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目的通过研究焦炉工人尿中多环芳烃代谢物水平与代谢综合征发病的关系,旨在评价职业环境中多环芳烃暴露是否会成为代谢综合征发生的重要危险因素之一。方法选取符合要求的1 157名男性焦炉工人为研究对象,测定其尿中12种多环芳烃水平,运用logistic回归分析它们与代谢综合征及其各组分的关联。结果焦炉工人中代谢综合征的发生率为26.5%,尿4-羟基菲水平与代谢综合征的发生风险以及增高的甘油三酯和空腹血糖呈明显的剂量—反应关系。与尿4-羟基菲最低四分位数相比,最高四分位数代谢综合征发生风险增加了97%(P<0.01)。分层分析发现,在工龄≥20a、吸烟和超重的工人中,4-羟基菲与代谢综合征以及高甘油三脂和高血糖的关联更加明显。另外,高水平的4-羟基菲分别与工龄≥20a和超重对代谢综合征的发生存在联合作用。结论焦炉工人尿中4-羟基菲与代谢综合征的发生呈明显的剂量—反应关系,并且4-羟基菲分别与工龄≥20a和超重对代谢综合征的发生存在联合作用。
Objective To investigate whether PAH exposure in occupational settings would be one of the important risk factors for metabolic syndrome by studying the relationship between the level of PAH metabolites in urine and the incidence of metabolic syndrome in coke oven workers. Methods A total of 1 157 male coke oven workers, who meet the requirements, were selected as study objects to determine the levels of 12 PAHs in urine. Logistic regression analysis was used to analyze their association with metabolic syndrome and its components. Results The incidence of metabolic syndrome in coke oven workers was 26.5%. Urinary 4-hydroxy-phenanthrene dose-response was significantly associated with the risk of metabolic syndrome and elevated triglycerides and fasting blood glucose. Compared with the lowest quartile of urinary 4-hydroxy-phenanthrene, the highest quartile metabolic syndrome increased the risk by 97% (P <0.01). Stratified analysis revealed that the association of 4-hydroxy-phenanthrene with the metabolic syndrome, as well as triglycerides and hyperglycemia, was more pronounced among workers who were older than 20 years and smokers and overweight. In addition, the high level of 4-hydroxy-phenanthrene and maternal age ≥20a and overweight, respectively, have a combined effect on the occurrence of metabolic syndrome. Conclusion The urinary excretion of 4-hydroxy-phenanthrene and metabolic syndrome in coke oven workers showed a dose-response relationship, and 4-hydroxy-phenanthrene was associated with the occurrence of metabolic syndrome more than 20 years and overweight, respectively.