Cadmium exposure is accompanied by increased prevalence and future growth of atherosclerotic plaques in 64-year-old women
Cadmium exposure is accompanied by increased prevalence and future growth of atherosclerotic plaques in 64-year-old women
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DOI：
10.1111/j.1365-2796.2012.02578.x
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发表时间：
2012-12-01
影响因子：
11.1
通讯作者：
Barregard, Lars
中科院分区：
文献类型：
--
作者：
Fagerberg, Bjorn;Bergstrom, Goran;Barregard, Lars
目的目前通过饮食和吸烟广泛接触有毒金属镉，有研究表明镉暴露可增加心血管疾病的风险。在这里，我们研究了镉暴露是否与颈动脉粥样硬化斑块的流行和增长有关。设计与对象：以筛查为基础的高加索妇女队列中，分层随机选择糖耐量正常组、糖耐量低减组和糖尿病组(n=599)。我们测量了基线时血和尿中的镉浓度。此外，我们还进行了超声检查，以确定颈动脉粥样硬化斑块的患病率和面积，并在基线和平均5.4年后的随访中评估了吸烟史和其他心血管危险因素。结果基线时，血镉水平与斑块风险增加相关，在调整混杂因素后，斑块面积较大。在从未吸烟的女性中，血镉水平与基线时的斑块面积呈正相关。在调整混杂因素后，大斑块的出现和斑块面积的变化与基线时的血和经肌酐校正的尿镉浓度有关。血和尿镉水平增加了预测动脉粥样硬化进展的心血管危险因素的信息。结论血和尿镉水平是基线和前瞻性动脉粥样硬化斑块形成的独立相关因素。这一新的观察结果强调了将镉视为促动脉粥样硬化污染物的必要性。
Objectives There is currently widespread exposure to the toxic metal cadmium through the diet as well as through smoking, and it has been suggested that cadmium exposure may increase the risk of cardiovascular disease. Here we examined whether cadmium exposure is associated with prevalence and growth of atherosclerotic plaques in the carotid arteries. Design and subjects The analyses were performed in a screening-based cohort of 64-year-old Caucasian women with stratified, random selection to groups with normal glucose tolerance, impaired glucose tolerance and diabetes (n = 599). We measured cadmium concentrations in blood and urine at baseline. In addition, we performed ultrasound examination to determine the prevalence and area of atherosclerotic plaques in the carotid arteries and assessed smoking history and other cardiovascular risk factors at baseline and at a follow-up examination after a mean of 5.4 years. Results At baseline, blood cadmium levels were associated with increased risk of plaque and a large plaque area after adjustment for confounders. In women who had never smoked, blood cadmium levels correlated positively with plaque area at baseline. The occurrence of large plaques and the change in plaque area at follow-up were associated with blood and creatinine-corrected urinary cadmium concentrations at baseline after adjustment for confounders. Blood and urine cadmium levels added information to established cardiovascular risk factors in predicting progress of atherosclerosis. Conclusions We have shown that cadmium levels in blood and urine are independent factors associated with the development of atherosclerotic plaques at baseline as well as prospectively. This novel observation emphasizes the need to consider cadmium as a pro-atherogenic pollutant.