Cardiovascular risk factors in Kuzbass coal industry workers. Focus on lipid metabolism disorders

Abstract

Introduction. Dyslipidemia is one of the most common risk factors for cardiovascular disease (RFCVD). In coal industry workers, working conditions are considered as an additional risk factor to the well-known RFCVD. The study aims to analyze the prevalence of RFCVD in coal industry workers in comparison with the general population of the Kemerovo region. Materials and methods. The study included 2,356 male respondents, 1,656 (70.3%) coal industry workers (the main group) and 700 (29.7%) people from the population sample of participants in the multicenter epidemiological study of ESSE-RF included in the territory of Kuzbass (control group). The traditional FSSR was evaluated, including the parameters of lipid metabolism (total cholesterol (TCH), triglycerides (TC), low-density lipoproteins (LDL) and high-density lipoproteins (HDL)). Results. A comparative analysis of the FSSRP of coal industry workers and the control group showed their high prevalence in the control group: the prevalence of diabetes mellitus by 12.3 times, previous stroke by 4.8 times, myocardial infarction by 4 times, arterial hypertension by 3.8 times, obesity by 1.8 times, dyslipidemia by 1.2 times. The average values of systolic (SBP) and diastolic (DBP) blood pressure and plasma glucose levels were within the normal range in both groups, but statistically significantly higher in the control group. There were 1.3 times more smokers among coal industry workers (60.4% compared to the control group). 45.7%, p<0.001). The median of TCH and its fractions, TC were within the limits of the normative values for workers in the coal industry, whereas in the control group the LDL level was statistically significantly higher. The incidence of hypertriglyceridemia (34.2% vs. 22.4%) and low HDL (15.8% vs. 2.0%) was statistically significantly higher in miners. The researchers observed hypercholesterolemia and high LDL levels in more than half of the patients (50.6% and 65.3%, respectively) of the control group. A correlation analysis of work experience in the coal industry and the FSSR demonstrated an association with age (r=0.83, p≤0.001), body mass index (BMI) (r=0.37, p≤0.001), SBP level (r=0.33, p≤0.001) and DBP (r=0.36, p≤0.001), concentration of TCH (r=0.65, p≤0.001), LDL (r=0.51, p≤0.001) and TC (r=0.84, p≤0.001). The authors found that coal miners had an 11.5-fold increased risk of HDL reduction, 2.3-fold increased hypertriglyceridemia, and 2-fold increased risk of smoking compared to the population of the region. The proportion of people with hypertriglyceridemia and low HDL prevailed in all age groups of coal industry workers. Taking into account the work experience of more trained individuals, the risk of hypercholesterolemia and high LDL levels increases by 2 times, the risk of hypertriglyceridemia and low HDL levels is slightly lower. Limitation. The design of the study did not allow to determine the causal relationship between the profession and the RFCVD. The analysis of the nature of nutrition, intake/abuse of alcoholic beverages was not carried out and metabolic syndrome was not diagnosed as possible causes of dyslipidemia. Inclusion in the main and control groups was carried out for different periods of time. Conclusion. Smoking and dyslipidemia are among the most common RFCVD among workers in the Kuzbass coal industry. The largest proportion is hypercholesterolemia, one third has hypertriglyceridemia and elevated LDL, half as often as low HDL. The duration of work in underground conditions is associated with age, BMI, SBP, DBP, concentrations of TCH, LDL, TC. The proportion of people with hypertriglyceridemia and low HDL prevails in all age groups of coal miners. In more trained workers, the risk of hypercholesterolemia and high LDL increases by 2 times, the risk of hypertriglyceridemia and low HDL is slightly lower. Ethics. The study was performed in accordance with the standards of good clinical practice and the principles of the Helsinki Declaration. Prior to inclusion, all respondents signed an informed consent form.