HDL cholesterol: A potential mediator of the association between serum levels of a mixture of metals and the risk of aortic dissection in a Chinese population
HDL cholesterol: A potential mediator of the association between serum levels of a mixture of metals and the risk of aortic dissection in a Chinese population
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高密度脂蛋白胆固醇：中国人群中金属混合物血清水平与主动脉夹层风险之间关联的潜在中介因素。
DOI：
10.1016/j.envpol.2021.117942
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发表时间：
2021-08-25
影响因子：
8.9
通讯作者：
Gu, Aihua
中科院分区：
文献类型：
--
作者：
Liu, Qian;Jin, Jing;Gu, Aihua
主动脉夹层（AD）是一种严重的心血管疾病，死亡率很高。然而，血清金属水平与 AD 风险之间的关联仍不清楚。纳入2017年至2019年南京医科大学第二附属医院确诊的127例AD（A型和B型）患者；还包括 183 个控件。进行逻辑回归分析以确定血清金属水平与 AD 风险之间的关联。进行加权分位数和 (WQS) 回归和贝叶斯核机器回归 (BKMR) 分析来探讨金属混合物对 AD 风险的影响。进行线性回归分析以评估血清金属水平与白细胞（WBC）计数以及血清脂质水平和血糖之间的关系。我们进行了中介分析，以探讨白细胞计数或血脂水平和血糖对金属水平与 AD 风险之间关联的贡献率。血清铜浓度暴露（系数 = 6.33；95% CI = 2.52, 10.14；p 趋势 < 0.001）与 AD 风险显着呈正相关。在 WQS 分析中，Cu (50.3%)、Ni (32.7%) 和 Mo (17.1%) 导致 AD 风险。在 BKMR 分析中，Cu 和 Mo 在与 AD 风险的关联中发挥着重要作用。此外，铜的血清浓度与高密度脂蛋白胆固醇水平显着呈负相关。 HDL-胆固醇水平介导了血清铜水平与 AD 患病率之间 7.42% 的关联。我们的研究提供了第一个证据，证明金属混合物的血清水平与中国人群的 AD 风险相关。金属（尤其是铜）浓度的增加可能会降低 HDL 胆固醇水平，从而增加 AD 的风险。
Aortic dissection (AD) is a severe cardiovascular disease with a high mortality rate. However, the associations between the serum levels of metals and the risk of AD remain unclear. One hundred twenty-seven patients with AD (type A and B) identified from 2017 to 2019 at the Second Affiliated Hospital of Nanjing Medical University were included; 183 controls that were also included. A logistic regression analysis was performed to determine the associations between serum levels of metals and the risk of AD. Weighted Quantile Sum (WQS) regression and Bayesian Kernel Machine Regression (BKMR) analyses were performed to explore the effects of mixtures of metals on the risk of AD. A linear regression analysis was performed to evaluate the relationships between the serum levels of metals and the white blood cells (WBCs) count and serum lipid levels and blood glucose. We conducted a mediation analysis to explore the contribution rates of WBC counts or serum lipid levels and blood glucose to the association between metal levels and the risk of AD. Exposure to serum levels of Cu (coefficient = 6.33; 95 % CI = 2.52, 10.14; p trend < 0.001) were significantly and positively associated with the risk of AD. In the WQS analysis, Cu (50.3 %), Ni (32.7 %) and Mo (17.1 %) contributed to the AD risk. In the BKMR analysis, Cu and Mo were shown to play important roles in the association with the AD risk. Moreover, serum concentrations of Cu were significantly and inversely associated with HDL-cholesterol levels. HDL-cholesterol levels mediated 7.42 % of the association between serum Cu levels and the prevalence of AD. Our study provided the first evidence that serum levels of mixtures of metals are associated with the AD risk in a Chinese population. Increased concentrations of metals, particularly Cu, may increase the risk of AD by reducing HDL-cholesterol levels.