手传振动接触水平与白细胞系指标和代谢综合征的关联性分析

Association analysis of hand-transmitted vibration exposure level with leucocyte lineage markers and metabolic syndrome

关键词: 手传振动  白细胞  代谢综合征(MetS)  炎症风险  关联性

Keywords: hand-transmitted vibration  white blood cell  metabolic syndrome (MetS)  inflammatory risk  relevance

摘 要: 目的 探索手传振动接触水平与白细胞系指标和代谢综合征(MetS)的关联性。方法 以广州市汽车制造业 1340 名手传振动作业男工为调查对象,收集年龄、接振工龄、4h等能量频率计权振动加速度[Ahw(4)]等基本资料,检测白细胞(WBC)、中性粒细胞(N)、淋巴细胞(L)和单核细胞(M)等血液学指标;根据体质量指数(BMI)、血压(BP)、血糖(FBG)、三酰甘油(TG)和高密度脂蛋白胆固醇(HDL-C)判定有无 MetS;采用多因素 logistic 回归分析、Mann-Whitney U 检验和趋势性 χ² 检验分析手传振动接触水平与白细胞系指标和 MetS 的关系。结果 调查对象的年龄、工龄、Ahw(4)、WBC、N、L和M的中位数[M(P₂₅,P₇₅ )]分别为 27.00 (24.00,31.00)岁、3.83 (1.50,8.17)年、1.72(1.35,2.03)m/s²、6.75(5.81,7.84)×10⁹/L、3.75(3.13,4.61)×10⁹/L、2.19(1.84,2.65)×10⁹/L和 0.43(0.35,0.51)×10⁹/L,MetS 患病率 12.24%(164/1340)。Ahw(4)为 WBC 升高的危险因素(OR=1.46),MetS是WBC、N、L和M升高的危险因素(OR=3.40,3.13,2.64,2.02),年龄是罹患 MetS 的危险因素(OR=1.71);Ahw(4)是 BMI、FBG、TG 升高和 HDL-C 降低的危险因素(OR=1.28,1.83,1.46,1.51),但和工龄与 MetS 无统计学关联(P>0.05);工龄是 BMI 增高和 HDL-C 降低的危险因素(OR=1.28,1.42)。结论 本调查提示,Ahw(4)和MetS 与 WBC 有统计学关联,Ahw(4)和 MetS 可能会增加机体炎症风险;Ahw(4)和接振工龄与 MetS 组分有统计学关联,长期接触手传振动可能会改变脂质代谢水平。

Abstract: Objective To explore the association between hand-transmitted vibration exposure levels and leucocyte lineage markers and metabolic syndrome (MetS). Methods A survey was conducted on 1340 male workers exposed to handtransmitted vibration of automobile manufacturing industries in Guangzhou.The basic data such as age,length of vibration exposue and 4-hour energy-equivalent frequency-weighted vibrating acceleration [Ahw(4)]were collected, and the hematological indicators such as white blood cell(WBC),neutrophil (N),lymphocyte (L) and monocyte (M) were detected,then determine the presence of MetS based on such indicators as body mass index (BMI),blood pressure (BP),fasting blood glucose(FBG),triglycerides (TG) and high density lipoprotein cholesterol (HDL-C).The multivariate logistic regression analysis, Mann-Whitney U test and trend chi-square test were used to analyze the relationship between hand-transmitted vibration contact level and leucocyte lineage indicators and metabolic syndrome. Results The results showed that the median age,length of service,Ahw(4),WBC,N,L and M [M(P₂₅,P₇₅)] among the subjects exposed to hand-transmitted vibration were 27.00(24.00,31.00) years,3.83 (1.50,8.17) years,1.72 (1.35,2.03) m/s2,6.75 (5.81,7.84)×10⁹/L,3.75(3.13,4.61)×10⁹/L,2.19(1.84,2.65)×10⁹/L and 0.43(0.35,0.51)×10⁹/L,respectively;the prevalence of MetS was 12.24%(164/1340). Ahw(4) was a risk factor for increased WBC (OR=1.46),MetS was a risk factor for increase of WBC N,L and M (OR=3.40,3.13,2.64,2.02,respectively). Age was a risk factor for MetS (OR=1.71);Ahw(4) was a risk factor for increased BMI, FBG, TG and decreased HDL-C (OR=1.28,1.83,1.46,1.51,respectively),but it was not statistically associated with service length or MetS (P>0.05);and service length was a risk factor for increased BMI and decreased HDL-C (OR=1.28,1.42).Conclusion This survey suggested that Ahw (4) and MetS showed statistically association with white blood cells,and Ahw(4) and MetS may increase the risk of inflammation in the body;Ahw(4) and length of exposure to hand-transmitted vibration are statistically correlated with MetS components,and long term exposure to handtransmitted vibrations may alter lipid metabolism levels.