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[背景]饮用水砷暴露与心脏疾病相关联,然而内在的机制尚不明确。[目的]评估饮用水砷暴露史与心率校正的QT(QTc)、PR和QRS间期延长之间的关联。[方法]从砷对健康影响的纵向研究中选择1715名基线入组的参加者进行研究。评估2005—2010年间,井水中的砷暴露和尿液样本与心电图(ECG)参数的关联,自基线开始平均跟踪了5.9年。[结果]QTc延长的定义为男性QTc≥450ms,女性≥460ms。井水中砷每增加1-SD(108.7μg/L),QTc延长的调整比值比(OR)为1.17(95%CI:1.01～1.35)。正相关仅限于女性,基线时井水和尿液中的砷每增加1-SD,女性调整后ORs分别比为1.24(95%CI:1.05～1.47)和1.24(95%CI:1.01～1.53);与之相比,男性调整后ORs分别为0.99(95%CI:0.73～1.33)和0.86(95%CI:0.49～1.51)。基线时井水砷或尿砷与女性或男性的PR或QRS间期延长之间无明显的关联。[结论]长期饮用水砷暴露(平均95μg/L,全距为0.1～790μg/L)与女性之后的QT间期延长相关联。在今后的纵向研究中,ECG的反复测量对于评估暴露变化的影响将具有重要意义。
[Background] Arsenic exposure to drinking water is associated with heart disease, yet the underlying mechanism is not yet known. [Objective] To evaluate the association between drinking water arsenic exposure history and heart rate corrected QT (QTc), PR, and QRS interval prolongation. [Methods] A total of 1715 participants who participated in the baseline study were selected from a longitudinal study of the health effects of arsenic. To assess the correlation between arsenic exposure in well water and urinalysis samples and ECG parameters between 2005 and 2010, the average follow-up was 5.9 years from baseline. [Results] The definition of QTc prolongation was QTc≥450ms in males and ≥460ms in females. Adjusted odds ratio (OR) for QTc prolongation was 1.17 (95% CI: 1.01 to 1.35) for each 1-SD increase in well water (108.7 μg / L). The positive correlation was limited to women only. For women with a 1-SD increase in well water and urine at baseline, adjusted ORs were 1.24 (95% CI: 1.05-1.47) and 1.24 (95% CI: 1.01-1.53) Compared with 0.99 (95% CI: 0.73-1.33) and 0.86 (95% CI: 0.49-1.51) in men, respectively. There was no significant association between well water arsenic or urinary arsenic and PR or QRS prolongation in women or men at baseline. [Conclusion] Long-term drinking water arsenic exposure (average 95μg / L, the full range of 0.1 ~ 790μg / L) is associated with prolonged QT interval after the female. In future longitudinal studies, repeated measures of ECG will be of great importance to assess the impact of changes in exposure.