Environmental heavy metals and risk of ischemic heart disease and stroke in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

巴西成人健康纵向研究 (ELSA-Brasil) 中的环境重金属与缺血性心脏病和中风的风险

• 批准号: 9890186
• 负责人: PAULO ANDRADE LOTUFO
• 金额: $ 17.37万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-21 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9890186
• 关键词: Adult; Affect; Arsenic; Biological Process; Biology; Biomedical Research; Blood; Blood Preservation; Brazil; Cadmium; Cardiovascular Diseases; Cardiovascular system; Case-Control Studies; Cessation of life; China; Chromium; Clinical; Cobalt; Collection; Consensus; Copper; Cross-Sectional Studies; Data; Developing Countries; Development; Diabetes Mellitus; Diet; Dietary Intervention; Disease; Disease Outcome; Environmental Exposure; Epidemic; Etiology; Europe; Event; Exposure to; Funding Opportunities; Health; Heavy Metals; Hypertension; Individual; International; Interview; Investments; Joints; Laboratories; Lead; Link; Longitudinal Studies; Magnesium; Manganese; Mediating; Mercury; Metabolism; Metal exposure; Metals; Molybdenum; Myocardial Ischemia; National Toxicology Program; Nested Case-Control Study; Nickel; Obesity; Outcome; Participant; Persons; Physical Examination; Play; Population; Portuguese; Positioning Attribute; Prospective Studies; Prospective cohort; Prospective cohort study; Public Health; Reporting; Research; Research Personnel; Resources; Risk; Risk Factors; Role; Sampling; Selenium; Serum; Site; Smoking; South America; Stroke; Supplementation; Testing; Time; Toxic effect; Trace Elements; Trace metal; Tungsten; United States; Urine; Vanadium; Vascular Diseases; Vascular System; Woman; Work; Zinc; adjudicate; cardiometabolism; cardiovascular disorder prevention; cardiovascular disorder risk; case control; cohort; coronary artery calcium; coronary calcium scoring; cost efficient; data resource; design; diabetes risk; dietary trace element; disability; experience; follow-up; global health; interest; men; nervous system disorder; physical inactivity; population based; population health; programs; toxic metal

PROJECT SUMMARY Environmental degradation and exposure to heavy metals (over which individuals often have little control) may have a direct impact on cardiovascular diseases (CVD) development, which have become one of the most pressing nemesis for individual- and population-health globally. Recent studies have provided provocative evidence linking environmental exposure to heavy metals to increased risk of diabetes and hypertension, which are strong CVD risk factors. In contrast, prospective cohort studies have shown that higher levels of dietary and serum essential trace metals are directly associated with lower CVD risk and that supplementation of which may have potential benefits by mitigating the effects of toxic metals on the cardiovascular system. However, very few studies have directly and comprehensively investigated exposure to multiple metals particularly their joint effects on affecting CVD risk (including stroke). The ongoing Brazilian Longitudinal Study of Adult Health (in Portuguese, ‘Estudo Longitudinal de Sau´ de do Adulto’, ELSA-Brasil), the only large prospective study established in South America to specifically investigate risk factors for cardiometabolic health, represents a unique resource to study the roles of multiple metal exposures and their interactions with dietary trace elements in affecting CVD risk. At baseline, 4,428 CVD-free participants at the ELSA-Brasil site in Sao Paulo completed 1) physical examinations; 2) clinical laboratory tests; 3) in-person interviews; 4) collections of blood and urine samples; and 5) a CT examination to quantify coronary artery calcium (CAC) score. To date, a total of 466 incident CVD (~150 stroke) cases have been adjudicated in the ELSA-Brasil cohort in the 10-year follow up. ln the current application aims to investigate, we will leverage these exceptional resources and the substantial investment of time and effort by ELSA-Brasil study investigators over the past ten years to investigate, in a most cost-efficient and timely manner, the roles of metals playing in CVD development. Specifically, the current application aims to utilize this ongoing prospective cohort study to not only determine whether heavy metal exposures increase CAC score and CVD risk, but also identify the optimal body levels of essential metals that could mitigate CVD risk from toxic metals. If antagonistic effects exist and optimal body levels of essential metals that could reduce toxic metal impacts are confirmed, this work would lead to simple, safe, readily-available, acceptable and highly-affordable nutritional intervention for CVD prevention that will have both clinical and public health significance worldwide.

项目总结