Cardiovascular Effects of Environmental Cadmium Exposure

描述（由申请人提供）：心血管疾病是美国主要的公共卫生问题，包括亚临床诊断，如外周动脉疾病和高血压。西班牙裔美国人是美国最大的少数民族人口，已被证明有较高的心血管危险因素的患病率。然而，已知的风险因素（例如，血脂水平，血压）已经无法解释所有的变化， 心血管疾病的风险，因此研究已扩展到检查环境因素，如金属作为风险来源。早期的流行病学和成熟的机制证据表明，镉可能是心血管疾病的一个重要危险因素。我们建议在圣路易斯谷糖尿病研究队列中进行一项队列研究，调查累积镉暴露与心血管疾病之间的关系，并提供纵向生理和行为数据。我们将使用历史采集的尿液样本估计个体研究受试者的累积镉暴露量。将考虑其他病理生理因素，包括临床信息、饮食、吸烟、体力活动、家庭 病史和相关的医学因素。鉴于队列中西班牙裔人数众多，我们将评估镉和CVD之间的关系是否因白色/西班牙裔种族而异。拟议的研究将通过克服与暴露评估和研究设计的精确性相关的先前研究的几个方法学限制，解决对镉和心血管疾病病因学的理解方面的差距。如果研究显示尿镉水平与心血管疾病之间存在关联，则有助于阐明心血管疾病的病理生物学，并有助于通过更广泛的监管来预防，以避免人群暴露，因为镉暴露的主要来源已得到充分认可。

DESCRIPTION (provided by applicant): Cardiovascular disease is a major public health concern in the United States including subclinical diagnoses such as peripheral arterial disease and hypertension. Hispanics comprise the largest minority population in the United States and have been shown to have higher prevalence of cardiovascular risk factors. However, known risk factors (e.g., lipid levels, blood pressure) have been unable to account for all the variability in cardiovascular disease risk and therefore research has expanded into examining environmental factors such as metals as a source of risk. Early epidemiologic and well-established mechanistic evidence suggest that cadmium may be an important risk factor in cardiovascular disease. We propose to conduct a cohort study investigating the association between cumulative cadmium exposure and cardiovascular disease in the San Luis Valley Diabetes Study cohort with longitudinal physiologic and behavioral data. We will estimate cumulative cadmium exposure for individual study subjects using historically collected urine samples. Other pathophysiologic factors will be considered including clinical information, diet, smoking, physical activity, family history, and contributing medical factors. Given the large numbers of Hispanics in the cohort, we will assess whether the relationship between cadmium and CVD varies by white/Hispanic ethnicity for several endpoints. The proposed study will address gaps in understanding of the etiology of cadmium and cardiovascular disease by overcoming several methodological limitations of previous studies related to precision of the exposure assessment and study design. If the study shows an association between urinary cadmium level and cardiovascular disease, it can help elucidate the pathobiology of cardiovascular disease, and aid in prevention by leading to more extensive regulation to avoid population exposure since primary sources of exposure to cadmium are well recognized.