Bergström Göran, Fagerberg Björn, Sallsten Gerd, Lundh Thomas, Barregard Lars
Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden.
Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden.
PLoS One. 2015 Mar 27;10(3):e0121240. doi: 10.1371/journal.pone.0121240. eCollection 2015.
The general population is exposed to cadmium from food and smoking. Cadmium is a widely spread toxic pollutant that seems to be associated with cardiovascular diseases, although little is known if it contributes to the occurrence of atherosclerotic plaques and the process whereby plaques become vulnerable and are prone to rupture. We tested the hypotheses that cadmium exposure is associated not only with an increased subclinical burden of atherosclerotic plaques in different vascular territories and early signs of plaque vulnerability, but also with cadmium content and plaque-rupture in the clinical phase of the disease. Ultrasound technique was used to measure plaque prevalence and echogenicity in the carotid and femoral arteries in a population sample of women (n = 599) in whom blood cadmium was measured. In addition cadmium was measured in snap-frozen endarterectomies and whole blood obtained from patients who were referred to surgery because of symptomatic carotid plaques (n = 37). Sixteen endarterectomies were divided into three parts corresponding to different flow conditions and plaque vulnerability. In the population sample blood cadmium was associated with the number of vascular territories with plaques (p = 0.003 after adjustment for potential confounders). The cadmium concentrations in symptomatic plaques were 50-fold higher in plaque tissue than in blood. Cadmium levels in blood and plaque correlated, also after adjustment for smoking and other cardiovascular risk factors (p<0.001). Compared with the other parts of the plaque, the cadmium content was double as high in the part where plaque rupture usually occurs. In conclusion, the results show that cadmium exposure is associated with the burden of subclinical atherosclerosis in middle-aged women with different degrees of glucose tolerance, and that the content of cadmium in symptomatic plaques in patients is related to that in blood, but much higher, and preferentially located in the part of plaque where rupture often occurs.
普通人群通过食物和吸烟接触镉。镉是一种广泛传播的有毒污染物，似乎与心血管疾病有关，尽管对于它是否会导致动脉粥样硬化斑块的形成以及斑块变得易损并易于破裂的过程知之甚少。我们检验了以下假设：镉暴露不仅与不同血管区域动脉粥样硬化斑块的亚临床负担增加以及斑块易损的早期迹象有关，而且与疾病临床阶段的镉含量和斑块破裂有关。我们使用超声技术测量了599名女性人群样本中颈动脉和股动脉的斑块患病率和回声性，这些女性的血镉含量也进行了测量。此外，还对因有症状的颈动脉斑块而接受手术的患者（n = 37）的速冻动脉内膜切除术标本和全血中的镉进行了测量。16个动脉内膜切除术标本被分成对应不同血流情况和斑块易损性的三个部分。在人群样本中，血镉与有斑块的血管区域数量相关（在对潜在混杂因素进行调整后，p = 0.003）。有症状斑块中的镉浓度在斑块组织中比在血液中高50倍。在对吸烟和其他心血管危险因素进行调整后，血液和斑块中的镉水平仍然相关（p<0.001）。与斑块的其他部分相比，通常发生斑块破裂的部分镉含量高出一倍。总之，结果表明，镉暴露与不同糖耐量的中年女性亚临床动脉粥样硬化负担有关，并且患者有症状斑块中的镉含量与血液中的镉含量相关，但前者要高得多，且优先位于经常发生破裂的斑块部位。
