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: 10600062
• 负责人: PAULO ANDRADE LOTUFO
• 金额: $ 17.39万
• 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 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10600062
• 关键词: Adult; Affect; Arsenic; Biological Process; Biology; Biomedical Research; Blood; Blood Preservation; Brazil; Cadmium; Calcium; 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; Dietary Intervention; Disease; Disease Outcome; Environmental Exposure; Epidemic; Etiology; Europe; Event; Exposure to; Funding Opportunities; Health; Heavy Metals; Hypertension; Individual; International; Interview; Investments; Ischemia; Joints; Laboratories; Lead; Link; Longitudinal Studies; Magnesium; Manganese; Mediating; Mercury; 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; Recommendation; Reporting; Research; Research Personnel; Resources; Risk; Risk Factors; Role; Sampling; Scientist; Selenium; Serum; Site; Smoking; South America; Stroke; Stroke prevention; Supplementation; Testing; Time; Toxic effect; Trace Elements; Trace metal; Tungsten; United States; Urine; Vanadium; Vascular Diseases; Vascular System; Woman; Work; Zinc; adjudication; cardiometabolism; cardiovascular disorder prevention; cardiovascular disorder risk; case control; cohort; coronary calcium scoring; cost efficient; data resource; design; diabetes risk; dietary; dietary trace element; disability; experience; follow-up; global health; interest; men; metal metabolism; 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.

项目概要 环境退化和重金属暴露（个人通常无法控制）可能会 直接影响心血管疾病（CVD）的发展，心血管疾病已成为最严重的疾病之一 全球个人和人口健康的紧迫克星。最近的研究提供了具有挑战性的 有证据表明环境中重金属暴露与糖尿病和高血压风险增加有关， 是强烈的 CVD 危险因素。相比之下，前瞻性队列研究表明，较高水平的饮食和 血清必需微量金属与较低的 CVD 风险直接相关，补充其可能 通过减轻有毒金属对心血管系统的影响具有潜在的好处。然而，极少数 研究直接、全面地调查了多种金属的暴露，特别是它们的联合影响 影响 CVD 风险（包括中风）。正在进行的巴西成人健康纵向研究（葡萄牙语， ‘Estudo Longitudinal de Sau´ de do Adulto’，ELSA-Brasil），是在南方建立的唯一大型前瞻性研究 美国专门调查心脏代谢健康的危险因素，代表了独特的研究资源 多种金属暴露及其与膳食微量元素的相互作用对心血管疾病风险的影响。在 基线时，圣保罗 ELSA-Brasil 中心的 4,428 名无 CVD 参与者完成了 1) 体检； 2）临床实验室检查； 3）面对面访谈； 4) 血液和尿液样本的采集； 5）CT 检查以量化冠状动脉钙化（CAC）评分。迄今为止，共有 466 起 CVD 事件（约 150 起中风） ELSA-巴西队列中的病例已在 10 年随访中得到裁决。在当前的应用目标中 为了进行调查，我们将利用这些特殊的资源以及大量的时间和精力投入 ELSA-巴西研究人员在过去十年中以最具成本效益和及时的方式进行调查， 金属在 CVD 开发中的作用。具体来说，当前的应用程序旨在利用这一正在进行的 前瞻性队列研究不仅确定重金属暴露是否会增加 CAC 评分和 CVD 风险，同时还确定了体内必需金属的最佳水平，可以减轻有毒金属引起的 CVD 风险。 如果存在拮抗作用，并且可以减少有毒金属影响的必需金属的最佳体内水平是 经证实，这项工作将带来简单、安全、易于获得、可接受和高度负担得起的营养品 CVD 预防干预措施将在全球范围内具有临床和公共卫生意义。

项目成果

Amino acid neurotransmitters and prognosis after stroke: nutrition as a modifiable factor to improve stroke outcomes.

氨基酸神经递质和中风后预后：营养作为改善中风结果的可改变因素。

• DOI: 10.1016/j.ajcnut.2023.07.022
• 发表时间: 2023
• 期刊: The American journal of clinical nutrition
• 作者: Madsen,TracyE;Liu,Simin
• 通讯作者: Liu,Simin

Urinary levels of 30 metal/metalloids in the Brazilian southeast population: Findings from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

• DOI: 10.1016/j.envres.2023.115624
• 发表时间: 2023-03
• 期刊: Environmental research
• 影响因子: 8.3
• 作者: Fernando Barbosa;Paula Pícoli Devóz;Marcos Rafael Nogueira Cavalcante;M. Gallimberti;J. C. Cruz;J. Domingo;E. Simões;P. Lotufo;Simin Liu;I. Benseñor

Environmental heavy metals and cardiovascular diseases: Status and future direction.

• DOI: 10.1016/j.cdtm.2020.02.005
• 发表时间: 2020-12
• 期刊: Chronic diseases and translational medicine
• 作者: Yang AM;Lo K;Zheng TZ;Yang JL;Bai YN;Feng YQ;Cheng N;Liu SM
• 通讯作者: Liu SM

Serum folate levels and cognitive performance in the ELSA-Brasil baseline assessment.

• DOI: 10.1590/0004-282x20200074
• 发表时间: 2020-11
• 期刊: Arquivos de neuro-psiquiatria
• 影响因子: 1.4
• 作者: Santos IS;Suemoto CK;ValladÃo-Junior JBR;Liu S;Barreto SM;Fedeli LMG;Lotufo PA;Bensenor IM
• 通讯作者: Bensenor IM