Paweł Gać

Relation between occupational exposure to lead, cadmium, arsenic and concentration of cystatin C.

UNLABELLED Lead, cadmium and arsenic represent well recognized toxic agents which in a specific manner disturb function of cardiovascular system. Cystatin C has been accepted to be a significant prognostic factor for cardiovascular diseases. The study aimed at defining relationship between occupational exposure to lead, cadmium and arsenic on one hand and concentration of cystatin C on the other. The studies were performed on 282 men occupationally exposed to lead, cadmium and arsenic. Among the tested individuals several groups of persons were distinguished: exposed exclusively to lead (Pb group), cadmium (Cd group), arsenic (As group), to lead and cadmium (Pb/Cd group), to lead and arsenic (Pb/As group) or to cadmium and arsenic (Cd/As group). In all the individuals serum concentration of cystatin C was estimated. Concentration of cystatin C was found to be significantly higher in Pb group than in Cd and As groups, also in Pb/Cd group higher than in Cd group and in Pb/As group than in As group. Positive linear correlations were established between Pb concentration in blood (Pb-B) and serum concentration of cystatin C (r=0.59; p<0.05) as well as between urinary concentration of As (As-U) and serum concentration of cystatin C (r=0.41; p<0.05). Regression analysis demonstrated that higher blood level of lead, higher urinary level of arsenic, more advanced age and higher body mass index represented independent risk factors of an increased serum concentration of cystatin C in the group of persons exposed to lead, cadmium and arsenic. CONCLUSIONS Higher blood level of lead and higher urinary level of arsenic represented independent risk factors of an increased serum concentration of cystatin C in the group of persons occupationally exposed to lead, cadmium and arsenic. Concentration of lead in blood was significantly influencing serum concentration of cystatin C. The highest mean serum concentration of cystatin C was detected in the group of foundry workers exposed simultaneously to lead and arsenic.

The relationship between occupational exposure to lead and manifestation of cardiovascular complications in persons with arterial hypertension

The chronic exposure to lead represents a risk factor of arterial hypertension development. Ambulatory blood pressure monitoring is the most prognostically reliable method of measuring of arterial blood pressure. The study is aimed at evaluating the relationship between occupational exposure to lead and manifestation of cardiovascular complications in patients with arterial hypertension. The studies included 73 men (mean age, 54.26±8.17 years) with arterial hypertension, treated with hypotensive drugs: group I-persons occupationally exposed to lead (n=35) and group II-individuals not exposed to lead (n=38). An analysis of results obtained during ambulatory blood pressure monitoring disclosed significantly higher values of mean systolic blood pressure, mean blood pressure, pulse pressure, and variability of systolic blood pressure in the group of hypertensive patients occupationally exposed to lead as compared to patients with arterial hypertension but not exposed to lead. The logistic regression showed that a more advanced age, higher concentration of blood zinc protoporphyrin, and a higher mean value of pulse pressure represented independent risk factors of left ventricular hypertrophy in the group of persons with arterial hypertension and chronically exposed to lead (OR(age)=1.11; OR(ZnPP)=1.32; OR(PP)=1,43; p<0.05). In view of the above data demonstration that occupational exposure to lead represents an independent risk factor of increased pulse pressure may be of key importance in the process of shaping general social awareness as to harmful effects of lead compounds on human health.

Ambulatory blood pressure monitoring and structural changes in carotid arteries in normotensive workers occupationally exposed to lead

Occupational exposure to lead may cause an increase in blood pressure. The aim of the study was to estimate the effect of occupational exposure to lead on selected parameters of ambulatory blood pressure monitoring (ABPM) and structural changes in carotid arteries. The study included 33 normotensive men occupationally exposed to lead and 39 unexposed men employed in administration of the foundry. All of the men underwent 24-hour ambulatory blood pressure monitoring and high-resolution B-mode ultrasonography to determine intima-media thickness (IMT). The group of men occupationally exposed to lead manifested significantly higher mean systolic blood pressure (MSBP), mean diastolic blood pressure (MDBP), mean blood pressure (MBP), pulse pressure (PP), variability of diastolic blood pressure (VDBP), and IMT than the unexposed group. The studied groups did not differ in mean values of variability of systolic blood pressure (VSBP). As compared to the unexposed group, in men exposed to lead, atherosclerotic plaques were significantly more common. In the group of persons exposed to lead the Pearson’s correlation coefficient analysis revealed significant linear positive correlations between MSBP and IMT, between lead level and the number of atherosclerotic plaques, and between lead level and PP. Multivariate stepwise regression analysis demonstrated that higher lead level in blood and higher triglyceride concentration in blood represent independent risk factors of an increased pulse pressure in the group of individuals occupationally exposed to lead. Occupational exposure to lead can be associated with increased blood pressure and accelerated progression of atherosclerosis.

Impaired endothelial function assessed by flow-mediated vasodilatation in workers occupationally exposed to lead

The aim of the study was to examine endothelial function in workers occupationally exposed to lead by means of FMD (flow-mediated dilatation). 44 men professionally exposed to lead, smelters and refiners, employees working at copper smelter and control group of 41 healthy men were enrolled into the study. Within the group of men occupationally exposed to lead the absolute increase in diameter after ischaemia (BAD, brachial artery diameter) and flow-mediated dilation were statistically less significant when compared to those of the control group. There was a negative linear correlation between FMD and lead concentration in copper smelters (r=-0.64). Multivariate backward step-wise regression analysis showed that blood lead concentration in copper smelters independently influenced the impairment of endothelial function expressed as decreased FMD value. In conclusion, results of our study suggest that endothelial function assessed by flow-mediated dilatation was impaired in workers occupationally exposed to lead.

The relationship between selected VDR, HFE and ALAD gene polymorphisms and several basic toxicological parameters among persons occupationally exposed to lead.

UNLABELLED The aim of this study was to find a relationship between polymorphisms of ALAD rs1805313, rs222808, rs1139488, VDR FokI and HFE C282Y and H63D and basic toxicological parameters (lead and ZnPP blood concentration) in people occupationally exposed to lead. We collected data of 101 workers (age 25-63 years) directly exposed to lead. The toxicological lab tests included blood lead, cadmium and ZnPP concentration measurement and arsenic urine concentration measurement. Workers were genotyped for ALAD (rs1805313, rs222808, rs1139488), HFE (C282Y, H63D) and VDR (FokI). Individuals with the lead exposure and coexisting F allel in the locus Fok-I of VDR gene are suspected of higher zinc protoporphyrins concentrations. Workers exposed to the lead with the Y allel in the locus C282Y of the HFE gene are predisposed to lower ZnPP levels and individuals with coexisting H allel in the locus H63D HFE gene are predisposed to lower Pb-B levels. The T allel in the locus rs1805313 of the ALAD gene determines lower Pb-B and ZnPP levels in lead-exposed individuals. The heterozigosity of the locus rs2228083 of the ALAD gene has a strong predilection to higher Pb-B levels. The carriage of the C allel in the locus rs1139488 of the ALAD gene might determine higher Pb-B levels and the heterozigosity of the locus rs1139488 of the ALAD gene might result in higher ZnPP levels. CONCLUSION The study revealed relationship between VDR, HFE and ALAD genes polymorphism and basic toxicological parameters in occupationally exposed workers.

Relationship between occupational exposure to lead and local arterial stiffness and left ventricular diastolic function in individuals with arterial hypertension

Relationship between occupational exposure to lead and frequency of complications in persons with arterial hypertension has been poorly investigated. This study aimed at evaluation of the relationship between occupational exposure to lead and manifestation of an increased local arterial stiffness and left ventricular diastolic dysfunction. The studies included 105 men (mean age: 44.47±9.12years) with arterial hypertension, treated with hypotensive drugs: group I - men occupationally exposed to lead (n=53), and group II - men not exposed to lead (n=52). In echocardiographic examination, the left ventricular diastolic dysfunction was diagnosed significantly more frequently in group I than in group II. In eTracking examination mean values of stiffness parameter (β), augmentation index (AI) and one-point pulse wave velocity (PWV-β) were significantly higher and mean values of arterial compliance (AC) were significantly lower in group I than in group II. The logistic regression showed that in the group of persons with arterial hypertension occupationally exposed to lead a more advanced age, higher blood lead concentration and higher mean values of augmentation index represent independent risk factors of left ventricular diastolic dysfunction. The multifactorial regression showed that amongst persons with arterial hypertension occupationally exposed to lead higher blood zinc protoporphyrin concentration, a more advanced age and higher value of body mass index (BMI) represent independent risk factors of an increased local arterial stiffness. In summary, we should note that in the group of persons with arterial hypertension occupationally exposed to lead the study has demonstrated a significantly more frequent manifestation of left ventricular diastolic dysfunction and an increase in local arterial stiffness.

Effects of cigarette smoke on Holter ECG recordings in patients with arterial hypertension. Part 1: Time domain parameters of heart rate variability.

UNLABELLED This report was intended to evaluate the effect of cigarette smoke on heart rate variability (HRV) in patients with arterial hypertension (AH). 223 individuals were qalified to the studies. The following groups of patients not suffering from other disease which may affect HRV were delineated: 1 - patients with AH (n=145); 2 - patients without AH (n=48). In group 1 the following patient groups were studied: A - active smokers (n=42), B - non-smokers exposed to cigarette smoke (n=30), C - non-smokers not exposed to tobacco smoke (n=34), D - former smokers (n=26). A time domain HRV analysis was carried out. Group 1 versus group 2 manifested significantly lower mean values of most parameters in the HRV time domain analysis. Subgroups A, B and D versus subgroup C also exhibited significantly lower mean values of most parameters in the HRV time domain analysis. Active cigarette smoking and passive exposure to tobacco smoke represented independent risk factors for a decreased HRV. CONCLUSIONS Active and passive exposure to cigarette smoke decreases HRV in hypertensive patients.

Heart Rate Variability and Heart Rate Turbulence in Patients with Hematologic Malignancies Subjected to High-Dose Chemotherapy in the Course of Hematopoietic Stem Cell Transplantation

In hematological malignancies, remissions and cures may be achieved by hematopoietic stem cell transplantation (HSCT) following high‐dose chemotherapy (HDC). Cardiotoxicity of such therapy has not yet been fully elucidated. Noninvasive approaches allowing to evaluate an autonomic control of the heart function include analyses of both heart rate variability (HRV) and heart rate turbulence (HRT).

The aortic mechanical properties in patients with the essential hypertension environmentally exposed to cigaret smoke

Abstract Context: The impairment of the aortic mechanical features constitutes the independent predictor of all-cause and cardiovascular mortality and morbidity. Objective: The purpose of the present research has been the determination of the influence of the environmental exposure to cigaret smoke on the aortic mechanical properties, namely, the stiffness and elasticity of aorta, in patients with essential hypertension. Materials and methods: The research has covered 128 people with essential hypertension: 64 nonsmokers, declaring the environmental exposure to cigaret smoke (group A) and 64 nonsmokers declaring the lack of environmental exposure to cigaret smoke selected on the case to case basis (group B). Aortic mechanical properties have been evaluated on the basis of the parameters: aortic stiffness index (AoSI), aortic strain (AoS) and aortic distensibility (AoD). Results: In group A, the average values of AoSI were significantly higher, and the average values of AoS and AoD significantly lower than in group B. It has been documented that the older age and environmental exposure to cigaret smoke form independent risk factors of increasing the aortic stiffness expressed by higher values of AoSI, whereas the older age, higher pulse pressure (PP) values and environmental exposure to cigaret smoke – independent risk factors of aortic elasticity reduction expressed for the age and “passive smoking” by lower values of AoS and AoD and for PP – lower values of AoD. Conclusion: In patients with essential hypertension, the environmental exposure to cigaret smoke seems to result in impairment of the aortic mechanical properties.

Interaction between blood selenium concentration and a levels of oxidative stress and antioxidative capacity in healthy children

The study aimed at defining the relationship between blood selenium concentration (Se-B) and levels of oxidative stress and antioxidative capacity in healthy children. The studies were conducted on 337 children (mean age: 8.53±1.92 years). The groups of individuals with Se-B <1st quartile (group I, Se-B<70μg/L), with Se-B fitting the range of 1st quartile and median (group II, Se-B: 70-76.9μg/L), with Se-B between the median and 3rd quartile (group III, Se-B: 77-83.9μg/L) and those with Se-B above the 3rd quartile (group IV, Se-B≥84μg/L) were distinguished. Level of oxidative stress was defined using determination of urine malonyldialdehyde concentration (MDA) and urine 8-hydroxy-2-deoxyguanosine concentration (8-OHdg). Urine total antioxidant status (TAS) was determined. In group IV TAS was significantly higher than in groups I-III. A positive correlation was detected between Se-B and TAS. In healthy children an appropriately high Se-B seems to ensure higher total antioxidative status.