Trace element levels and risk of stroke

描述（由申请人提供）：尽管有轻微的地理变化，“中风带”，半个世纪前确定的美国东南部中风死亡率最高的地区，今天仍然存在。最近的研究发现，东南地区的儿童中风死亡率也较高，因此除了生活方式和社会经济地位等其他假设外，环境因素也被假设为“中风带”的原因。几十年来，美国以外的地区已经证明，微量元素的地理差异可能在心血管疾病的发展中发挥关键作用。然而，微量元素水平与中风风险的地理差异仍不清楚。该项目的总体目标是研究微量元素水平与中风风险之间的关系，并调查微量元素水平的地理差异是否与“中风带”有关。我们提出了一项病例队列研究，其中包括缺血性卒中病例（n=~620）和非卒中病例的亚队列（n=~2500），这些病例随机抽样于卒中地理和种族差异原因（REGARDS）研究的区域-种族-性别阶层，这是一项正在进行的美国全国人口为基础的普通人群队列，包括30,239名年龄在45岁及以上的非裔美国人和高加索成年人（2003-2007年）。拟议的研究将重点关注砷、镉、汞、镁和硒。具体来说，我们将根据研究参与者的人口统计学和地理特征来描述尿液或血清中微量元素水平的分布；并研究微量元素水平与中风风险之间的潜在联系。这项研究将有助于确定中风高危人群，从而提供重要数据，确定是否可以通过改变微量元素模式的饮食、补充剂、生活方式或环境干预来降低中风风险。

DESCRIPTION (provided by applicant): Despite minor geographic shifts, the "Stroke Belt", a region of highest stroke mortality in the Southeastern US identified a half century ago, still persists today. Recent studies have found that the stroke mortality is also higher among children in the Southeast, thus environmental factors have been hypothesized contributing to the "Stroke Belt" in addition to other hypotheses on lifestyle and social-economic status. For decades, it has been demonstrated outside the US that geographic variations in trace elements may play critical roles in the development of cardiovascular diseases. However, the geographic variation of trace element levels in relation to stroke risk remains unclear. The overall objectives of this project ae to examine the associations between trace element levels and stroke risk and to investigate whether geographic variation of trace element levels is related to the "Stroke Belt". We propose a case-cohort study, which will include incident ischemic stroke cases (n=~620) and a sub-cohort (n=~2500) of non-stroke cases randomly sampled within region-race-sex stratum from the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study, an ongoing US national population-based, general population cohort of 30,239 African American and Caucasian adults, aged 45 and older at baseline (2003-2007). The proposed study will focus on arsenic, cadmium, mercury, magnesium and selenium. Specifically, we will characterize the distribution of trace element levels measured in urine or serum according to demographic and geographic characteristics of study participants; and to examine prospective associations between trace element levels and risk of stroke. This research will help identify at-risk individuals for stroke, thus providing important data identifying whether stroke risk can be reduced by dietary, supplemental, lifestyle or environmental interventions that modify trace element patterns. PUBLIC HEALTH RELEVANCE: Despite minor geographic shifts, the "Stroke Belt", a region of highest stroke mortality in the Southeastern US identified a half century ago, still persists today It has been demonstrated in other countries that geographic variations in trace elements may play critical roles in the development of cardiovascular diseases. This project is to investigate whether geographic variation of trace element levels contributes to the "Stroke Belt". Data from this research will help identify at-risk individuals for stroke development, thus providing important data identifying whether stroke risk can be reduced by dietary, supplemental, lifestyle or environmental interventions that modify trace element patterns.