Environmental toxic metal contaminants and risk of cardiovascular disease: systematic review and meta-analysis.
Environmental toxic metal contaminants and risk of cardiovascular disease: systematic review and meta-analysis.
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DOI：
10.1136/bmj.k3310
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发表时间：
2018-08-29
期刊：
影响因子：
--
通讯作者：
Di Angelantonio E
中科院分区：
文献类型：
--
作者：
Chowdhury R;Ramond A;O'Keeffe LM;Shahzad S;Kunutsor SK;Muka T;Gregson J;Willeit P;Warnakula S;Khan H;Chowdhury S;Gobin R;Franco OH;Di Angelantonio E
对调查砷、铅、镉、汞和铜与心血管疾病相关性的流行病学研究进行系统综述和荟萃分析。系统回顾和荟萃分析. PubMed、Embase和Web of Science检索截至2017年12月。研究报告的风险估计总的心血管疾病，冠心病，中风的水平砷，铅，镉，汞，或铜被纳入。两名研究者根据PRISMA和MOOSE指南独立提取研究特征和结局的信息。相对风险标准化为一个共同的规模，并汇总研究中的每一个标志物使用随机效应荟萃分析。该综述确定了37项独特的研究，包括348259名非重叠的参与者，其中冠心病13033例，中风4205例，心血管疾病15274例。比较基线水平的上三分之一与下三分之一，砷和铅的合并相对风险为1.30（95%置信区间1.04 - 1.63）和1.43（1.16至1.76）心血管疾病，1.23冠心病组为1.04 ~ 1.45（1.27 ~ 2.69），脑卒中组为1.15（0.92 ~ 1.43），脑卒中组为1.63（1.14 ~ 2.34）。镉和铜的相对危险度为1.33（1.09至1.64）和1.81（1.05至3.11）心血管疾病，1.29冠心病组分别为0.98 ~ 1.71和2.22（1.31 ~ 3.74），脑卒中组分别为1.72（1.29 ~ 2.28）和1.29（0.77 ~ 2.17）。汞与心血管结局无明显相关性。砷、铅和镉与心血管疾病结局呈线性剂量反应关系。接触砷、铅、镉和铜与心血管疾病和冠心病的风险增加有关。汞与心血管风险无关。这些发现加强了环境有毒金属在心血管风险中的重要性，超越了传统行为风险因素的作用。
To conduct a systematic review and meta-analysis of epidemiological studies investigating the association of arsenic, lead, cadmium, mercury, and copper with cardiovascular disease. Systematic review and meta-analysis. PubMed, Embase, and Web of Science searched up to December 2017. Studies reporting risk estimates for total cardiovascular disease, coronary heart disease, and stroke for levels of arsenic, lead, cadmium, mercury, or copper were included. Two investigators independently extracted information on study characteristics and outcomes in accordance with PRISMA and MOOSE guidelines. Relative risks were standardised to a common scale and pooled across studies for each marker using random effects meta-analyses. The review identified 37 unique studies comprising 348 259 non-overlapping participants, with 13 033 coronary heart disease, 4205 stroke, and 15 274 cardiovascular disease outcomes in aggregate. Comparing top versus bottom thirds of baseline levels, pooled relative risks for arsenic and lead were 1.30 (95% confidence interval 1.04 to 1.63) and 1.43 (1.16 to 1.76) for cardiovascular disease, 1.23 (1.04 to 1.45) and 1.85 (1.27 to 2.69) for coronary heart disease, and 1.15 (0.92 to 1.43) and 1.63 (1.14 to 2.34) for stroke. Relative risks for cadmium and copper were 1.33 (1.09 to 1.64) and 1.81 (1.05 to 3.11) for cardiovascular disease, 1.29 (0.98 to 1.71) and 2.22 (1.31 to 3.74) for coronary heart disease, and 1.72 (1.29 to 2.28) and 1.29 (0.77 to 2.17) for stroke. Mercury had no distinctive association with cardiovascular outcomes. There was a linear dose-response relation for arsenic, lead, and cadmium with cardiovascular disease outcomes. Exposure to arsenic, lead, cadmium, and copper is associated with an increased risk of cardiovascular disease and coronary heart disease. Mercury is not associated with cardiovascular risk. These findings reinforce the importance of environmental toxic metals in cardiovascular risk, beyond the roles of conventional behavioural risk factors.
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影响因子：
--
作者：
Dubben, HH;Beck-Bornholdt, HP
通讯作者：
Beck-Bornholdt, HP
影响因子：
3.9
作者：
Afridi, Hassan Imran;Kazi, Tasneem Gul;Kolachi, Nida Fatima
通讯作者：
Kolachi, Nida Fatima
影响因子：
10.4
作者：
Barregard L;Sallsten G;Fagerberg B;Borné Y;Persson M;Hedblad B;Engström G
通讯作者：
Engström G
DOI：
10.1007/s00420-012-0746-8
发表时间：
2013-01-01
影响因子：
3
作者：
Bergdahl, Ingvar A.;Ahlqwist, Margareta;Lissner, Lauren
通讯作者：
Lissner, Lauren
影响因子：
8.7
作者：
Chen, CJ;Chiou, HY;Tai, TY
通讯作者：
Tai, TY