rfhealthЗдравоохранение Российской ФедерацииHealth care of the Russian Federation0044-197X2412-0723Federal Scientific Center of Hygiene named after F.F. Erisman10.47470/0044-197X-2023-67-6-549-555onbhwurfhealth-1433Research ArticleАКТУАЛЬНЫЕ ВОПРОСЫ ГИГИЕНЫTOPICAL ISSUES OF HYGIENEСтруктурно-функциональные изменения артерий у женщин молодого возраста, проживающих в промышленном регионе Крайнего Севера в условиях аэрогенного влияния химических техногенных факторовStructural and functional changes in the arteries in young women living in the industrial region of the Far North under the aerogenic impact of chemical technogenic factorshttps://orcid.org/0000-0003-0539-569XНосовАлександр ЕвгеньевичNosovAlexander E.

Канд. мед. наук, зав. отделением лучевой и функциональной диагностики ФБУН «Федеральный научный центр медико-профилактических технологий управления рисками здоровью населения», 614045, Пермь.

e-mail: nosov@fcrisk.ru

MD, PhD, Head of the Department of Radiation and Functional Diagnostics, Federal scientific center for medical and preventive health risk management technologies, Perm, 614045, Russian Federation.

e-mail: nosov@fcrisk.ru

nosov@fcrisk.ruhttps://orcid.org/0000-0002-9916-5491УстиноваОльга Ю.UstinovaOlga Yu.noemail@neicon.ruФедеральный научный центр медико-профилактических технологий управления рисками здоровью населенияРоссияFederal Scientific Center for Medical and Preventive Health Risk Management TechnologiesRussian FederationФедеральный научный центр медико-профилактических технологий управления рисками здоровью населения; ФГАОУ ВО «Пермский государственный национальный исследовательский университет»РоссияFederal Scientific Center for Medical and Preventive Health Risk Management Technologies; Perm State National Research UniversityRussian Federation202325122023676549555Copyright © Носов А.Е., Устинова О.Ю., 20232023Носов А.Е., Устинова О.Ю.Nosov A.E., Ustinova O.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rfhealth.ru/jour/article/view/1433Введение

Введение. Загрязнение атмосферного воздуха — значимый фактор риска сердечно-сосудистых заболеваний.

Цель работы

Цель работы: изучить структурно-функциональные характеристики сонных артерий у женщин, проживающих на Крайнем Севере в условиях воздействия металлов и взвешенных твёрдых частиц.

Материал и методы

Материал и методы. Группа наблюдения — 78 женщин, проживающих на Крайнем Севере в зоне влия-ния металлургических предприятий; группа сравнения — 20 женщин, проживающих в аналогичных климатических условиях. Методом дуплексного сканирования брахиоцефальных артерий оценивались комплекс интима–медиа (КИМ), эластические модули Петерсона (Ep) и Юнга (Ym). Исследовали причинно-следственные связи сосудистых нарушений с концентрацией в крови никеля, меди и хрома.

Результаты

Результаты. Толщина КИМ в группе наблюдения была больше, чем в группе сравнения (0,55 (95% ДИ 0,49–0,62) мм против 0,46 (95% ДИ 0,45–0,5) мм; p < 0,0001). В группе наблюдения Ер превышал показатели группы сравнения в 1,84 раза, Ym — в 1,52 раза. Относительный риск увеличения КИМ достигал 2,1 (95% ДИ 1,1–4,3). Выявлено повышение вероятности утолщения КИМ при увеличении концентрации хрома в крови (R2 = 0,10; p = 0,003), возрастание значений Ep меди (R2 = 0,15; p = 0,002) и хрома (R2 = 0,19; р = 0,0002), значений Ym меди (R2 = 0,39; р < 0,0001).

Ограничения исследования

Ограничения исследования: исследование не включало женщин среднего и пожилого возраста, мужчин и население иных территорий, кроме Крайнего Севера.

Выводы

Выводы. У молодых женщин, проживающих в условиях ингаляционного воздействия никеля, хрома, меди и взвешенных твёрдых частиц, наблюдается интенсификация атеросклеротического и артериосклеротического процессов, проявляющихся увеличением КИМ, атеросклеротическими бляшками, увеличением жёсткости общей сонной артерии. Установлена причинно-следственная связь концентрации в крови меди и хрома с вероятностью увеличения КИМ, Ер и Ym. Выявленные изменения общей сонной артерии позволяют отнести молодых женщин, проживающих на территории экологического неблагополучия, к более высокой категории сердечно-сосудистого риска.

Соблюдение этических стандартов. Программа исследования была одобрена Этическим комитетом ФБУН «Федеральный научный центр медико-профилактических технологий управления рисками здоровью населения» (протокол № 3 от 26.01.2022). Все пациенты были проинформированы о цели проведения исследования и дали добровольное согласие.

Участие авторов

Участие авторов:Носов А.Е. — сбор материала, статистическая обработка, написание текста;Устинова О.Ю. — концепция исследования, редактирование.Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Исследование не имело спонсорской поддержки.

Конфликт интересов

Конфликт интересов. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов в связи с публикацией данной статьи.

Поступила 22

Поступила 22.08.2023Принята в печать 11.10.2023Опубликована 23.12.2023

Ambient air pollution is a significant risk factor for cardiovascular diseases.

Purpose of the work

Purpose of the work: to study the structural and functional characteristics of the carotid arteries in women living in the Far North under conditions of exposure to metals and particulate matter.

Materials and methods

Materials and methods. Observation group consisted of seventy eight women living in the Far North in the zone of impact of metallurgical enterprises; comparison group included 20 women living in similar climatic conditions. Duplex scanning of the brachiocephalic arteries was used to evaluate the intima-media thickness (IMT), Peterson’s (Ep) and Young’s (Ym) elastic modules. The cause-and-effect relationships of vascular disorders with blood concentrations of nickel, copper, and chromium were studied.

Results

Results. In the observation group the IMT thickness was greater than in the comparison group (0.55 (0.49;0.62) mm versus 0.46 (0.45;0.5) mm, p < 0.0001). In the observation group, Ep was 1.84 times and Ym was 1.52 times higher than the indicators in the comparison group. The relative risk of increasing IMT reached 2.1 (95% CI 1.1–4.3). An increase in the probability of IMT thickening was revealed with an increase in the blood chromium concentration (R2 = 0.10; p = 0.003), an increase in the values of Ep — copper (R2 = 0.15; p = 0.002) and chromium (R2 = 0.19; p = 0.0002), and Ym values — copper (R2 = 0.39; p < 0.0001).

Limitations of the study

Limitations of the study. This study did not include middle-aged and elderly women, men, and did not include the population of territories other than the Far North.

Conclusions

Conclusions. Young women living in conditions of inhalation exposure to nickel, chromium, copper, and particulate matter experience an intensification of atherosclerotic and arteriosclerotic processes, manifested by an increase in IMT, atherosclerotic plaques, and an increase in the stiffness of the common carotid artery (CCA). A cause-and-effect relationship between the copper and chromium blood concentration and the probability of an increase in IMT, Ep and Ym has been established. The identified changes in the CCA make it possible to classify young women living in environmentally unfavourable areas as a higher category of cardiovascular risk.

Compliance with ethical standards. The study program was approved by the ethics committee of the FBSI «Federal scientific center for medical and preventive health risk management technologies» (protocol No. 3 dated January 26, 2022). All patients were informed about the purpose of the study, and voluntary informed consent was obtained.

Contribution of the authors:Nosov A.E. — collection of material, statistical processing, text writing;Ustinova O.Yu. — concept, editing.All authors are responsible for the integrity of all parts of the manuscript and approval of its final version.

Acknowledgment

Acknowledgment. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: August 22, 2023Accepted: October 11, 2023Published: December 23, 2023

жёсткость артерийаэрогенные поллютантыдуплексное сканированиеобщая сонная артерияникельмедьхромвзвешенные твёрдые частицысердечно-сосудистый рискarterial stiffnessairborne pollutantsduplex scanningcommon carotid arterynickelcopperchromiumparticulate mattercardiovascular riskReferencesRajagopalan S., Al-Kindi S.G., Brook R.D. Air pollution and cardiovascular disease: JACC state-of-the-art review. J. Am. Coll. Cardiol. 2018; 72(17): 2054–70. https://doi.org/10.1016/j.jacc.2018.07.099Rajagopalan S., Al-Kindi S.G., Brook R.D. Air pollution and cardiovascular disease: JACC state-of-the-art review. J. Am. Coll. Cardiol. 2018; 72(17): 2054–70. https://doi.org/10.1016/j.jacc.2018.07.099Edlund K.K., Sallsten G., Molnár P., Andersson E.M., Ögren M., Segersson D., et al. Long-term exposure to air pollution, coronary artery calcification, and carotid artery plaques in the population-based Swedish SCAPIS Gothenburg cohort. Environ. Res. 2022; 214(Pt. 2): 113926. https://doi.org/10.1016/j.envres.2022.113926Edlund K.K., Sallsten G., Molnár P., Andersson E.M., Ögren M., Segersson D., et al. Long-term exposure to air pollution, coronary artery calcification, and carotid artery plaques in the population-based Swedish SCAPIS Gothenburg cohort. Environ. Res. 2022; 214(Pt. 2): 113926. https://doi.org/10.1016/j.envres.2022.113926Al-Kindi S.G., Brook R.D., Biswal S., Rajagopalan S. Environmental determinants of cardiovascular disease: lessons learned from air pollution. Nat. Rev. Cardiol. 2020; 17(10): 656–72. https://doi.org/10.1038/s41569-020-0371-2Al-Kindi S.G., Brook R.D., Biswal S., Rajagopalan S. Environmental determinants of cardiovascular disease: lessons learned from air pollution. Nat. Rev. Cardiol. 2020; 17(10): 656–72. https://doi.org/10.1038/s41569-020-0371-2Münzel T., Sørensen M., Gori T., Schmidt F.P., Rao X., Brook J., et al. Environmental stressors and cardio-metabolic disease: part I-epidemiologic evidence supporting a role for noise and air pollution and effects of mitigation strategies. Eur. Heart J. 2017; 38(8): 550–6. https://doi.org/10.1093/eurheartj/ehw269Münzel T., Sørensen M., Gori T., Schmidt F.P., Rao X., Brook J., et al. Environmental stressors and cardio-metabolic disease: part I-epidemiologic evidence supporting a role for noise and air pollution and effects of mitigation strategies. Eur. Heart J. 2017; 38(8): 550–6. https://doi.org/10.1093/eurheartj/ehw269Münzel T., Sørensen M., Gori T., Schmidt F.P., Rao X., Brook J., et al. Environmental stressors and cardio-metabolic disease: part II – mechanistic insights. Eur. Heart J. 2017; 38(8): 557–64. https://doi.org/10.1093/eurheartj/ehw294Münzel T., Sørensen M., Gori T., Schmidt F.P., Rao X., Brook J., et al. Environmental stressors and cardio-metabolic disease: part II – mechanistic insights. Eur. Heart J. 2017; 38(8): 557–64. https://doi.org/10.1093/eurheartj/ehw294Münzel T., Gori Т., Al-Kindi S., Deanfield J., Lelieveld L., Daiber A., et al. Effects of gaseous and solid constituents of air pollution on endothelial function. Eur. Heart J. 2018; 39(38): 3543–50. https://doi.org/10.1093/eurheartj/ehy481Münzel T., Gori Т., Al-Kindi S., Deanfield J., Lelieveld L., Daiber A., et al. Effects of gaseous and solid constituents of air pollution on endothelial function. Eur. Heart J. 2018; 39(38): 3543–50. https://doi.org/10.1093/eurheartj/ehy481Kelly F.J., Fussell J.C. Air pollution and public health: emerging hazards and improved understanding of risk. Environ. Geochem. Health. 2015; 37(4): 631–49. https://doi.org/10.1007/s10653-015-9720-1Kelly F.J., Fussell J.C. Air pollution and public health: emerging hazards and improved understanding of risk. Environ. Geochem. Health. 2015; 37(4): 631–49. https://doi.org/10.1007/s10653-015-9720-1Май И.В., Клейн С.В., Балашов С.Ю., Вековшинина С.А., Маркович Н.И. Опыт обоснования и результаты мониторинга приоритетных веществ, загрязняющих атмосферный воздух г. Норильска (в рамках федерального проекта «Чистый воздух»). Здоровье населения и среда обитания – ЗНиСО. 2022; 30(12): 45–52. https://doi.org/10.35627/2219-5238/2022-30-12-45-52 https://elibrary.ru/mkzzzqMay I.V., Kleyn S.V., Balashov S.Yu., Vekovshinina S.A., Markovich N.I. Experience of substantiation and results of monitoring of priority air pollutants in Norilsk within the Federal Clean Air Project. Zdorov’e naseleniya i sreda obitaniya – ZNiSO. 2022; 30(12): 45–52. https://doi.org/10.35627/2219-5238/2022-30-12-45-52 https://elibrary.ru/mkzzzq (in Russian)Touboul P.J., Hennerici M.G., Meairs S., Adams H., Amarenco P., Bornstein N., et al. Mannheim carotid intima-media thickness and plaque consensus (2004-2006-2011). An update on behalf of the advisory board of the 3rd, 4th and 5th watching the risk symposia, at the 13th, 15th and 20th European Stroke Conferences, Mannheim, Germany, 2004, Brussels, Belgium, 2006, and Hamburg, Germany, 2011. Cerebrovasc. Dis. 2012; 34(4): 290–6. https://doi.org/10.1159/000343145Touboul P.J., Hennerici M.G., Meairs S., Adams H., Amarenco P., Bornstein N., et al. Mannheim carotid intima-media thickness and plaque consensus (2004-2006-2011). An update on behalf of the advisory board of the 3rd, 4th and 5th watching the risk symposia, at the 13th, 15th and 20th European Stroke Conferences, Mannheim, Germany, 2004, Brussels, Belgium, 2006, and Hamburg, Germany, 2011. Cerebrovasc. Dis. 2012; 34(4): 290–6. https://doi.org/10.1159/000343145Cohen A.J., Brauer M., Burnett R., Anderson H.R., Frostad J., Estep K., et al. Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015. Lancet. 2017; 389(10082): 1907–18. https://doi.org/10.1016/S0140-6736(17)30505-6Cohen A.J., Brauer M., Burnett R., Anderson H.R., Frostad J., Estep K., et al. Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015. Lancet. 2017; 389(10082): 1907–18. https://doi.org/10.1016/S0140-6736(17)30505-6Langrish J.P., Fuller R., Acosta N.J.R., Adeyi O., Arnold R., Basu N.N., et al. The Lancet Commission on pollution and health. Lancet. 2018; 391(10119): 462–512. https://doi.org/10.1016/S0140-6736(17)32345-0Langrish J.P., Fuller R., Acosta N.J.R., Adeyi O., Arnold R., Basu N.N., et al. The Lancet Commission on pollution and health. Lancet. 2018; 391(10119): 462–512. https://doi.org/10.1016/S0140-6736(17)32345-0Langrish J.P., Unosson J., Bosson J., Barath S., Muala A., Blackwell S., et al. Altered nitric oxide bioavailability contributes to diesel exhaust inhalation-induced cardiovascular dysfunction in man. J. Am. Heart Assoc. 2013; 2(1): e004309. https://doi.org/10.1161/JAHA.112.004309Langrish J.P., Unosson J., Bosson J., Barath S., Muala A., Blackwell S., et al. Altered nitric oxide bioavailability contributes to diesel exhaust inhalation-induced cardiovascular dysfunction in man. J. Am. Heart Assoc. 2013; 2(1): e004309. https://doi.org/10.1161/JAHA.112.004309Byrd J.B., Morishita M., Bard R.L., Das R., Wang L., Sun Z., et al. Acute increase in blood pressure during inhalation of coarse particulate matter air pollution from an urban location. J. Am. Soc. Hypertens. 2016; 10(2): 133–9.e4. https://doi.org/10.1016/j.jash.2015.11.015Byrd J.B., Morishita M., Bard R.L., Das R., Wang L., Sun Z., et al. Acute increase in blood pressure during inhalation of coarse particulate matter air pollution from an urban location. J. Am. Soc. Hypertens. 2016; 10(2): 133–9.e4. https://doi.org/10.1016/j.jash.2015.11.015Kaufman J.D., Adar S.D., Barr R.G., Budoff M., Burke J.L., Curl C.L., et al. Association between air pollution and coronary artery calcification within six metropolitan areas in the USA (the Multi-Ethnic Study of Atherosclerosis and Air Pollution): a longitudinal cohort study. Lancet. 2016; 388(10045): 696–704. https://doi.org/10.1016/S0140-6736(16)00378-0Kaufman J.D., Adar S.D., Barr R.G., Budoff M., Burke J.L., Curl C.L., et al. Association between air pollution and coronary artery calcification within six metropolitan areas in the USA (the Multi-Ethnic Study of Atherosclerosis and Air Pollution): a longitudinal cohort study. Lancet. 2016; 388(10045): 696–704. https://doi.org/10.1016/S0140-6736(16)00378-0Wang F., Jia X., Wang X., Zhao Y., Hao W. Particulate matter and atherosclerosis: a bibliometric analysis of original research articles published in 1973–2014. BMC Public Health. 2016; 16: 348. https://doi.org/10.1186/s12889-016-3015-zWang F., Jia X., Wang X., Zhao Y., Hao W. Particulate matter and atherosclerosis: a bibliometric analysis of original research articles published in 1973–2014. BMC Public Health. 2016; 16: 348. https://doi.org/10.1186/s12889-016-3015-zProvost E.B., Madhloum N., Panis L.I., De Boever P., Nawrot T.S. Carotid intima-media thickness, a marker of subclinical atherosclerosis, and particulate air pollution exposure: the meta-analytical evidence. PLoS One. 2015; 10(5): e0127014. https://doi.org/10.1371/journal.pone.0127014Provost E.B., Madhloum N., Panis L.I., De Boever P., Nawrot T.S. Carotid intima-media thickness, a marker of subclinical atherosclerosis, and particulate air pollution exposure: the meta-analytical evidence. PLoS One. 2015; 10(5): e0127014. https://doi.org/10.1371/journal.pone.0127014Zanoli L., Lentini P., Granata F., Gaudio A., Fatuzzo P., Serafino L., et al. A systematic review of arterial stiffness, wave reflection and air pollution. Mol. Med. Rep. 2017; 15(5): 3425–9. https://doi.org/10.3892/mmr.2017.6392Zanoli L., Lentini P., Granata F., Gaudio A., Fatuzzo P., Serafino L., et al. A systematic review of arterial stiffness, wave reflection and air pollution. Mol. Med. Rep. 2017; 15(5): 3425–9. https://doi.org/10.3892/mmr.2017.6392Chowdhury R., Ramond A., O’Keeffe L.M., Shahzad S., Kunutsor S.K., Muka T., et al. Environmental toxic metal contaminants and risk of cardiovascular disease: systematic review and meta-analysis. BMJ. 2018; 362: k3310. https://doi.org/10.1136/bmj.k3310Chowdhury R., Ramond A., O’Keeffe L.M., Shahzad S., Kunutsor S.K., Muka T., et al. Environmental toxic metal contaminants and risk of cardiovascular disease: systematic review and meta-analysis. BMJ. 2018; 362: k3310. https://doi.org/10.1136/bmj.k3310Kang Y.J. Copper and homocysteine in cardiovascular diseases. Pharmacol. Ther. 2011; 129(3): 321–31. https://doi.org/10.1016/j.pharmthera.2010.11.004Kang Y.J. Copper and homocysteine in cardiovascular diseases. Pharmacol. Ther. 2011; 129(3): 321–31. https://doi.org/10.1016/j.pharmthera.2010.11.004Мамырбаев А.А. Токсикология хрома и его соединений. Актобе; 2012.Mamyrbaev A.A. Toxicology of Chromium and Its Compounds [Toksikologiya khroma i ego soedineniy]. Aktobe; 2012. (in Russian)Яковлев Н.А. Психофизиологические исследования в ранней диагностике изменений нервной системы при воздействии на организм соединений хрома. Гигиена труда и профзаболевания. 1982; (7): 33–6.Yakovlev N.A. Psychophysiological studies in the early diagnosis of changes in the nervous system when exposed to chromium compounds on the body. Gigiena truda i profzabolevaniya. 1982; (7): 33–6. (in Russian)Balali-Mood M., Naseri K., Tahergorabi Z., Khazdair M.R., Sadeghi M. Toxic mechanisms of five heavy metals: mercury, lead, chromium, cadmium, and arsenic. Front. Pharmacol. 2021; 12: 643972. https://doi.org/ 10.3389/fphar.2021.643972Balali-Mood M., Naseri K., Tahergorabi Z., Khazdair M.R., Sadeghi M. Toxic mechanisms of five heavy metals: mercury, lead, chromium, cadmium, and arsenic. Front. Pharmacol. 2021; 12: 643972. https://doi.org/ 10.3389/fphar.2021.643972Lippmann M., Ito K., Hwang J.S., Maciejczyk P., Chen L.C. Cardiovascular effects of nickel in ambient air. Environ. Health Perspect. 2006; 114(11): 1662–9. https://doi.org/10.1289/ehp.9150Lippmann M., Ito K., Hwang J.S., Maciejczyk P., Chen L.C. Cardiovascular effects of nickel in ambient air. Environ. Health Perspect. 2006; 114(11): 1662–9. https://doi.org/10.1289/ehp.9150Navas-Acien A., Martinez-Morata I., Hilpert M., Rule A., Shimbo D., LoIacono N.J. Early cardiovascular risk in E-cigarette users: the potential role of metals. Curr. Environ. Health Rep. 2020; 7(4): 353–61. https://doi.org/10.1007/s40572-020-00297-yNavas-Acien A., Martinez-Morata I., Hilpert M., Rule A., Shimbo D., LoIacono N.J. Early cardiovascular risk in E-cigarette users: the potential role of metals. Curr. Environ. Health Rep. 2020; 7(4): 353–61. https://doi.org/10.1007/s40572-020-00297-yLamas G.A., Navas-Acien A., Mark D.B., Lee K.L. Heavy metals, cardiovascular disease, and the unexpected benefits of chelation therapy. J. Am. Coll. Cardiol. 2016; 67(20): 2411–8. https://doi.org/10.1016/j.jacc.2016.02.066Lamas G.A., Navas-Acien A., Mark D.B., Lee K.L. Heavy metals, cardiovascular disease, and the unexpected benefits of chelation therapy. J. Am. Coll. Cardiol. 2016; 67(20): 2411–8. https://doi.org/10.1016/j.jacc.2016.02.066

The authors declare that there are no conflicts of interest present.