Hanafi Noorul Izzati, Othman Mohd Hafiz Dzarfan, Sheikh Abdul Kadir Siti Hamimah
Cardiovascular Advancement and Research Excellence Institute (CARE Institute), Universiti Teknologi MARA, Campus Sungai Buloh, Jalan Hospital, Sungai Buloh, 47000, Selangor, Malaysia.
Advanced Membrane Technology Research Centre (AMTEC), Universiti Teknologi Malaysia, 81310, Skudai, Johor, Malaysia.
Biol Trace Elem Res. 2025 Jun 10. doi: 10.1007/s12011-025-04674-2.
Arsenic is a natural compound of metalloid (both metal and non-metal) found in soil and minerals used in semiconductor and alloys. Arsenic exposure is associated with an increased risk of cardiovascular disease (CVD) risk from drinking water or environmental sources. Exploring the emerging biomarkers associated with CVD upon arsenic exposure is crucial. Thus, this review paper aimed to analyze the prediction of emerging CVD biomarkers in population exposed to arsenic and their associated risk factors in humans by a systematic review and meta-analysis. A systematic search was conducted using PubMed, Scopus, and Web of Science to identify eligible studies on arsenic exposure associated with CVDs and their risk factors. Sensitivity, specificity, and predictive value of biomarkers for CVD of arsenic exposed population were assessed by calculating the quality criteria, standard means different (SMD), odds ratio (OR), and 95% confidence intervals (CIs). A meta-analysis was used to derive a combined SMD and OR for the heterogeneity test in between studies. The meta-analysis of nine articles were included. The overall effect sizes revealed significant heterogeneity across studies (I = 97.57%), with pooled effect size was 3.578 (95% CI 3.032 to 4.123, p < 0.0001) under the random-effects model. These results indicate a robust association between arsenic exposure and adverse cardiovascular outcomes, as confirmed by sensitivity analyses and bias assessments (Systematic review registration: PROSPERO CRD42024616848). To improve the quality of future research, efforts should concentrate on enhancing control for confounders, enrolling diverse participant populations, and implementing and yield more substantial findings concerning the cardiovascular effects of arsenic exposure.
砷是一种类金属（兼具金属和非金属特性）的天然化合物，存在于土壤和用于半导体及合金的矿物质中。接触砷会因饮用水或环境来源而增加患心血管疾病（CVD）的风险。探索与砷暴露相关的新兴心血管疾病生物标志物至关重要。因此，本综述旨在通过系统评价和荟萃分析，分析砷暴露人群中新兴心血管疾病生物标志物的预测情况及其在人类中的相关危险因素。通过使用PubMed、Scopus和Web of Science进行系统检索，以识别与心血管疾病及其危险因素相关的砷暴露的合格研究。通过计算质量标准、标准化均值差（SMD）、比值比（OR）和95%置信区间（CIs），评估砷暴露人群心血管疾病生物标志物的敏感性、特异性和预测价值。采用荟萃分析得出合并后的SMD和OR，用于研究间的异质性检验。纳入了9篇文章的荟萃分析。总体效应大小显示各研究间存在显著异质性（I = 97.57%），在随机效应模型下，合并效应大小为3.578（95% CI 3.032至4.123，p < 0.0001）。敏感性分析和偏倚评估证实，这些结果表明砷暴露与不良心血管结局之间存在密切关联（系统评价注册：PROSPERO CRD42024616848）。为提高未来研究的质量，应集中精力加强对混杂因素的控制，纳入多样化的参与者群体，并实施研究以获得更多关于砷暴露心血管影响的实质性发现。
