Environmental heavy metals and cardiovascular diseases: Status and future direction.
Environmental heavy metals and cardiovascular diseases: Status and future direction.
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DOI：
10.1016/j.cdtm.2020.02.005
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发表时间：
2020-12
影响因子：
--
通讯作者：
Liu SM
中科院分区：
文献类型：
--
作者：
Yang AM;Lo K;Zheng TZ;Yang JL;Bai YN;Feng YQ;Cheng N;Liu SM
心血管疾病（CVD）和环境退化是我们这个时代的主要全球健康问题。最近的研究表明，接触重金属与心血管疾病和糖尿病的风险有关，特别是在伴随快速发展的低收入和中等收入国家的人群中。在这篇综述中，我们1)评估了现有流行病学研究的总体、数量和一致性，将重金属暴露与心血管疾病（包括中风和冠心病）的风险联系起来；2)讨论了一些诱人的人类观察结果背后的潜在生物学机制；3)确定了我们知识库中的空白，这些空白必须在未来的工作中进行调查。来自实验和观察性研究的越来越多的证据表明，以剂量反应方式暴露于重金属会增加心血管疾病的风险。大多数现有研究的局限性包括统计能力不足，缺乏全面的暴露评估，以及横断面设计。鉴于重金属暴露的广泛存在，迫切需要在不同人群的特征明确的队列中，单独或联合调查这些假定的环境暴露与CVD事件结果的关联，并确定预防和控制重金属暴露对个人和人群心脏代谢健康结果影响的潜在策略。
Cardiovascular disease (CVD) and environmental degradation are leading global health problems of our time. Recent studies have linked exposure to heavy metals to the risks of CVD and diabetes, particularly in populations from low- and middle-income countries, where concomitant rapid development occurs. In this review, we 1) assessed the totality, quantity, and consistency of the available epidemiological studies, linking heavy metal exposures to the risk of CVD (including stroke and coronary heart disease); 2) discussed the potential biological mechanisms underlying some tantalizing observations in humans; and 3) identified gaps in our knowledge base that must be investigated in future work. An accumulating body of evidence from both experimental and observational studies implicates exposure to heavy metals, in a dose-response manner, in the increased risk of CVD. The limitations of most existing studies include insufficient statistical power, lack of comprehensive assessment of exposure, and cross-sectional design. Given the widespread exposure to heavy metals, an urgent need has emerged to investigate these putative associations of environmental exposures, either independently or jointly, with incident CVD outcomes prospectively in well-characterized cohorts of diverse populations, and to determine potential strategies to prevent and control the impacts of heavy metal exposure on the cardiometabolic health outcomes of individuals and populations.