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血清双酚A浓度与高血压发生风险的关联

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[背景]现有的研究表明双酚A暴露可能与高血压风险相关,但大多数为横断面研究,且结论尚不一致。[目的]探讨双酚A暴露与高血压发生风险的关联。[方法]基于东风-同济队列的一项纳入 1990名研究对象的巢式病例对照研究,在排除基线887名高血压患者和随访后血压数据缺失的 23名研究对象后,共有 1080名研究对象纳入本研究。通过问卷调查获得流行病学资料,采用高效液相色谱串联质谱仪检测血清双酚A质量浓度(后简称为浓度)。采用logistic回归模型分析血清双酚A水平与高血压发生风险的关联,线性回归模型分析血清双酚A水平与基线和随访血压变化值的关联。[结果]1080名研究对象的平均年龄为(62。03±7。45)岁,其中 41。1%为男性。在经过随访之后,共有477人(44。2%)新发高血压。总人群中血清双酚A中位数浓度为3。15 μg·L-1,新发病例组基线双酚A浓度(3。24 μg·L-1)高于对照组(2。98 μg·L-1)(P<0。05)。在调整所有协变量之后,自然对数转换的双酚A浓度每增加一个单位,高血压的发生风险增加 12%(OR=1。12,95%CI:1。02~1。22);基线与随访的收缩压和舒张压的变化值分别增加1。88(95%CI:1。08~2。69)mmHg和1。14(95%CI:0。68~1。61)mmHg。根据血清双酚A三分位数将研究对象分为三组,与第一分位组相比,第二和第三分位组的高血压发生风险分别增加39%(OR=1。39,95%CI:1。01~1。91)和40%(OR=1。40,95%CI:1。02~1。93),第二分位与第三分位的收缩压变化量分别增加 5。91(95%CI:3。06~8。76)mmHg和 5。71(95%CI:2。82~8。59)mmHg,舒张压变化量分别增加 3。09(95%CI:1。44~4。75)mmHg和 2。89(95%CI:1。22~4。57)mmHg(P趋势<0。001)。在女性、不吸烟/戒烟、不饮酒/戒酒、无高血压家族史、有体育锻炼和基线高血压前期的人群中发现血清双酚A水平与高血压存在正向关联(所有P趋势<0。05),但未发现分层变量与双酚A水平对高血压发生存在交互作用(所有P交互>0。05)。[结论]双酚A暴露与高血压发生风险存在正向关联。
Association between serum bisphenol A concentration and incident risk of hypertension
[Background]Previous studies have shown that bisphenol A exposure is associated with the risk of hypertension;however,most of them are cross-sectional and the conclusions are not consis-tent.[Objective]To evaluate the association between bisphenol A exposure and the incident risk of hypertension.[Methods]Based on a nested case-control design involving 1990 subjects derived from the Dongfeng-Tongji cohort,a total of 1080 subjects were included in this study after excluding 887 hypertensive cases at baseline and 23 subjects with missing blood pressure data in follow-up vis-its.Epidemiological information was collected through questionnaire survey,and serum bisphenol A concentration was detected by high performance liquid chromatography tandem mass spec-trometry.Logistic regression model was used to analyze the potential association between serum bisphenol A level and the risk of hypertension incidence,and linear regression model was used to analyze the association between serum bisphenol A level and blood pressure changes between baseline and follow-up.[Results]The average age of the 1 080 participants was(62.03±7.45)years,of which 41.1%were male.During the follow-up period,a total of 477(44.2%)developed hypertension.The median serum concentration of bisphenol A in the total population was 3.15 μg·L-1,and the baseline bisphenol A concentration in the new case group(3.24 μg·L-1)was higher than that in the control group(2.98 μg·L-1)(P<0.05).After adjustment for selected covariates,the risk of hypertension increased by 12%(OR=1.12,95%CI:1.02,1.22)for each unit increase in naturally log-transformed bisphenol A;the systolic blood pressure and diastolic blood pressure increased by 1.88(95%CI:1.08,2.69)mmHg and 1.14(95%CI:0.68,1.61)mmHg,respectively.Compared with the low bisphenol A tertile group,the risk of hypertension in the middle tertile and high tertile groups increased by 39%(OR=1.39,95%CI:1.01,1.91)and 40%(OR=1.40,95%CI:1.02,1.93)respectively;the systolic blood pressure increased by 5.91(95%CI:3.06,8.76)mmHg and 5.71(95%CI:2.82,8.59)mmHg,and the diastolic blood pressure increased by 3.09(95%CI:3.06,8.59)mmHg and 2.89(95%CI:1.22,4.57)mmHg,respectively(Ptrend<0.001).A positive association between serum bisphenol A level and hypertension was found among those who were female,never/former smokers,never/former drinkers,without family history of hypertension,with physical exercise,and with prehypertension at baseline(Ptrend<0.05).There was no interaction between selected stratified variables and bisphenol A levels on hypertension(Pinteraction>0.05).[Conclusion]Bisphenol A exposure is positively associated with the risk of hypertension.

bisphenol Ahypertensionblood pressure change

官佑兵、赵卓雅、程旭、张佳禛、刘越男、何美安

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华中科技大学同济医学院公共卫生学院劳动卫生与环境卫生学系,湖北武汉 430030

双酚A 高血压 血压变化

国家自然科学基金项目

82273717

2024

环境与职业医学
上海市疾病预防控制中心 中华预防医学会

环境与职业医学

CSTPCD北大核心
影响因子:0.71
ISSN:1006-3617
年,卷(期):2024.41(6)