Hecht Eric M, Arheart Kristopher L, Lee David J, Hennekens Charles H, Hlaing WayWay M
Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA,
Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA.
Cardiology. 2018;141(4):177-182. doi: 10.1159/000496016. Epub 2019 Jan 30.
The interrelationships between cadmium biomarker levels, smoking, and myocardial infarction and stroke have been established. In this cross-sectional analysis, we explored the interrelationships of blood cadmium levels, smoking, and angina. We analyzed the National Health and Nutrition Examination Survey (NHANES, 2003-2014) accounting for the multi-staged complex sampling design. Participants 40-79 years of age with blood cadmium levels but without a history of myocardial infarction and/or stroke were included (n = 14,832). We examined blood cadmium levels (3 tertile groups) in relation to 3 (diagnosed, undiagnosed, and composite diagnosed and/or undiagnosed) angina outcomes. Multivariable logistic regression models adjusted for age, diabetes, smoking status, and household income were used to estimate odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). Of 14,832 participants, 741 (4.2%) had positive composite angina. The crude and adjusted ORs comparing those in the lowest tertile (referent group) of blood cadmium to those in the highest tertile for the composite outcome were 1.82 (95% CI 1.42-2.34) and 1.45 (95% CI 1.12-1.88), respectively. These cross-sectional data from a nationally representative sample contribute to the hypothesis that there are interrelationships between smoking, cadmium, and angina.
镉生物标志物水平、吸烟与心肌梗死及中风之间的相互关系已得到证实。在这项横断面分析中，我们探究了血镉水平、吸烟与心绞痛之间的相互关系。我们分析了考虑到多阶段复杂抽样设计的美国国家健康与营养检查调查（NHANES，2003 - 2014年）。纳入了年龄在40 - 79岁、有血镉水平数据但无心肌梗死和/或中风病史的参与者（n = 14832）。我们研究了血镉水平（3个三分位数组）与3种（已诊断、未诊断以及已诊断和/或未诊断的综合情况）心绞痛结果之间的关系。使用针对年龄、糖尿病、吸烟状况和家庭收入进行调整的多变量逻辑回归模型来估计比值比（OR）及其相应的95%置信区间（CI）。在14832名参与者中，741人（4.2%）有综合心绞痛阳性结果。对于综合结果，将血镉处于最低三分位数（参照组）的参与者与最高三分位数的参与者进行比较，粗比值比和调整后的比值比分别为1.82（95% CI 1.42 - 2.34）和1.45（95% CI 1.12 - 1.88）。这些来自具有全国代表性样本的横断面数据支持了吸烟、镉与心绞痛之间存在相互关系的假设。
