金属污染物与心血管疾病：暴露的机制及后果
Metal pollutants and cardiovascular disease: mechanisms and consequences of exposure.
作者信息
Solenkova Natalia V, Newman Jonathan D, Berger Jeffrey S, Thurston George, Hochman Judith S, Lamas Gervasio A
机构信息
Department of Medicine, Mount Sinai Medical Center, Miami Beach, FL.
Leon H Charney Division of Cardiology, New York University School of Medicine, New York, NY.
出版信息
Am Heart J. 2014 Dec;168(6):812-22. doi: 10.1016/j.ahj.2014.07.007. Epub 2014 Jul 22.
INTRODUCTION
There is epidemiological evidence that metal contaminants may play a role in the development of atherosclerosis and its complications. Moreover, a recent clinical trial of a metal chelator had a surprisingly positive result in reducing cardiovascular events in a secondary prevention population, strengthening the link between metal exposure and cardiovascular disease (CVD). This is, therefore, an opportune moment to review evidence that exposure to metal pollutants, such as arsenic, lead, cadmium, and mercury, is a significant risk factor for CVD.
METHODS
We reviewed the English-speaking medical literature to assess and present the epidemiological evidence that 4 metals having no role in the human body (xenobiotic), mercury, lead, cadmium, and arsenic, have epidemiologic and mechanistic links to atherosclerosis and CVD. Moreover, we briefly review how the results of the Trial to Assess Chelation Therapy (TACT) strengthen the link between atherosclerosis and xenobiotic metal contamination in humans.
CONCLUSIONS
There is strong evidence that xenobiotic metal contamination is linked to atherosclerotic disease and is a modifiable risk factor.
引言
有流行病学证据表明，金属污染物可能在动脉粥样硬化及其并发症的发生发展中起作用。此外，最近一项关于金属螯合剂的临床试验在二级预防人群中降低心血管事件方面取得了出人意料的积极结果，这加强了金属暴露与心血管疾病（CVD）之间的联系。因此，现在是回顾证据的时候了，这些证据表明，接触金属污染物，如砷、铅、镉和汞，是心血管疾病的一个重要危险因素。
方法
我们查阅了英文医学文献，以评估并呈现流行病学证据，即四种在人体中无作用的金属（外源性物质），汞、铅、镉和砷，在流行病学和机制上与动脉粥样硬化和心血管疾病存在联系。此外，我们简要回顾了评估螯合疗法试验（TACT）的结果如何加强了人类动脉粥样硬化与外源性金属污染之间的联系。
结论
有强有力的证据表明，外源性金属污染与动脉粥样硬化疾病有关，并且是一个可改变的危险因素。
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