Trace element levels and risk of stroke

描述(申请人提供)：尽管地理位置发生了微小的变化，但半个世纪前在美国东南部发现的中风死亡率最高的地区“中风带”至今仍然存在。最近的研究发现，东南部儿童的中风死亡率也较高，因此，除了生活方式和社会经济地位的其他假设外，还假设环境因素是导致“中风带”的原因。几十年来，美国以外的地区已经证明，微量元素的地理变异可能在心血管疾病的发展中发挥关键作用。然而，与中风风险相关的微量元素水平的地理变异仍不清楚。该项目的总体目标是研究微量元素水平与卒中风险之间的关系，并调查微量元素水平的地理变异是否与中风带有关。我们提出了一项病例队列研究，它将包括发生缺血性中风病例(n=~620例)和非中风病例(n=~2500例)，这些病例是从中风的地理和种族差异(CONTs)研究中随机抽取的，该研究是一项正在进行的基于美国全国人口的普通人群队列研究，包括30239名非洲裔美国人和高加索成年人，基线年龄为45岁及以上(2003-2007年)。拟议的研究将侧重于砷、镉、汞、镁和硒。具体地说，我们将根据研究参与者的人口统计和地理特征来表征尿液或血清中测得的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前瞻性联系。这项研究将有助于识别中风的高危个体，从而提供重要的数据，确定是否可以通过饮食、补充、生活方式或环境干预改变微量元素模式来降低中风风险。

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.