Diabetes, Cardiovascular Disorders and 2,3,7,8‐Tetrachlorodibenzo‐ p‐ p‐ Dioxin Body Burden in Czech Patients 50?Years After the Intoxication

摘要

Abstract The correlation between 2,3,7,8‐tetrachlorodibenzo‐ p ‐dioxin ( TCDD ) intoxication and the parameters of metabolic impairment was examined in the last eight male survivors of 80 workers exposed to TCDD during the production of herbicides in a chemical factory in 1965–1967. Their median TCDD blood level was 112 (46–390) pg/g lipids, and the median TCDD body deposit was 3.9 (0.8–11.7) μg. This puts these patients into the most severely intoxicated group of subjects, according to back‐calculated levels of TCDD . The median TCDD blood level in eight controls was 12?pg/g (0.10 to 22.2?pg/g). Markers of metabolic impairment – diabetes, dyslipidaemia, arterial hypertension, carotid artery plaque, skin microvascular reactivity, eye fundus hypertensive angiopathy and history of coronary heart disease – were assessed and compared to a general male population of comparable age. Measured parameters compared with a population of comparable age were as follows: prevalence of diabetes (62.5% versus 17.6%), arterial hypertension (87.5% versus 71.8%), dyslipidaemia (87.5% versus 88.8%), history of coronary heart disease (62.5% versus 26.0%) and eye fundus hypertension angiopathy (50% versus 14%). All eight patients (100% versus 43%) developed plaques in carotid arteries, six had stenosis 50% and two had a carotid intervention (stenting or endarterectomy). Total cholesterol levels decreased compared to the earlier study this patient group in 2008, most likely due to a more intensive use of lipid‐lowering drugs. Several metabolic parameters were higher (diabetes as much as 3.5‐fold) in the group of severely TCDD ‐intoxicated subjects than in a general population of comparable age. This suggests that TCDD plays a role in the development of metabolic impairment and vascular changes.