RESUMEN
Little is known about the mechanisms of aging on vascular beds and its relationship with tetra and di-hydrobiopterin (BH4 and BH2) levels. This observational clinical study analyzed the impact of aging on plasma and platelet biopterins, cutaneous blood flow (CBF), and coronary flow reserve (CFR) in healthy adults. The study enrolled healthy adults in 3 age groups: 18-30, 50-59, and 60-70 years (n = 25/group). Biopterins were assessed by LC-MS/MS using newly defined pre-analytical conditions limiting BH4 oxidation and improving long-term stability. CBF was measured by Laser Speckle Contrast Imaging coupled with acetylcholine-iontophoresis and CFR by adenosine stress cardiac magnetic resonance. In healthy adults, aging (60-70 years vs 18-30 years) significantly increased platelet BH2 (+75%, P = 0.033) and BH2 + BH4 (+31%, P = 0.033), and to a lesser extent plasma BH2 (+29%, P = 0.009) without affecting BH4 and BH4/BH2. Simultaneously, CBF was decreased (-23%, P = 0.004) but not CFR, CBF being inversely correlated with platelet BH2 (r = -0.42, P = 0.001) and BH2 + BH4 (r = -0.41, P = 0.002). The proportion of adults with abnormal platelet BH2 increased with age (+28% in 60-70y). These abnormal BH2 levels were significantly associated with reduced CBF and CFR (-16%, P = 0.03 and -26%, P = 0.02). In conclusion, our study showed that age-related peripheral endothelial dysfunction was associated with an increase in circulating BH2 without decreasing BH4, the effect being more marked in platelets, the most relevant blood compartment to assess biopterin bioavailability. Peripheral but not coronary vascular function is progressively impaired with aging in healthy adults. All these findings support biopterins as therapeutic targets to improve vascular function.
Asunto(s)
Envejecimiento/fisiología , Biopterinas/análogos & derivados , Endotelio Vascular/fisiopatología , Adolescente , Adulto , Anciano , Animales , Biopterinas/sangre , Plaquetas/metabolismo , Vasos Sanguíneos/fisiología , Endotelio Vascular/fisiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ratas Endogámicas SHR , Ratas Endogámicas WKY , Ratas Zucker , Adulto JovenRESUMEN
The study aimed to determine the risk factors for incident carpal tunnel syndrome (CTS) in a large working population, with a special focus on factors related to work organization. In 2002-2005, 3710 workers were assessed and, in 2007-2010, 1611 were re-examined. At baseline all completed a self-administered questionnaire about personal/medical factors and work exposure. CTS symptoms and physical examination signs were assessed by a standardized medical examination at baseline and follow-up. The risk of "symptomatic CTS" was higher for women (OR = 2.9 [1.7-5.2]) and increased linearly with age (OR = 1.04 [1.00-1.07] for 1-year increment). Two work organizational factors remained in the multivariate risk model after adjustment for the personal/medical and biomechanical factors: payment on a piecework basis (OR = 2.0, 95% CI 1.1-3.5) and work pace dependent on automatic rate (OR = 1.9, 95% CI 0.9-4.1). Several factors related to work organization were associated with incident CTS after adjustment for potential confounders.
Asunto(s)
Síndrome del Túnel Carpiano/epidemiología , Salud Laboral , Vigilancia de la Población , Lugar de Trabajo , Adulto , Factores de Edad , Síndrome del Túnel Carpiano/etiología , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Salarios y Beneficios , Factores Sexuales , Carga de Trabajo , Lugar de Trabajo/organización & administraciónRESUMEN
PURPOSE: The aim of the study was to examine the organizational and psychosocial risk factors for carpal tunnel syndrome (CTS) in workers exposed to various levels of work-related constraints, with a special focus on factors related to the work organization. METHODS: From 3,710 workers, representative of a French region's working population, trained occupational physicians diagnosed a total of 156 cases of CTS between 2002 and 2005. Diagnoses were established by standardized physical examination, while personal factors and work exposure were assessed by self-administered questionnaires. Statistical associations between CTS and personal and work-related factors were analyzed for each gender using logistic regression modeling. RESULTS: Among the factors related to work organization, working with temporary workers was associated with CTS for women (OR = 1.99, 95 % CI 1.23-3.25), but not for men. Task rotation during the job (OR = 2.45 95 % CI 1.41-4.24) and work pace dependent on quantified targets (OR = 1.93 95 % CI 1.08-3.46) were associated with CTS only for men. The work-related psychosocial factors highlighted by the logistic modeling were high psychological demand for women (OR = 1.90, 95 % CI 1.17-3.09) and low skill discretion (OR = 1.77, 95 % CI 1.01-3.11) for men. CONCLUSION: This study has identified some psychosocial factors and factors related to work organization associated with clinically diagnosed and symptom-only cases of CTS as well as personal and biomechanical factors. However, due to the cross-sectional design of the study, no causal conclusion could be drawn and longitudinal studies are necessary to confirm these results.