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

作　　者：梁灿坤 汤永翔 梁锦梅 李燕茹[1] 宋慧东 王致[1] LIANG Cankun;TANG Yongxiang;LIANG Jinmei;LI Yanru;SONG Huidong;WANG Zhi(Occupational Health Monitoring Center,Guangzhou Municipal Occupational Disease Prevention and Treatment Hospital,Guangzhou,Guangdong 510620,China)

机构地区：[1]广州市职业病防治院职业健康监护中心,广东广州510620

出　　处：《中国工业医学杂志》2024年第5期447-451,486,共6页Chinese Journal of Industrial Medicine

基　　金：广州市市校(院)企联合资助项目(2024A03J0502);广州市校(院)企联合资助专题(广州市职业环境与健康重点实验室)(编号:2023A03J0502);广州市科学技术局重点研发计划项目(编号:202206010061)。

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、4 h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χ^(2)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)×10^(9)/L、3.75(3.13,4.61)×10^(9)/L、2.19(1.84,2.65)×10^(9)/L和0.43(0.35,0.51)×10^(9)/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。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/s 2,6.75(5.81,7.84)×10^(9)/L,3.75(3.13,4.61)×10^(9)/L,2.19(1.84,2.65)×10^(9)/L and 0.43(0.35,0.51)×10^(9)/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-trans

关 键 词：手传振动 白细胞 代谢综合征(MetS) 炎症风险 关联性 

分 类 号：R135.4[医药卫生—劳动卫生]