HDL cholesterol: A potential mediator of the association between urinary cadmium concentration and cardiovascular disease risk
HDL cholesterol: A potential mediator of the association between urinary cadmium concentration and cardiovascular disease risk
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高密度脂蛋白胆固醇：尿镉浓度与心血管疾病风险之间关联的潜在中介因素
DOI：
10.1016/j.ecoenv.2020.111433
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发表时间：
2021
影响因子：
6.8
通讯作者：
Gu Aihua
中科院分区：
文献类型：
--
作者：
Xu Cheng;Weng Zhenkun;Zhang Liye;Xu Jin;Dahal Maginsh;Basnet Til Bahadur;Gu Aihua
以前的研究证据表明，接触金属与心血管疾病（CVD）有关。然而，金属混合物和CVD风险之间的关联以及流行病学研究中的潜在机制仍不清楚。分析了1999-2016年参加美国国家健康和营养检查调查（NHANES）的14，795名成年人的数据。采用多因素Logistic回归分析尿金属水平与心血管疾病的关系。进行加权分位数和（WQS）回归以检查混合金属对CVD的影响。采用多元线性回归和中介变量分析探讨金属元素与血脂的关系。尿镉（Cd）与总心血管疾病风险增加和个体心血管疾病风险显着相关。WQS指数最高四分位数中CVD的比值比（OR）为1.43（95%置信区间[CI]：1.19，1.71）。在完全校正的模型中，一个增加的尿镉浓度单位（Log 10）与HDL胆固醇降低0.93 mg/dL、LDL胆固醇升高1.34 mg/dL和总胆固醇升高1.30 mg/dL相关。中介作用分析显示，HDL胆固醇介导了4.91%的尿镉与CVD患病率的关联。我们的研究结果表明，尿镉和金属混合物与CVD显着和积极相关。HDL胆固醇的下调可能在介导镉缺乏相关的CVD风险增加中起重要作用。
Evidence from previous studies has shown that exposure to metals is associated with cardiovascular disease (CVD). However, the association between metal mixtures and CVD risk and the potential mechanisms in epidemiologic studies remain unclear. The data of 14,795 adults who participated in the U.S. National Health and Nutrition Examination Survey (NHANES) 1999–2016 were analyzed. Multivariate logistic regression was performed to investigate the associations between urinary metal levels and CVDs. Weighted quantile sum (WQS) regression was performed to examine the effects of mixed metals on CVDs. Multivariate linear regression and mediation analysis were conducted to explore the associations between metals and blood lipids. Urinary cadmium (Cd) was significantly associated with an increased total CVD risk and with individual CVD risk. The odds ratio (OR) for CVD in the highest quartile of the WQS index was 1.43 (95% confidence interval [CI]: 1.19, 1.71). One augmented urinary Cd concentration unit (Log10) was associated with a 0.93 mg/dL decrease in HDL cholesterol, a 1.34 mg/dL increase in LDL cholesterol and a 1.30 mg/dL increase in total cholesterol in the fully adjusted model. Mediation analysis showed that HDL cholesterol mediated 4.91% of the association between urinary Cd and the prevalence of CVD. Our findings suggest that urinary Cd and metal mixtures were significantly and positively associated with CVD. The downregulation of HDL cholesterol might play a significant role in mediating Cd exposure-associated CVD risk increases.