背景:对单个苯的影响进行综合研究,甲苯,乙苯,和二甲苯(BTEX)及其混合物在血液样本中测量,一般人群对心血管疾病(CVD)及相关危险因素的研究有限。
目的:研究血液个体和混合BTEX对总CVD及其亚型的影响,脂质分布,和白细胞(WBC)计数。
方法:在NHANES1999-2018年的17,007名参与者中,使用调查加权多变量逻辑回归检查血液个体与混合BTEX与CVD及其亚型之间的关联。使用加权分位数和建模和分位数g计算来估计BTEX混合物对CVD的综合影响。加权多元线性回归评估BTEX对血脂和白细胞的影响,包括它的五部分差分计数。
结果:与BTEX混合物的参考四分位数相比,最高四分位数的个体的CVD风险校正比值比显著增加(1.64,95%CI:1.23~2.19,趋势P=0.008).观察到苯呈正相关,甲苯,乙苯,和间二甲苯/对二甲苯,表现出单调增加的暴露-反应关系。混合BTEX与充血性心力衰竭(CHF)有关,心绞痛,还有心脏病.个别苯,甲苯,和乙苯与CHF有关,而甲苯,乙苯,所有二甲苯异构体都与心绞痛有关。苯,甲苯,邻二甲苯与心脏病发作有关。混合和个体BTEX均显示与甘油三酯呈正相关,胆固醇,低密度脂蛋白,WBC,包括它的五部分差分计数,但与高密度脂蛋白呈负相关。亚组分析确定了吸烟的改善作用,饮酒,锻炼,BMI,高血压,和糖尿病对特定毒物和CVD风险之间的关联。
结论:BTEX暴露与心血管疾病和心血管危险因素相关。这些发现强调了在评估心血管健康风险时考虑血液BTEX水平的重要性。
BACKGROUND: Comprehensive research on the effects of individual benzene, toluene, ethylbenzene, and xylenes (BTEX) and their mixture measured in blood samples, on cardiovascular diseases (CVD) and related risk factors among the general population is limited.
OBJECTIVE: To investigate the effects of blood individual and mixed BTEX on total CVD and its subtypes, lipid profiles, and white blood cell (WBC) count.
METHODS: Survey-weighted multivariate logistic regression was used to examine the associations between blood individual and mixed BTEX with CVD and its subtypes in 17,007 participants from NHANES 1999-2018. The combined effect of BTEX mixture on CVD was estimated using weighted quantile sum modeling and quantile g-computation. Weighted multivariate linear regression assessed the effects of BTEX on lipid profiles and WBC, including its five-part differential count.
RESULTS: In comparison to the reference quartile of BTEX mixture, individuals in the highest quartile had a significantly increased adjusted odds ratio of CVD risk (1.64, 95 % CI: 1.23 to 2.19, P for trend = 0.008). Positive associations were observed for benzene, toluene, ethylbenzene, and m-/p-xylene, demonstrating a monotonically increasing exposure-response relationship. Mixed BTEX was associated with congestive heart failure (CHF), angina pectoris, and heart attack. Individual benzene, toluene, and ethylbenzene were associated with CHF, while toluene, ethylbenzene, and all xylene isomers were linked to angina pectoris. Benzene, toluene, and o-xylene were associated with heart attack. Both mixed and individual BTEX showed positive associations with triglycerides, cholesterol, low-density lipoprotein, and WBC, including its five-part differential count, but a negative relationship with high-density lipoprotein. Subgroup analyses identified modifying effects of smoking, drinking, exercise, BMI, hypertension, and diabetes on the associations between specific toxicants and CVD risk.
CONCLUSIONS: Exposure to BTEX was associated with cardiovascular diseases and cardiovascular risk factors. These findings emphasize the importance of considering blood BTEX levels when assessing cardiovascular health risks.