为探讨环氧乙烷(EO)与心血管疾病风险之间的关系,纳入2013~2018年美国国家健康与营养检查调查(NHANES)数据库中的5041名成年人,采用血红蛋白-环氧乙烷结合物(HbEO)测定血清中的环氧乙烷水平.通过加权logistic回归模型和限制性三次样条图探讨HbEO与心血管疾病风险之间的剂量-反应关系,并进行亚组分析以评估研究的异质性.通过多因素回归分析发现,血清HbEO水平与心血管疾病风险呈正相关,且在调整混杂因素后具有统计学显著性(OR:1.15,[95%CI:1.02~1.30],P=0.021).对于大多数心血管疾病,随着环氧乙烷暴露量的增加,OR值也有所增加,但这种增加并不总是具有统计学显著性.此外,HbEO与心绞痛、心脏病发作患病率呈正相关,且在调整混杂因素后OR值最高(OR:1.36,[95%CI:1.11~1.68],OR:1.35[95%CI:1.14~1.60]),其中对心绞痛的影响更为显著.HbEO与心血管疾病风险之间存在显著的非线性关系(P-overall=0.002, P-nonlinear=0.006).剂量-反应相关性提示,血清HbEO水平升高与心绞痛风险相关,血清HbEO水平与心绞痛风险之间可能存在线性关系(p-overall=0.012,p-nonlinear= 0.748).HbEO与心脏病发作风险之间存在显著的非线性关系(p-overall<0.001, p-nonlinear=0.011).综上,血液中环氧乙烷代谢产物与心血管疾病患病率的升高有关,尤其是心绞痛和心脏病发作两种心血管疾病,但仍需进一步研究证实.
Abstract
The relationship between ethylene oxide (EO) and cardiovascular disease risk was investigated in this article. A total of 5041 adults were enrolled, and ethylene oxide levels were measured in serum using hemoglobin ethylene oxide conjugate (HbEO) as a biomarker. Data were obtained from the National Health and and Nutrition Examination Survey (NHANES) database in the United States between 2013 and 2018. Weighted logistic regression models and restricted cubic spline plots were used to examine the dose-response relationship between HbEO and cardiovascular disease risk. Subgroup analyses were conducted to evaluate heterogeneity in the study. Through multiple regression analysis, it was found that serum HbEO levels were positively associated with cardiovascular disease risk, and statistical significance was maintained after adjustment for multiple confounders (OR: 1.15, [95% CI: 1.02~1.30], P=0.021). For most cardiovascular diseases, increased exposure to ethylene oxide was associated with elevated OR values, although this increase was not always statistically significant. Additionally, HbEO was positively correlated with the incidence of angina pectoris and heart attack, with the highest OR values observed after full adjustment (OR=1.36 [95% CI: 1.11~1.68] and OR=1.35 [95% CI: 1.14~1.60], respectively). Angina pectoris was the most affected outcome.A significant non-linear relationship was identified between HbEO and overall cardiovascular disease risk (P-overall=0.002, P-non-linear=0.006). Dose-response analysis indicated that elevated serum HbEO levels were associated with an increased risk of angina, with evidence supporting a linear relationship (p-overall=0.012, p-non-linear=0.748). A significant non-linear association was also observed between HbEO and heart attack risk (p-overall<0.001, p-non-linear=0.011).In summary, ethylene oxide metabolites in the blood were associated with an increased incidence of cardiovascular diseases, particularly angina pectoris and heart attack. Further research is needed to confirm these findings.
关键词
心血管疾病 /
环氧乙烷 /
横断面研究 /
NHANES
Key words
cardiovascular disease /
ethylene oxide /
cross-sectional study /
NHANES
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