Pesticide exposure and risk of monoclonal gammopathy of undetermined significance in the Agricultural Health Study
Pesticide exposure and risk of monoclonal gammopathy of undetermined significance in the Agricultural Health Study
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DOI：
10.1182/blood-2009-02-203471
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发表时间：
2009-06-18
期刊：
影响因子：
20.3
通讯作者：
Alavanja, Michael C.
中科院分区：
文献类型：
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作者：
Landgren, Ola;Kyle, Robert A.;Alavanja, Michael C.
农药与多发性骨髓瘤的过度风险有关，尽管尚无定论。我们纳入了678名男性（30-94岁），他们来自一个特征明确的限制使用农药的前瞻性队列，以评估意义不明的单克隆丙种球蛋白病（MGUS）的风险。所有受试者的血清样本进行了分析，通过琼脂糖凝胶电泳进行，样品与离散或局部带进行免疫固定。对明尼苏达州9469名男性的MGUS患病率进行了比较。农药暴露和MGUS患病率之间的关联进行了评估的logistic回归模型调整的年龄和教育水平。在50岁以上的研究参与者（n = 555）中，发现38例MGUS，患病率为6.8%（95% CI，5.0%-9.3%）。与明尼苏达州的男性相比，男性农药施用者中MGUS的年龄调整患病率高1.9倍（95%CI，1.3- 2.7倍）。在应用程序中，5.6倍（95% CI，1.9- 16.6倍），3.9倍（95% CI，1.5- 10.0倍）和2.4倍（95%氯，1.1- 5.3倍）在使用氯化杀虫剂狄氏剂、四氯化碳/二硫化碳熏蒸剂混合物、和杀真菌剂百菌清。总之，农药施用者中MGUS的患病率是明尼苏达州男性人群样本的两倍，这进一步支持了特定农药与骨髓瘤发生有因果关系的假设。（血。2009; 113：6386-6391）
Pesticides are associated with excess risk of multiple myeloma, albeit inconclusively. We included 678 men (30-94 years) from a well-characterized prospective cohort of restricted-use pesticide applicators to assess the risk of monoclonal gammopathy of undetermined significance (MGUS). Serum samples from all subjects were analyzed by electrophoresis performed on agarose gel; samples with a discrete or localized band were subjected to immunofixation. Age-adjusted prevalence estimates of MGUS were compared with MGUS prevalence in 9469 men from Minnesota. Associations between pesticide exposures and MGUS prevalence were assessed by logistic regression models adjusted for age and education level. Among study participants older than 50 years (n = 555), 38 were found to have MGUS, yielding a prevalence of 6.8% (95% Cl, 5.0%-9.3%). Compared with men from Minnesota, the age-adjusted prevalence of MGUS was 1.9-fold (95% Cl, 1.3- to 2.7-fold) higher among male pesticide applicators. Among applicators, a 5.6-fold (95% Cl, 1.9- to 16.6-fold), 3.9-fold (95% Cl, 1.5- to 10.0-fold), and 2.4-fold (95% Cl, 1.1- to 5.3-fold) increased risk of MGUS prevalence was observed among users of the chlorinated insecticide dieldrin, the fumigant mixture carbon-tetrachloride/carbon disulfide, and the fungicide chlorothalonil, respectively. In summary, the prevalence of MGUS among pesticide applicators was twice that in a population-based sample of men from Minnesota, adding support to the hypothesis that specific pesticides are causatively linked to myelomagenesis. (Blood. 2009; 113: 6386-6391)