Cardiovascular Effects of Environmental Cadmium Exposure

描述(申请人提供)：心血管疾病在美国是一个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。拉美裔是美国最大的少数族裔人口，已被证明有更高的心血管风险因素患病率。然而，已知的危险因素(例如，血脂水平、血压)一直无法解释 因此，研究已扩展到考察环境因素，如将金属作为风险来源。早期的流行病学和完善的机制证据表明，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，利用纵向的生理和行为数据来调查累积镉暴露与心血管疾病之间的关系。我们将使用历史上收集的尿样来估计单个研究对象的累积镉暴露。其他病理生理因素将被考虑，包括临床信息、饮食、吸烟、体力活动、家庭 病史，以及相关的医学因素。鉴于队列中的大量拉美裔美国人，我们将评估镉和心血管疾病之间的关系是否因白人/西班牙裔种族的不同而在几个终点上有所不同。拟议的研究将通过克服先前研究在暴露评估和研究设计的精确度方面的几个方法学限制，解决对镉和心血管疾病病因的理解方面的差距。如果这项研究表明尿镉水平与心血管疾病之间存在关联，它可以帮助阐明心血管疾病的病理生物学，并通过导致更广泛的监管来帮助预防，因为人们已经很好地认识到镉的主要暴露来源。

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.