Mercury in serum predicts low risk of death and myocardial infarction in Gothenburg women
Mercury in serum predicts low risk of death and myocardial infarction in Gothenburg women
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DOI：
10.1007/s00420-012-0746-8
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发表时间：
2013-01-01
影响因子：
3
通讯作者：
Lissner, Lauren
中科院分区：
文献类型：
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作者：
Bergdahl, Ingvar A.;Ahlqwist, Margareta;Lissner, Lauren
汞（Hg）暴露的标志物与心血管疾病（CVD）既有积极的联系，也有消极的联系。我们在一项前瞻性人群队列研究中评估了血清汞（S-Hg）与心血管疾病风险之间的关系，并关注了牙齿健康和鱼类消费的作用，对1,391名女性的总死亡率、急性心肌梗死（AMI）和中风的发病率和死亡率进行了32年的随访（最初年龄38-60岁），与基线时的S-Hg相关，使用考克斯回归模型。潜在混杂因素（年龄、社会经济地位、血脂、饮酒、牙齿健康、吸烟、高血压、腰臀比和糖尿病）和其他协变量（例如，仅根据年龄调整的风险比（HR）显示基线S-Hg与总死亡率[最高四分位数：风险比（HR）0.76; 95%置信区间（CI）0.59-0.97]、急性心肌梗死事件（HR 0.56; CI 0.34-0.93）和致命性急性心肌梗死（HR 0.31; CI 0.15-0.66）之间存在强负相关。调整潜在的混杂因素，特别是牙齿健康，对风险估计有很大的影响，调整后，只有致命性AMI的风险降低仍然具有统计学意义。原因可能与良好的牙齿健康（也与这些年龄组中汞合金填充物的数量有关）和/或鱼类消费相混淆。研究结果表明，牙齿健康和/或鱼类消费对CVD的潜在影响值得在预防医学中予以关注。
Markers of mercury (Hg) exposure have shown both positive and negative associations with cardiovascular disease (CVD). We assessed the association between serum Hg (S-Hg) and risk of cardiovascular disease in a prospective population-based cohort, with attention to the roles of dental health and fish consumption.Total mortality, as well as morbidity and mortality from acute myocardial infarction (AMI) and stroke, was followed up for 32 years in 1,391 women (initially age 38-60), in relation to S-Hg at baseline, using Cox regression models. Potential confounders (age, socioeconomic status, serum lipids, alcohol consumption, dental health, smoking, hypertension, waist-hip ratio, and diabetes) and other covariates (e.g., fish consumption) were also considered.Hazard ratios (HR) adjusted only for age showed strong inverse associations between baseline S-Hg and total mortality [highest quartile: hazard ratio (HR) 0.76; 95% confidence interval (CI) 0.59-0.97], incident AMI (HR 0.56; CI 0.34-0.93), and fatal AMI (HR 0.31; CI 0.15-0.66). Adjustment for potential confounding factors, especially dental health, had a strong impact on the risk estimates, and after adjustment, only the reduced risk of fatal AMI remained statistically significant.There was a strong inverse association between Hg exposure and CVD. Likely, reasons are confounding with good dental health (also correlated with the number of amalgam fillings in these age groups) and/or fish consumption. The results suggest potential effects of dental health and/or fish consumption on CVD that deserve attention in preventive medicine.