Dipartimento di Scienze Mediche, Chirurgiche e Sperimentali, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy.
Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
Nutrients. 2021 Aug 20;13(8):2858. doi: 10.3390/nu13082858.
The role of water hardness on human health is still debated, ranging from beneficial to harmful. Before the rise of drinking bottled water, it was a common habit to obtain supplies of drinking water directly from spring-fed public fountains. According to the geographic location, spring waters are characterized by a variable content of mineral components. In this ecological study, for the first time in Sardinia, Italy, the spatial association between spring water quality/composition and standardized mortality ratio (SMR) for coronary artery disease (CAD) in the decade from 1981 to 1991 was investigated using data retrieved from published databases. In a total of 377 municipalities, 9918 deaths due to CAD, including acute myocardial infarction (AMI), ICD-9 code 410, and ischemic heart disease (IHD), ICD-9 code 411-414, were retrieved. A conditional autoregressive model with spatially structured random effects for each municipality was used. The average SMR for CAD in municipalities with a predominantly "soft" (<30 mg/L) or "hard" (≥30 mg/L) water was, respectively, 121.4 ± 59.1 vs. 104.7 ± 38.2 ( = 0.025). More specifically, an inverse association was found between elevated calcium content in spring water and cardiovascular mortality (AMI: r = -0.123, = 0.032; IHD: r = -0.146, = 0.009) and borderline significance for magnesium (AMI: r = -0.131, = 0.054; IHD: r = -0.138, = 0.074) and bicarbonate (IHD: r = -0.126, = 0.058), whereas weak positive correlations were detected for sodium and chloride. The lowest CAD mortality was observed in geographic areas (North-West: SMR 0.92; South-East: SMR 0.88), where calcium- and bicarbonate-rich mineral waters were consumed. Our results, within the limitation of an ecological study, confirm the beneficial role of waters with high content in calcium and bicarbonate against coronary artery disease.
水的硬度对人体健康的影响仍存在争议，其影响范围从有益到有害。在瓶装水兴起之前，直接从泉水供应的公共喷泉获取饮用水是一种常见的习惯。根据地理位置的不同，泉水的矿物质成分含量也各不相同。在这项针对意大利撒丁岛的生态研究中，首次利用从已发表的数据库中检索到的数据，调查了 1981 年至 1991 年十年间泉水水质/成分与冠心病（CAD）标准化死亡率（SMR）之间的空间关联。在总共 377 个市/镇中，检索到了 9918 例 CAD 死亡病例，包括急性心肌梗死（AMI），ICD-9 代码 410 和缺血性心脏病（IHD），ICD-9 代码 411-414。为每个市/镇使用具有空间结构随机效应的条件自回归模型。水硬度主要为“软”（<30mg/L）或“硬”（≥30mg/L）的市/镇中 CAD 的平均 SMR 分别为 121.4 ± 59.1 与 104.7 ± 38.2（=0.025）。更具体地说，发现泉水的钙含量升高与心血管死亡率呈负相关（AMI：r=-0.123，=0.032；IHD：r=-0.146，=0.009），而镁的相关性则接近显著（AMI：r=-0.131，=0.054；IHD：r=-0.138，=0.074），对于碳酸氢盐（IHD：r=-0.126，=0.058）也呈边缘显著。检测到钠和氯呈弱正相关。在钙和碳酸氢盐含量高的地理区域（西北：SMR 0.92；东南：SMR 0.88）观察到 CAD 死亡率最低。在生态研究的限制内，我们的结果证实了富含钙和碳酸氢盐的水对冠心病的有益作用。
