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ECG conduction disturbances and ryanodine receptor expression levels in occupational lead exposure workers
Jie Xie1,2, Guihua Du1,2, Yuanyuan Zhang1,2
1Department of Occupational Health and Toxicology, School of Public Health, Nanchang University, Nanchang, China.
Insights
Occupational lead exposure is linked to cardiac conduction abnormalities like high QRS voltage. This may be due to reduced RyR1 expression, impacting cardiac function in lead-poisoned workers.
Area of Science:
- Cardiovascular toxicology
- Occupational health
- Cardiac electrophysiology
Background:
- Occupational lead (Pb) exposure is a known risk factor for cardiovascular disease.
- Evidence linking lead exposure to cardiac conduction abnormalities and the role of ryanodine receptors (RyRs) is limited.
- RyRs are crucial for cardiac excitation-contraction coupling, a process implicated in cardiovascular pathologies.
Purpose of the Study:
- To investigate the association between occupational lead exposure and electrocardiogram (ECG) conduction abnormalities.
- To explore the role of ryanodine receptors (RyRs) in lead-induced ECG abnormalities.
Main Methods:
- A study of 529 lead smelter workers, measuring blood lead (BPb), zinc protoporphyrin (ZPP), ECG parameters, and RyR expression.
- Workers were stratified into three groups based on BPb levels: not elevated, elevated, and lead poisoning.
- Descriptive and multivariable analyses were employed to assess relationships.
Main Results:
- The lead poisoning group exhibited a higher incidence of high QRS voltage and lower RyR1 gene expression compared to the non-elevated group.
- High QRS voltage was positively associated with BPb levels and inversely associated with RyR1 expression.
- The QTc interval showed a positive association with ZPP levels.
Conclusions:
- Occupational lead exposure is associated with adverse ECG outcomes, specifically high QRS voltage.
- Decreased levels of RyR1 may contribute to lead-induced ECG abnormalities.
- These findings highlight potential mechanisms linking lead exposure to cardiac dysfunction.
Objectives:
A significant number of researches have evidenced that occupational lead (Pb) exposure increased risks of cardiovascular disease. However, evidences about the potential effects of Pb on the cardiac conduction system are sparse and inconclusive. Besides, ryanodine receptors (RyRs) induced dysfunction of cardiac excitation contraction coupling which is considered to be one of the mechanisms in cardiovascular diseases. Therefore, we examined the association between occupational Pb exposure and ECG conduction abnormalities, as well as RyRs in Pb-induced ECG abnormalities.
Methods:
We investigated 529 Pb smelter workers, and measured blood lead (BPb), zinc protoporphyrin (ZPP), ECG outcomes and RyR expression levels. Based on BPb levels, the workers were divided into three groups: the BPb not elevated group, the BPb elevated group and the Pb poisoning group. Descriptive and multivariable analyses were performed.
Results:
Compared with the BPb not elevated group, the Pb poisoning group had a higher incidence of high QRS voltage, and a lower level of RyR1 gene expression (p<0.05). Further unconditional multivariable logistic regression analyses showed that high QRS voltage was positively related to BPb (OR=1.045, 95% CI 1.014 to 1.078) and inversely associated with RyR1 expression (OR=0.042, 95% CI 0.002 to 0.980) after adjusting for potential confounders. In addition, multiple linear regression analyses showed that the QTc interval was positively associated with ZPP (β=0.299, 95% CI 0.130 to 0.468) after adjusting for potential confounders.
Conclusions:
Our study provided evidences that occupational exposure to Pb may be associated with worse ECG outcomes (high QRS voltage), which might be related to decreased levels of RyR1.
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