| Summary: | 碩士 === 國防醫學院 === 公共衛生學研究所 === 104 === Cardiovascular disease (CVDs) is the leading global cause of death. Recently, database analysis research indicated that the more Nickel content in PM2.5, the higher incidence and mortality of CVDs. It’s known that the rise of insulin resistance, blood pressure, cholesterol, advanced glycation end-products (AGEs) and reduce of renal function and soluble receptor for advanced glycation end-products (sRAGE) will raise the risk of CVDs. Research from our team pointed out that Nickel exposure causes enhancement of insulin resistance, but the relation between Nickel exposure and other risk factors or biomarkers of CVDs still need to be confirmed. The aim of our study is to determine whether Nickel exposure would be associated with the increase of blood pressure, cholesterol and AGEs or decrease of renal function and sRAGE. Further, we assessed the relation between Nickel exposure and risk of having CVDs by Globorisk score and Framingham coronary heart disease risk score（FCRS）.
We recruit 95 Taiwanese male staff of a shipyard including shipyard workers and office workers at the first year, and followed up 79 at the second year. The study population underwent an interview and a health examination on the Tuesday or Friday morning in September 2014 and September 2015, where blood and urine samples were collected. The concentration of Nickel in urine and blood indicated the amount of Nickel exposure. Relationship between Nickel exposure and biomarkers or risk index of CVDs were examined separately in multiple linear regression model, logistic regression model or using Generalized Estimating Equations (GEE) after adjusting age, smoking status, drinking status, waist-hip ratio and physical activity.
The study showed the mean concentration of nickel in the urine is 8.59±4.47(μg/g Creatinine), and 6.84±4.72 (μg/L) in the blood. Using multiple linear regression, after adjusting confounder, urinary nickel increasing 1 μg/g Creatinine, systolic blood pressure raises 1.64 mmHg (95％CI: 0.32, 2.96) in Exposure group and AGEs/sRAGE raises 0.22 (95％CI: 0.09, 0.34) in Reference group. Blood nickel increases 1 μg/L, Total cholesterol(T-CHO)/HDL raises 0.1(95％CI: 0.02, 0.18) and LDL/HDL raises 0.08 (95％CI: 0.04, 0.12). In logistic regression model, after adjusting confounder, Blood nickel increases 1 μg/L, the odds ratio of increasing T-CHO/HDL becomes 1.58(95％CI:1.27, 1.95), and the odds ratio of increasing LDL/HDL becomes 1.53(95％CI:1.25, 1.88). The result of using GEE found mix effect of urinary nickel and time makes creatinine clearance rate (CCR) decline(β＝-0.86; 95％CI：-1.68, -0.05), and makes LDL/HDL get high(β＝0.05; 95％CI：0.02, 0.08). There is not any significant finding about nickel exposure and Globorisk score or FCRS.
In conclusion, nickel exposure influences on many CVD biomarkers. That may increase risk of CVD indirectly though we did not ensure the relationship by assessing nickel exposure and risk index of CVD.
|
|---|
