环境镉暴露对血管内皮功能障碍的贡献度分析
|
摘要
目的:探讨环境中不同镉(Cd)暴露水平对血管内皮功能障碍的贡献程度。方法:在广西某废弃铅锌矿周边及相邻乡镇非污染区的下属行政村屯招募当地20～80岁的常住居民共667名作为研究对象,以肱动脉血流介导的血管舒张功能(FMD)评价血管内皮功能,以尿镉(UCd)浓度反映机体慢性Cd暴露的程度。基于性别分层,按UCd浓度将研究对象分成低、中、高3个浓度组,运用Logistic回归和优势分析法分析不同Cd暴露水平对血管内皮功能障碍的影响和贡献大小。结果:低、中、高水平Cd暴露下,UCd对血管内皮功能障碍的贡献在男性中分别为1.1%、5.5%、8.6%,在女性中分别为7.1%、4.4%、3.2%;不同暴露水平下,UCd对血管内皮功能障碍发生风险的影响差异均无统计学意义(均P>0.05)。结论:不同Cd暴露水平对血管内皮功能障碍的贡献不同且存在性别差异,在男性中呈增高趋势,在女性中呈降低趋势。
Objective:To explore the contribution of different levels of environmental cadmium(Cd) exposure to vascular endothelial dysfunction.Methods:We recruited 667 residents aged 20-80 years old in the subordinate administrative village of an abandoned lead-zinc mine and the non-polluted area in an adjacent township in Guangxi.Vascular endothelial function was assessed by brachial artery flow-mediated dilatation(FMD),the degree of chronic Cd exposure was reflected by urinary cadmium(UCd).Subjects were divided into three groups of low,medium and high according to the concentration of UCd by sex,logistic regression and dominance analysis were used to analyze the effects of different Cd exposure levels on vascular endothelial dysfunction and its contribution.Results:At levels of low,medium and high of Cd exposure,the contribution of UCd to vascular endothelial dysfunction in men were 1.1%,5.5%,and 8.6%,respectively,in women were 7.1%,4.4%,and 3.2%,respectively.Under different exposure levels,there were no significant difference in the effects of UCd on the risk of vascular endothelial dysfunction(P>0.05).Conclusion:Different Cd exposure levels contribute differently to vascular endothelial dysfunction and there are gender differences,which are increased in men and decreased in women.
Objective:To explore the contribution of different levels of environmental cadmium(Cd) exposure to vascular endothelial dysfunction.Methods:We recruited 667 residents aged 20-80 years old in the subordinate administrative village of an abandoned lead-zinc mine and the non-polluted area in an adjacent township in Guangxi.Vascular endothelial function was assessed by brachial artery flow-mediated dilatation(FMD),the degree of chronic Cd exposure was reflected by urinary cadmium(UCd).Subjects were divided into three groups of low,medium and high according to the concentration of UCd by sex,logistic regression and dominance analysis were used to analyze the effects of different Cd exposure levels on vascular endothelial dysfunction and its contribution.Results:At levels of low,medium and high of Cd exposure,the contribution of UCd to vascular endothelial dysfunction in men were 1.1%,5.5%,and 8.6%,respectively,in women were 7.1%,4.4%,and 3.2%,respectively.Under different exposure levels,there were no significant difference in the effects of UCd on the risk of vascular endothelial dysfunction(P>0.05).Conclusion:Different Cd exposure levels contribute differently to vascular endothelial dysfunction and there are gender differences,which are increased in men and decreased in women.
引文
[1]TINKOV A A,FILIPPINI T,AJSUVAKOVA O P,et al.Cadmium and atherosclerosis:a review of toxicological mechanisms and a meta-analysis of epidemiologic studies[J].Environ Res,2018(162):240-260.
[2]GUTIERREZ E,FLAMMER A J,LERMAN L O,et al.Endothelial dysfunction over the course of coronary artery disease[J].Eur Heart J,2013,34(41):3175-3181.
[3]PROZIALECK W C,EDWARDS J R,WOODS J M.The vascular endothelium as a target of cadmium toxicity[J].Life Sci,2006,79(16):1493-1506.
[4]ZHONG Q,LI X,NONG Q,et al.Metabolic Profiling in Association with Vascular Endothelial Cell Dysfunction Following Non-Toxic Cadmium Exposure[J].Int J Mol Sci,2017,18(9):E1905.
[5]KIM J,LIM W,KO Y,et al.The effects of cadmium on VEGF-mediated angiogenesis in HUVECs[J].J Appl Toxicol,2012,32(5):342-349.
[6]GOKALP O,OZDEM S,DONMEZ S,et al.Impairment of endothelium-dependent vasorelaxation in cadmiumhypertensive rats[J].Toxicol Ind Health,2009,25(7):447-453.
[7]OLIVEIRA T F,BATISTA P R,LEAL M A,et al.Chronic cadmium exposure accelerates the development of atherosclerosis and induces vascular dysfunction in the aorta of ApoE(-/-)Mice[J].Biol Trace Elem Res,2019,187(1):163-171.
[8]丁春光,潘亚娟,张爱华,等.中国八省份一般人群血和尿液中铅、镉水平及影响因素调查[J].中华预防医学杂志,2014,48(2):91-96.
[9]FLAMMER A J,ANDERSON T,CELERMAJER D S,et al.The assessment of endothelial function:from research into clinical practice[J].Circulation,2012,126(6):753-767.
[10]COSSELMAN K E,NAVAS-ACIEN A,KAUFMAN JD.Environmental factors in cardiovascular disease[J].Nat Rev Cardiol,2015,12(11):627-642.
[11]SAWADA T,EMOTO T,MOTOJI Y,et al.Possible association between non-invasive parameter of flowmediated dilatation in brachial artery and whole coronary plaque vulnerability in patients with coronary artery disease[J].Int J Cardiol,2013,166(3):613-620.
[12]WEI B,BERNERT J T,BLOUNT B C,et al.Temporal trends of secondhand smoke exposure:nonsmoking workers in the United States(NHANES 2001-2010)[J].Environ Health Perspect,2016,124(10):1568-1574.
[13]TUCKER A M,VOGEL R.A,LINCOLN A E,et al.Prevalence of cardiovascular disease risk factors among National Football League players[J].JAMA,2009,301(20):2111-2119.
[14]樊萌语,吕筠,何平平.国际体力活动问卷中体力活动水平的计算方法[J].中华流行病学杂志,2014,35(8):961-964.
[15]SHOU Y,SMITHSON M.Evaluating predictors of dispersion:a comparison of Dominance Analysis and Bayesian Model Averaging[J].Psychometrika,2015,80(1):236-256.
[16]TELLEZ-PLAZA M,GUALLAR E,HOWARD B V,et al.Cadmium exposure and incident cardiovascular disease[J].Epidemiology,2013,24(3):421-429.
[17]TELLEZ-PLAZA M,NAVAS-ACIEN A,CRAINICE-ANU C M,et al.Cadmium and peripheral arterial disease:gender differences in the 1999-2004US National Health and Nutrition Examination Survey[J].Am J Epidemiol,2010,172(6):671-681.
[18]MENKE A,MUNTNER P,SILBERGELD E K,et al.Cadmium levels in urine and mortality among U.S.adults[J].Environ Health Perspect,2009,117(2):190-196.
[19]DEERING K E,CALLAN A C,PRINCE R L,et al.Low-level cadmium exposure and cardiovascular outcomes in elderly Australian women:a cohort study[J].Int J Hyg Environ Health,2018,221(2):347-354.
[20]TELLEZ-PLAZA M,JONES M R,DOMINGUEZ-LU-CAS A,et al.Cadmium exposure and clinical cardiovascular disease:a systematic review[J].Curr Atheroscler Rep,2013,15(10):356.
[21]VAHTER M,AKESSON A,LIDEN C,et al.Gender differences in the disposition and toxicity of metals[J].Environ Res,2007,104(1):85-95.
[22]SATARUG S,GARRETT S H,SENS M A,et al.Cadmium,environmental exposure,and health outcomes[J].Cien Saude Colet,2011,16(5):2587-2602.
[23]LARSSON S C,WOLK A.Urinary cadmium and mortality from all causes,cancer and cardiovascular disease in the general population:systematic review and metaanalysis of cohort studies[J].Int J Epidemiol,2016,45(3):782-791.
[24]MESSNER B,KNOFLACH M,SEUBERT A,et al.Cadmium is a novel and independent risk factor for early atherosclerosis mechanisms and in vivo relevance[J].Arterioscler Thromb Vasc Biol,2009,29(9):1392-1398.
[2]GUTIERREZ E,FLAMMER A J,LERMAN L O,et al.Endothelial dysfunction over the course of coronary artery disease[J].Eur Heart J,2013,34(41):3175-3181.
[3]PROZIALECK W C,EDWARDS J R,WOODS J M.The vascular endothelium as a target of cadmium toxicity[J].Life Sci,2006,79(16):1493-1506.
[4]ZHONG Q,LI X,NONG Q,et al.Metabolic Profiling in Association with Vascular Endothelial Cell Dysfunction Following Non-Toxic Cadmium Exposure[J].Int J Mol Sci,2017,18(9):E1905.
[5]KIM J,LIM W,KO Y,et al.The effects of cadmium on VEGF-mediated angiogenesis in HUVECs[J].J Appl Toxicol,2012,32(5):342-349.
[6]GOKALP O,OZDEM S,DONMEZ S,et al.Impairment of endothelium-dependent vasorelaxation in cadmiumhypertensive rats[J].Toxicol Ind Health,2009,25(7):447-453.
[7]OLIVEIRA T F,BATISTA P R,LEAL M A,et al.Chronic cadmium exposure accelerates the development of atherosclerosis and induces vascular dysfunction in the aorta of ApoE(-/-)Mice[J].Biol Trace Elem Res,2019,187(1):163-171.
[8]丁春光,潘亚娟,张爱华,等.中国八省份一般人群血和尿液中铅、镉水平及影响因素调查[J].中华预防医学杂志,2014,48(2):91-96.
[9]FLAMMER A J,ANDERSON T,CELERMAJER D S,et al.The assessment of endothelial function:from research into clinical practice[J].Circulation,2012,126(6):753-767.
[10]COSSELMAN K E,NAVAS-ACIEN A,KAUFMAN JD.Environmental factors in cardiovascular disease[J].Nat Rev Cardiol,2015,12(11):627-642.
[11]SAWADA T,EMOTO T,MOTOJI Y,et al.Possible association between non-invasive parameter of flowmediated dilatation in brachial artery and whole coronary plaque vulnerability in patients with coronary artery disease[J].Int J Cardiol,2013,166(3):613-620.
[12]WEI B,BERNERT J T,BLOUNT B C,et al.Temporal trends of secondhand smoke exposure:nonsmoking workers in the United States(NHANES 2001-2010)[J].Environ Health Perspect,2016,124(10):1568-1574.
[13]TUCKER A M,VOGEL R.A,LINCOLN A E,et al.Prevalence of cardiovascular disease risk factors among National Football League players[J].JAMA,2009,301(20):2111-2119.
[14]樊萌语,吕筠,何平平.国际体力活动问卷中体力活动水平的计算方法[J].中华流行病学杂志,2014,35(8):961-964.
[15]SHOU Y,SMITHSON M.Evaluating predictors of dispersion:a comparison of Dominance Analysis and Bayesian Model Averaging[J].Psychometrika,2015,80(1):236-256.
[16]TELLEZ-PLAZA M,GUALLAR E,HOWARD B V,et al.Cadmium exposure and incident cardiovascular disease[J].Epidemiology,2013,24(3):421-429.
[17]TELLEZ-PLAZA M,NAVAS-ACIEN A,CRAINICE-ANU C M,et al.Cadmium and peripheral arterial disease:gender differences in the 1999-2004US National Health and Nutrition Examination Survey[J].Am J Epidemiol,2010,172(6):671-681.
[18]MENKE A,MUNTNER P,SILBERGELD E K,et al.Cadmium levels in urine and mortality among U.S.adults[J].Environ Health Perspect,2009,117(2):190-196.
[19]DEERING K E,CALLAN A C,PRINCE R L,et al.Low-level cadmium exposure and cardiovascular outcomes in elderly Australian women:a cohort study[J].Int J Hyg Environ Health,2018,221(2):347-354.
[20]TELLEZ-PLAZA M,JONES M R,DOMINGUEZ-LU-CAS A,et al.Cadmium exposure and clinical cardiovascular disease:a systematic review[J].Curr Atheroscler Rep,2013,15(10):356.
[21]VAHTER M,AKESSON A,LIDEN C,et al.Gender differences in the disposition and toxicity of metals[J].Environ Res,2007,104(1):85-95.
[22]SATARUG S,GARRETT S H,SENS M A,et al.Cadmium,environmental exposure,and health outcomes[J].Cien Saude Colet,2011,16(5):2587-2602.
[23]LARSSON S C,WOLK A.Urinary cadmium and mortality from all causes,cancer and cardiovascular disease in the general population:systematic review and metaanalysis of cohort studies[J].Int J Epidemiol,2016,45(3):782-791.
[24]MESSNER B,KNOFLACH M,SEUBERT A,et al.Cadmium is a novel and independent risk factor for early atherosclerosis mechanisms and in vivo relevance[J].Arterioscler Thromb Vasc Biol,2009,29(9):1392-1398.