| Objectives To explore the influence of noise,Angiotensinogen(AGT)gene polymorphism and their interaction on the incidence of Essential hypertension(EH)of workers in an iron and steel enterprise,so as to screen out the sensitive population.It can be used to predict and assess the EH risk of workers exposed to noise,so as to avoid individuals with serious noise hazards from entering the work,thus providing a theoretical basis for the prevention and control of EH of workers in iron and steel enterprises.Methods A total of 725 employees who participated in the annual physical examination in a steel enterprise in Tangshan in 2014 were selected as the research subjects,including224 cases in EH group and 501 cases in control group.The basic personal information,career history,family history and living habits of the employees were collected through questionnaire survey.Physical examination measures such as height,weight,blood pressure were collected and venous blood were collected.Serum,blood sugar,blood lipid and so on were detected by biochemical indexes.The employees’exposure to high temperature,noise and other environmental factors at the work site were detected and collected.DNA was extracted and purified by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).The polymorphisms of A-6G,A-20C and T174M of AGT gene were detected by PCR-RFLP,and the differences in genotype and allele frequency of each site of AGT gene in EH group and control group were compared.Univariate analysis,binary multivariate Logistic regression,cross generation analysis and generalized multifactor dimensionality reduction(GMDR)were used to analyze the interaction between AGT gene polymorphism and noise on the pathogenesis of EH.Results 1 All AGT sites conformed to the hardy-weinberg equilibrium(HWE)test.2Univariate analysis showed that average age,average working age,noise exposure ratio,average cumulative noise exposure ratio,body mass index(BMI),proportion of family history of hypertension,salt intake ratio,total cholesterol(TC),triglyceride(TG)and other factors in EH group were higher than those in the control group(P<0.05).The proportion of college or above,the proportion of regular vegetable intake and the proportion of regular physical exercise in EH group were lower than those in control group(P<0.05).In univariate analysis of association between AGT gene polymorphism and EH,it was found that the GG genotype frequency of A-6G locus in EH group(15.6%)was higher than that of control group(7.4%),and the G allele frequency(31.9%)was higher than that of control group(25.9%).The frequency of MM genotype(3.2%)at T174M locus was higher than that in control group(1.1%),and the frequency of M allele(19.2%)was higher than that in control group(13.3%),with statistical significance(P<0.05).3Binary multivariate Logistic regression analysis showed that compared with BMI<24kg/m~2,the risk of EH with BMI≥24 and<28 kg/m~2 was 2.785 times(95%CI:1.778～4.363),and the risk of EH with BMI≥28 kg/m~2 was 7.643 times(95%CI:4.465～13.086).Compared with TG≤1.7 mmol/L,the risk of developing EH with TG>1.7 mmol/L was1.840 times(95%CI:1.258～2.692).The risk of EH was 1.600 times that of non-noise exposed subjects(95%CI:1.093～2.342).The risk of developing EH increased by 1.086times(95%CI:1.031～1.144)for each additional year of age.The risk of EH with salt intake was 1.523 times(95%CI:1.025～2.262)compared with that with salt intake.The risk of developing EH was 0.569 times(95%CI:0.356～0.909)for those with college education or above.The risk of developing EH with a family history of hypertension was1.849 times(95%CI:1.265～2.702)compared with that without a family history of hypertension.The risk of frequent EH was 0.611 times lower with vegetable intake(95%CI:0.390～0.957);The risk of EH in steel workers with GG genotype in A-6G site of AGT gene was 2.454 times higher than that of AA genotype(95%CI:1.346～4.474).The risk of developing EH of steel workers with TM genotype in T174M locus was 1.857 times that of TT genotype(95%CI:1.230～2.803),and the risk of developing EH of steel workers with MM genotype was 4.110 times that of TT genotype(95%CI:1.051～16.077).4 There was A multiplicative interaction between A-6G site and T174M site of AGT gene(P<0.05).Compared with those who carried both A-6G AA genotype and T174M TT genotype,the risk of those who carried A-6G GG genotype and T174M MM genotype developing EH was increased by 2.726 times(95%CI:1.485～7.702).Compared with those with AA genotype at A-6G locus but not exposed to noise,the risk of those with GG genotype and exposed to noise developing EH was increased by 2.578 times(95%CI:1.079～6.159).Compared with those who carry the TT genotype at the T174M locus and are not exposed to noise,those who carry the TM genotype and are exposed to noise have an increased risk of EH by 2.020 times(95%CI:1.064～3.835).5 In the analysis of GMDR gene-gene-noise interaction model,A-6G-T174M-A20C-noise four-factor model is the best model,and the consistency of cross-validation reaches 100%.Workers with homozygous mutant genotype and noise exposure had a 2.742 times higher risk of developing EH than those with homozygous wild type genotype and no noise exposure(95%CI:1.730～4.351).Conclusions 1 Noise is a risk factor for EH.GG genotype at A-6G site and TM genotype at T174M site are risk factors for EH.2 The interaction between A-6G site and T174M site and between A-6G site and noise based on multiplication model increases the risk of EH in workers.3 The gene-gene-noise interaction model of GMDR shows that the A-6G-T174M-A20C-noise four-factors model is the best model.Figure 6;Table 24;Reference 115... |
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