Blood Cadmium Levels and Incident Cardiovascular Events during Follow-up in a Population-Based Cohort of Swedish Adults: The Malmö Diet and Cancer Study.
Blood Cadmium Levels and Incident Cardiovascular Events during Follow-up in a Population-Based Cohort of Swedish Adults: The Malmö Diet and Cancer Study.
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DOI：
10.1289/ehp.1509735
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发表时间：
2016-05
影响因子：
10.4
通讯作者：
Engström G
中科院分区：
文献类型：
--
作者：
Barregard L;Sallsten G;Fagerberg B;Borné Y;Persson M;Hedblad B;Engström G
镉暴露可能会增加心血管疾病的风险。唯一发表的关于镉和心血管疾病事件的纵向研究是在镉暴露相对较高的美洲印第安人中进行的。我们的目的是在一项以人群为基础的研究中检查基线血镉与心血管事件之间的关系，该研究的对象是镉水平与大多数欧洲和美国人群相似的瑞典男性和女性。在1991年至1994年期间招募了一个基于瑞典人群的队列（n = 6，103，年龄46-67岁）。在我们排除了那些缺失吸烟数据的人之后，剩下4,819名参与者。急性冠状动脉事件、其他主要心脏事件、卒中和心血管死亡率随访至2010年。使用考克斯比例风险回归分析与血镉（根据红细胞中的镉估计）的相关性，包括潜在的混杂因素和重要的心血管风险因素。所有心血管终点的风险比在第四血镉四分位数（中位数，0.99 μg/L）的参与者中持续增加。在还包括性别、吸烟、腰围、教育、体力活动、酒精摄入、血清甘油三酯、HbA 1c和C反应蛋白的模型中，比较暴露的最高和最低四分位数的风险比，急性冠状动脉事件为1.8（95% CI：1.2，2.7），卒中为1.9（1.3，2.9）。从不吸烟者的风险比与这些估计值一致。在我们的瑞典成人人群样本中，血镉含量最高的四分位数与心血管疾病和死亡率相关。从不吸烟者之间的一致结果很重要，因为吸烟是一个很强的混杂因素。我们的研究结果表明，即使在没有异常暴露源的人群中，也需要采取措施减少镉暴露。Barregard L，Sallsten G，Fagerberg B，Borné Y，Pasterson M，Hedblad B，Engström G. 2016.瑞典成人人群队列随访期间的血镉水平和心血管事件：马尔默饮食与癌症研究环境健康展望124：594-600; http：dx.doi.org/10.1289/ehp.1509735
Cadmium exposure may increase the risk of cardiovascular disease. The only published longitudinal study on cadmium and incident cardiovascular disease was performed in American Indians with relatively high cadmium exposure. Our aim was to examine the association between blood cadmium at baseline and incident cardiovascular events in a population-based study of Swedish men and women with cadmium levels similar to those of most European and U.S. populations. A Swedish population-based cohort (n = 6,103, age 46–67 years) was recruited between 1991 and 1994. After we excluded those with missing data on smoking, 4,819 participants remained. Acute coronary events, other major cardiac events, stroke, and cardiovascular mortality were followed until 2010. Associations with blood cadmium (estimated from cadmium in erythrocytes) were analyzed using Cox proportional hazards regression including potential confounders and important cardiovascular risk factors. Hazard ratios for all cardiovascular end points were consistently increased for participants in the 4th blood cadmium quartile (median, 0.99 μg/L). In models that also included sex, smoking, waist circumference, education, physical activity, alcohol intake, serum triglycerides, HbA1c, and C-reactive protein, the hazard ratios comparing the highest and lowest quartiles of exposure were 1.8 (95% CI: 1.2, 2.7) for acute coronary events, and 1.9 (1.3, 2.9) for stroke. Hazard ratios in never-smokers were consistent with these estimates. Blood cadmium in the highest quartile was associated with incident cardiovascular disease and mortality in our population-based samples of Swedish adults. The consistent results among never-smokers are important because smoking is a strong confounder. Our findings suggest that measures to reduce cadmium exposures are warranted, even in populations without unusual sources of exposure. Barregard L, Sallsten G, Fagerberg B, Borné Y, Persson M, Hedblad B, Engström G. 2016. Blood cadmium levels and incident cardiovascular events during follow-up in a population-based cohort of Swedish adults: the Malmö Diet and Cancer Study. Environ Health Perspect 124:594–600; http://dx.doi.org/10.1289/ehp.1509735