart Assoc,2018,7(5):e008507.
[15]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华内分泌代谢杂志,2014,30(10):447-498.
[16]NAMEKATA T,SUZUKI K,ISHIZUKA N,et al.Establishing baseline criteria of cardio-ankle vascular index as a new indicator of arteriosclerosis:a cross-sectional study[J].BMC Cardiovasc Disord,2011,11(1):1-10.
[17]MIYOSHI T,ITO H.Assessment of arterial stiffness using the cardioankle vascular index[J].Pulse(Basel),2016,4(1):11-23.
[18]折茂肇,齐藤康,白井厚治,等.新动脉硬化指标CAVI概述——从基础到临床应用[M].北京:北京大学医学出版社,2011:2-22.
[19]宋明强,田海晔,蛭田啓之,等.心-踝血管指数与颈动脉内膜中膜厚度在动脉硬化评价中的诊断效度比较[J].中国动脉硬化杂志,2010,18(2):141-145.
[20]田海晔,宋明强,田啓之,等.心-踝血管指数与颈动脉内膜中膜厚度在动脉硬化疾病评价中的价值[J].中国动脉硬化杂志,2012,20(3):252-256.
[21]VIGILI D K S,TIENGO A,AVOGARO A.Cerebrovascular disease in diabetes mellitus:the role of carotid intima-media thickness[J].Nutr Metab Cardiovasc Dis,2009,19(9):667-673.
[22]BROEDL U C,GEISS H C,PARHOFER K G,et al.Comparison of current guidelines for primary prevention of coronary heart disease[J].J Gen Intern Med,2003,18(3):190-195.
[23]GOFF D C Jr,LLOYD-JONES D M,BENNETT G,et al.2013ACC/AHA guideline on the assessment of cardiovascular risk:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines[J].J Am Coll Cardiol,2014,63(25):2935-2959.