Area of Cardiometabolic and Renal Risk, Biomedical Research Institute INCLIVA, Valencia, Spain (M.G.-P., M.J.C.-M., M.T.-P.).
Department of Preventive Medicine and Microbiology, Autonomous University of Madrid, Spain (M.G.-P., M.T.-P.).
Arterioscler Thromb Vasc Biol. 2022 Jan;42(1):87-99. doi: 10.1161/ATVBAHA.121.316358. Epub 2021 Dec 9.
Studies evaluating the association of metals with subclinical atherosclerosis are mostly limited to carotid arteries. We assessed individual and joint associations of nonessential metals exposure with subclinical atherosclerosis in 3 vascular territories. Approach and Results: One thousand eight hundred seventy-three Aragon Workers Health Study participants had urinary determinations of inorganic arsenic species, barium, cadmium, chromium, antimony, titanium, uranium, vanadium, and tungsten. Plaque presence in carotid and femoral arteries was determined by ultrasound. Coronary Agatston calcium score ≥1 was determined by computed tomography scan. Median arsenic, barium, cadmium, chromium, antimony, titanium, uranium, vanadium, and tungsten levels were 1.83, 1.98, 0.27, 1.18, 0.05, 9.8, 0.03, 0.66, and 0.23 μg/g creatinine, respectively. The adjusted odds ratio (95% CI) for subclinical atherosclerosis presence in at least one territory was 1.25 (1.03-1.51) for arsenic, 1.67 (1.22-2.29) for cadmium, and 1.26 (1.04-1.52) for titanium. These associations were driven by arsenic and cadmium in carotid, cadmium and titanium in femoral, and titanium in coronary territories and mostly remained after additional adjustment for the other relevant metals. Titanium, cadmium, and antimony also showed positive associations with alternative definitions of increased coronary calcium. Bayesian Kernel Machine Regression analysis simultaneously evaluating metal associations suggested an interaction between arsenic and the joint cadmium-titanium exposure.
Our results support arsenic and cadmium and identify titanium and potentially antimony as atherosclerosis risk factors. Exposure reduction and mitigation interventions of these metals may decrease cardiovascular risk in individuals without clinical disease.
评估金属与亚临床动脉粥样硬化之间关联的研究大多局限于颈动脉。我们评估了个体和联合暴露于非必需金属与 3 个血管区域亚临床动脉粥样硬化之间的关联。
1873 名阿拉贡工人健康研究参与者的尿液中测定了无机砷形态、钡、镉、铬、锑、钛、铀、钒和钨。通过超声检查确定颈动脉和股动脉斑块的存在。通过计算机断层扫描确定冠状动脉 Agatston 钙评分≥1。砷、钡、镉、铬、锑、钛、铀、钒和钨的中位数水平分别为 1.83、1.98、0.27、1.18、0.05、9.8、0.03、0.66 和 0.23μg/g 肌酐。至少一个区域存在亚临床动脉粥样硬化的调整后比值比（95%CI）分别为 1.25（1.03-1.51）、1.67（1.22-2.29）和 1.26（1.04-1.52）。这些关联是由颈动脉中的砷和镉、股动脉中的镉和钛以及冠状动脉中的钛驱动的，并且在对其他相关金属进行额外调整后仍然存在。钛、镉和锑也与增加的冠状动脉钙的替代定义呈正相关。同时评估金属关联的贝叶斯核机器回归分析表明砷和镉联合暴露存在相互作用。
我们的研究结果支持砷和镉，并确定钛和潜在的锑是动脉粥样硬化的危险因素。减少这些金属的暴露和缓解干预可能会降低没有临床疾病的个体的心血管风险。
