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Wei Y, Wang X, Sun Q, Shi W, Zhang W, Gao X, Li Y, Hao R, Dong X, Chen C, Cao K, Jiang W, Yang Z, Zhu Y, Lv Y, Xv D, Li J, Shi X. Associations of environmental cadmium exposure with kidney damage: Exploring mediating DNA methylation sites in Chinese adults. ENVIRONMENTAL RESEARCH 2024; 251:118667. [PMID: 38462081 DOI: 10.1016/j.envres.2024.118667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 03/12/2024]
Abstract
Environmental exposure is widely recognized as the primary sources of Cadmium (Cd) in the human body, and exposure to Cd is associated with kidney damage in adults. Nevertheless, the role of DNA methylation in Cd-induced kidney damage remains unclear. This study aimed to investigate the epigenome-wide association of environmental Cd-related DNA methylation changes with kidney damage. We included 300 non-smoking adults from the China in 2019. DNA methylation profiles were measured with Illumina Infinium MethylationEPIC BeadChip array. Linear mixed-effect model was employed to estimate the effects of urinary Cd with DNA methylation. Differentially methylated positions (DMPs) associated with urinary Cd were then tested for the association with kidney damage indicators. The mediation analysis was further applied to explore the potential DNA methylation based mediators. The prediction model was developed using a logistic regression model, and used 1000 bootstrap resampling for the internal validation. We identified 27 Cd-related DMPs mapped to 20 genes after the adjustment of false-discovery-rate for multiple testing among non-smoking adults. 17 DMPs were found to be associated with both urinary Cd and kidney damage, and 14 of these DMPs were newly identified within the Chinese. Mediation analysis revealed that DNA methylation of cg26907612 and cg16848624 mediated the Cd-related reduced kidney damage. In addition, ten variables were selected using the LASSO regression analysis and were utilized to develop the prediction model. It found that the nomogram model predicted the risk of kidney damage caused by environmental Cd with a corrected C-index of 0.779. Our findings revealed novel DMPs associated with both environmental Cd exposure and kidney damage among non-smoking adults, and developed an easy-to-use nomogram-illustrated model using these novel DMPs. These findings could provide a theoretical basis for formulating prevention and control strategies for kidney damage from the perspective of environmental pollution and epigenetic regulation.
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Affiliation(s)
- Yuan Wei
- Department of Hygienic Inspection, School of Public Health, Jilin University, Changchun, Jilin, 130021, China; China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Xiaochen Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Qi Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Wanying Shi
- Department of Epidemiology and Health Statistics, and Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Wenli Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Xu Gao
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100083, China
| | - Yawei Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Ruiting Hao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Xiaojie Dong
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Chen Chen
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Kangning Cao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Weilong Jiang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Zhengxiong Yang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Ying Zhu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Yuebin Lv
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Dongqun Xv
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Juan Li
- Department of Hygienic Inspection, School of Public Health, Jilin University, Changchun, Jilin, 130021, China.
| | - Xiaoming Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, China.
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Ruggles A, Benakis C. Exposure to Environmental Toxins: Potential Implications for Stroke Risk via the Gut- and Lung-Brain Axis. Cells 2024; 13:803. [PMID: 38786027 PMCID: PMC11119296 DOI: 10.3390/cells13100803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/24/2024] [Accepted: 05/02/2024] [Indexed: 05/25/2024] Open
Abstract
Recent evidence indicates that exposure to environmental toxins, both short-term and long-term, can increase the risk of developing neurological disorders, including neurodegenerative diseases (i.e., Alzheimer's disease and other dementias) and acute brain injury (i.e., stroke). For stroke, the latest systematic analysis revealed that exposure to ambient particulate matter is the second most frequent stroke risk after high blood pressure. However, preclinical and clinical stroke investigations on the deleterious consequences of environmental pollutants are scarce. This review examines recent evidence of how environmental toxins, absorbed along the digestive tract or inhaled through the lungs, affect the host cellular response. We particularly address the consequences of environmental toxins on the immune response and the microbiome at the gut and lung barrier sites. Additionally, this review highlights findings showing the potential contribution of environmental toxins to an increased risk of stroke. A better understanding of the biological mechanisms underlying exposure to environmental toxins has the potential to mitigate stroke risk and other neurological disorders.
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Affiliation(s)
| | - Corinne Benakis
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich, 81337 Munich, Germany;
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Qiang YW, Hao MH, Yang J. Urinary cadmium was linearly and positively associated with cardiac infarction/injury score and subclinical myocardial injury in the general population without cardiovascular diseases and chronic kidney disease. Int Urol Nephrol 2024; 56:1677-1685. [PMID: 37898564 DOI: 10.1007/s11255-023-03853-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/08/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE The study was to investigate the association between urinary cadmium with cardiac infarction/injury score (CIIS) and subclinical myocardial injury (SC-MI) in the general population without cardiovascular diseases (CVDs) and chronic kidney disease (CKD). METHODS In this large-scale cross-sectional study, we enrolled 4492 individuals without CVDs and CKD from the third National Health and Nutrition Examination Survey. Logistic regression models, linear regression models, subgroup analyses, and restricted cubic spline (RCS) were performed to assess the association between urinary cadmium with CIIS and SC-MI. RESULTS Participants with SC-MI had higher levels of urinary cadmium compared with those without SC-MI (P < 0.001). In multivariate regression analyses adjusting for all confounding variables, higher levels of urinary cadmium were strongly associated not only with higher risk of SC-MI but also with higher CIIS (P < 0.05). Further subgroup analyses showed that the association between urinary cadmium and SC-MI remained significant in the subgroups of ≥ 50 years, men, smokers, and those without diabetes or hypertension (P < 0.05). Additionally, RCS analysis showed that after adjusting for all confounding factors, urinary cadmium was linearly and positively associated with CIIS and SC-MI (P overall < 0.05, P for nonlinearity > 0.05). CONCLUSION Urinary cadmium was linearly and positively associated with CIIS and SC-MI in the general population without CVDs and CKD.
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Affiliation(s)
- Yu-Wei Qiang
- Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, Beijing, 101100, China.
| | - Ming-Hui Hao
- Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, Beijing, 101100, China
| | - Jing Yang
- Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, Beijing, 101100, China
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Verzelloni P, Urbano T, Wise LA, Vinceti M, Filippini T. Cadmium exposure and cardiovascular disease risk: A systematic review and dose-response meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 345:123462. [PMID: 38295933 DOI: 10.1016/j.envpol.2024.123462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/30/2023] [Accepted: 01/27/2024] [Indexed: 02/05/2024]
Abstract
Exposure to toxic metals is a global public health threat. Among other adverse effects, exposure to the heavy metal cadmium has been associated with greater risk of cardiovascular disease (CVD). Nonetheless, the shape of the association between cadmium exposure and CVD risk is not clear. This systematic review summarizes data on the association between cadmium exposure and risk of CVD using a dose-response approach. We carried out a literature search in PubMed, Web of Science, and Embase from inception to December 30, 2023. Inclusion criteria were: studies on adult populations, assessment of cadmium exposure, risk of overall CVD and main CVD subgroups as endpoints, and observational study design (cohort, cross-sectional, or case-control). We retrieved 26 eligible studies published during 2005-2023, measuring cadmium exposure mainly in urine and whole blood. In a dose-response meta-analysis using the one-stage method within a random-effects model, we observed a positive association between cadmium exposure and risk of overall CVD. When using whole blood cadmium as a biomarker, the association with overall CVD risk was linear, yielding a risk ratio (RR) of 2.58 (95 % confidence interval-CI 1.78-3.74) at 1 μg/L. When using urinary cadmium as a biomarker, the association was linear until 0.5 μg/g creatinine (RR = 2.79, 95 % CI 1.26-6.16), after which risk plateaued. We found similar patterns of association of cadmium exposure with overall CVD mortality and risks of heart failure, coronary heart disease, and overall stroke, whereas for ischemic stroke there was a positive association with mortality only. Overall, our results suggest that cadmium exposure, whether measured in urine or whole blood, is associated with increased CVD risk, further highlighting the importance of reducing environmental pollution from this heavy metal.
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Affiliation(s)
- Pietro Verzelloni
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Teresa Urbano
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Marco Vinceti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Tommaso Filippini
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; School of Public Health, University of California Berkeley, Berkeley, CA, USA.
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Deng X, Liu D, Li M, He J, Fu Y. Physical activity can reduce the risk of blood cadmium and blood lead on stroke: Evidence from NHANES. Toxicol Appl Pharmacol 2024; 483:116831. [PMID: 38266873 DOI: 10.1016/j.taap.2024.116831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/14/2024] [Accepted: 01/19/2024] [Indexed: 01/26/2024]
Abstract
The detrimental impact of heavy metals on cardiovascular well-being is a global concern, and engaging in suitable physical activity has been shown to confer cardiovascular advantage. Nevertheless, the potential of exercise to mitigate the deleterious effects of heavy metals on stroke remains uncertain. We conducted a cross-sectional survey to assess the influence of blood cadmium and blood lead on stroke occurrence, while also examining the role of physical activity. Weighted multivariate regression analysis was employed to examine the potential correlation, while subgroup and interaction analyses were used to investigate the sensitivity and robustness of the results. After controlling risk factors, it revealed a positive correlation between blood cadmium and lead levels and the occurrence of stroke. Specifically, a 50% increase in blood cadmium was associated with a 28% increase in stroke incidence, while a 50% increase in blood lead was associated with a 47% increase in stroke incidence. To estimate the non-linear relationship, we employed restricted cubic models. The results demonstrate a gradual decrease in the slope of the model curve as the intensity of physical activity increases, implying that engaging in physical activity may contribute to a reduction in the occurrence of stroke caused by blood cadmium and lead. Our findings suggest that blood cadmium and lead could be considered an autonomous risk factor for stroke within the general population of the United States. Moreover, engaging in physical activity has the potential to mitigate the potential detrimental consequences associated with exposure to heavy metals.
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Affiliation(s)
- Xiaoqi Deng
- The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Dichuan Liu
- The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China.
| | - Miao Li
- Beijing Tiantan Hospital, Capital Medical University, 100070, China
| | - Jie He
- The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Yufan Fu
- The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
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Xu Y, Hong H, Lin X, Tong T, Zhang J, He H, Yang L, Mao G, Hao R, Deng P, Yu Z, Pi H, Cheng Y, Zhou Z. Chronic cadmium exposure induces Parkinson-like syndrome by eliciting sphingolipid disturbance and neuroinflammation in the midbrain of C57BL/6J mice. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 337:122606. [PMID: 37742865 DOI: 10.1016/j.envpol.2023.122606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 09/26/2023]
Abstract
Cadmium (Cd) is known as a widespread environmental neurotoxic pollutant. Cd exposure is recently recognized as an etiological factor of Parkinson's disease (PD) in humans. However, the mechanism underlying Cd neurotoxicity in relation to Parkinsonism pathogenesis is unclear. In our present study, C57BL/6 J mice were exposed to 100 mg/L CdCl2 in drinking water for 8 weeks. It was found Cd exposure caused motor deficits, decreased DA neurons and induced neuropathological changes in the midbrain. Non-targeted lipidomic analysis uncovered that Cd exposure altered lipid profile, increased the content of proinflammatory sphingolipid ceramides (Cer), sphingomyelin (SM) and ganglioside (GM3) in the midbrain. In consistency with increased proinflammatory lipids, the mRNA levels of genes encoding sphingolipids biosynthesis in the midbrain were dysregulated by Cd exposure. Neuroinflammation in the midbrain was evinced by the up-regulation of proinflammatory cytokines at mRNA and protein levels. Blood Cd contents and lipid metabolites in Parkinsonism patients by ICP-MS and LC-MS/MS analyses demonstrated that elevated blood Cd concentration and proinflammatory lipid metabolites were positively associated with the score of Unified Parkinson's Disease Rating Scale (UPDRS). 3 ceramide metabolites in the blood showed good specificity as the candidate biomarkers to predict and monitor Parkinsonism and Cd neurotoxicity (AUC>0.7, p < 0.01). In summary, our present study uncovered that perturbed sphingomyelin lipid metabolism is related to the Parkinsonism pathogenesis and Cd neurotoxicity, partially compensated for the deficiency in particular metabolic biomarkers for Parkinsonism in relation to Cd exposure, and emphasized the necessity of reducing Cd exposure at population level.
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Affiliation(s)
- Yudong Xu
- Department of Environmental Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Huihui Hong
- Center for Neurointelligence, School of Medicine, Chongqing University, Chongqing, China
| | - Xiqin Lin
- Department of Environmental Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Tong Tong
- Department of Environmental Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingjing Zhang
- Department of Environmental Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Haotian He
- Department of Environmental Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Lingling Yang
- Department of Occupational Health, Third Military Medical University, Chongqing, China
| | - Gaofeng Mao
- Neurology Department, General Hospital of Center Theater Command, Wuhan, China
| | - Rongrong Hao
- Department of Occupational Health, Third Military Medical University, Chongqing, China
| | - Ping Deng
- Department of Occupational Health, Third Military Medical University, Chongqing, China
| | - Zhengping Yu
- Department of Occupational Health, Third Military Medical University, Chongqing, China
| | - Huifeng Pi
- Department of Occupational Health, Third Military Medical University, Chongqing, China
| | - Yong Cheng
- Neurology Department, General Hospital of Center Theater Command, Wuhan, China
| | - Zhou Zhou
- Department of Environmental Medicine, Zhejiang University School of Medicine, Hangzhou, China; Center for Neurointelligence, School of Medicine, Chongqing University, Chongqing, China.
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Saceleanu VM, Toader C, Ples H, Covache-Busuioc RA, Costin HP, Bratu BG, Dumitrascu DI, Bordeianu A, Corlatescu AD, Ciurea AV. Integrative Approaches in Acute Ischemic Stroke: From Symptom Recognition to Future Innovations. Biomedicines 2023; 11:2617. [PMID: 37892991 PMCID: PMC10604797 DOI: 10.3390/biomedicines11102617] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023] Open
Abstract
Among the high prevalence of cerebrovascular diseases nowadays, acute ischemic stroke stands out, representing a significant worldwide health issue with important socio-economic implications. Prompt diagnosis and intervention are important milestones for the management of this multifaceted pathology, making understanding the various stroke-onset symptoms crucial. A key role in acute ischemic stroke management is emphasizing the essential role of a multi-disciplinary team, therefore, increasing the efficiency of recognition and treatment. Neuroimaging and neuroradiology have evolved dramatically over the years, with multiple approaches that provide a higher understanding of the morphological aspects as well as timely recognition of cerebral artery occlusions for effective therapy planning. Regarding the treatment matter, the pharmacological approach, particularly fibrinolytic therapy, has its merits and challenges. Endovascular thrombectomy, a game-changer in stroke management, has witnessed significant advances, with technologies like stent retrievers and aspiration catheters playing pivotal roles. For select patients, combining pharmacological and endovascular strategies offers evidence-backed benefits. The aim of our comprehensive study on acute ischemic stroke is to efficiently compare the current therapies, recognize novel possibilities from the literature, and describe the state of the art in the interdisciplinary approach to acute ischemic stroke. As we aspire for holistic patient management, the emphasis is not just on medical intervention but also on physical therapy, mental health, and community engagement. The future holds promising innovations, with artificial intelligence poised to reshape stroke diagnostics and treatments. Bridging the gap between groundbreaking research and clinical practice remains a challenge, urging continuous collaboration and research.
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Affiliation(s)
- Vicentiu Mircea Saceleanu
- Neurosurgery Department, Sibiu County Emergency Hospital, 550245 Sibiu, Romania;
- Neurosurgery Department, “Lucian Blaga” University of Medicine, 550024 Sibiu, Romania
| | - Corneliu Toader
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-A.C.-B.); (H.P.C.); (B.-G.B.); (D.-I.D.); (A.B.); (A.D.C.); (A.V.C.)
- Department of Vascular Neurosurgery, National Institute of Neurology and Neurovascular Diseases, 020022 Bucharest, Romania
| | - Horia Ples
- Centre for Cognitive Research in Neuropsychiatric Pathology (NeuroPsy-Cog), “Victor Babes” University of Medicine and Pharmacy, 300736 Timisoara, Romania
- Department of Neurosurgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Razvan-Adrian Covache-Busuioc
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-A.C.-B.); (H.P.C.); (B.-G.B.); (D.-I.D.); (A.B.); (A.D.C.); (A.V.C.)
| | - Horia Petre Costin
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-A.C.-B.); (H.P.C.); (B.-G.B.); (D.-I.D.); (A.B.); (A.D.C.); (A.V.C.)
| | - Bogdan-Gabriel Bratu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-A.C.-B.); (H.P.C.); (B.-G.B.); (D.-I.D.); (A.B.); (A.D.C.); (A.V.C.)
| | - David-Ioan Dumitrascu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-A.C.-B.); (H.P.C.); (B.-G.B.); (D.-I.D.); (A.B.); (A.D.C.); (A.V.C.)
| | - Andrei Bordeianu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-A.C.-B.); (H.P.C.); (B.-G.B.); (D.-I.D.); (A.B.); (A.D.C.); (A.V.C.)
| | - Antonio Daniel Corlatescu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-A.C.-B.); (H.P.C.); (B.-G.B.); (D.-I.D.); (A.B.); (A.D.C.); (A.V.C.)
| | - Alexandru Vlad Ciurea
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-A.C.-B.); (H.P.C.); (B.-G.B.); (D.-I.D.); (A.B.); (A.D.C.); (A.V.C.)
- Neurosurgery Department, Sanador Clinical Hospital, 010991 Bucharest, Romania
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Yang M, Yoo H, Kim SY, Kwon O, Nam MW, Pan KH, Kang MY. Occupational Risk Factors for Stroke: A Comprehensive Review. J Stroke 2023; 25:327-337. [PMID: 37813670 PMCID: PMC10574301 DOI: 10.5853/jos.2023.01011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 10/11/2023] Open
Abstract
For primary prevention, it is important for public health and clinical medicine to identify and characterize modifiable risk factors of stroke. In existing literature, the impact of occupational variables on ischemic and hemorrhagic stroke has been extensively studied. This review summarizes the available data on the significance of occupational variables in stroke. The results of this review suggest that there is sufficient evidence for the relationship between increased risk of stroke and job stress, working in extreme temperatures, long working hours, and/or shift work. The association between long working hours and occupational exposure to noise and chemicals remains inconclusive although several studies have reported this finding. This review will act as a step toward future research and provide information that may serve as a baseline for developing targeted interventions to prevent stroke in the working population.
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Affiliation(s)
- Munyoung Yang
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyoungseob Yoo
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seo-Young Kim
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ohwi Kwon
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Min-Woo Nam
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Seoul, Korea
| | - Kwang Hyun Pan
- Department of Neurology, Anam Hospital, Korea University, Seoul, Korea
| | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Wu YJ, Wang SB, Sun JT, Gu LF, Wang ZM, Deng B, Wang H, Wang LS. Association between urinary cadmium level and subclinical myocardial injury in the general population without cardiovascular disease aged ≥ 50 years. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-27923-0. [PMID: 37261691 DOI: 10.1007/s11356-023-27923-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/22/2023] [Indexed: 06/02/2023]
Abstract
Cadmium (Cd) is a toxic heavy metal linked to an increased risk of cardiovascular disease (CVD). But the relationship between urinary Cd (U-Cd) and electrocardiographic subclinical myocardial injury (SC-MI) in older people is unclear. This study evaluated the connection between U-Cd and SC-MI in people who did not have CVD. The study involved 4269 participants from the National Health and Nutrition Examination Survey III(NHANES III) aged ≥ 50 years and had no history of CVD. The relationship between U-Cd and cardiac infarction/injury score (CIIS) was assessed by multivariable linear regression. Whether U-Cd and SC-MI were correlated was determined by multivariate logistic regression, restricted cubic spline, and subgroup analysis. There was a significant association between U-Cd and CIIS (β, 1.04, 95% confidence interval (CI): 0.39-1.69; P = 0.003) in the highest quartile and fully adjusted model. After adjusting for relevant confounders, multivariable logistic regression showed that participants in the highest quartile of U-Cd had a greater chance of having SC-MI than those in the first ( OR (95% CI), 1.37(1.13,1.66), P for trend = 0.003), and this relationship was especially strong among hypertensive participants. And a positive linear correlation between U-Cd and the prevalence of SC-MI was shown by restricted cubic spline analysis. U-Cd may be a novel risk element for SC-MI because it is independently and linearly linked to CIIS and SC-MI.
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Affiliation(s)
- Yu-Jie Wu
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
| | - Si-Bo Wang
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
| | - Jia-Teng Sun
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
| | - Ling-Feng Gu
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
| | - Ze-Mu Wang
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
| | - Bo Deng
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
| | - Hao Wang
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
| | - Lian-Sheng Wang
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China.
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Zhang J, Wang X, Ma Z, Dang Y, Yang Y, Cao S, Ouyang C, Shi X, Pan J, Hu X. Associations of urinary and blood cadmium concentrations with all-cause mortality in US adults with chronic kidney disease: a prospective cohort study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:61659-61671. [PMID: 36933131 DOI: 10.1007/s11356-023-26451-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/10/2023] [Indexed: 05/10/2023]
Abstract
Epidemiological evidence for the relationship between cadmium exposure and mortality in specific chronic kidney disease (CKD) populations remains scarce. We aimed to explore the relationships between cadmium concentrations in urine and blood and all-cause mortality among CKD patients in the USA. This cohort study was composed of 1825 CKD participants from the National Health and Nutrition Examination Survey (NHANES) (1999-2014) who were followed up to December 31, 2015. All-cause mortality was ascertained by matching the National Death Index (NDI) records. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality in relation to urinary and blood cadmium concentrations by Cox regression models. During an average follow-up period of 82 months, 576 CKD participants died. Compared with the lowest quartiles, HRs (95% CIs) for all-cause mortality associated with the fourth weighted quartiles of urinary and blood cadmium concentrations were 1.75 (1.28 to 2.39) and 1.59 (1.17 to 2.15), respectively. Furthermore, the HRs (95% CIs) for all-cause mortality per ln-transformed IQR increment in cadmium concentrations in urine (1.15 μg/g UCr) and blood (0.95 μg/L) were 1.40 (1.21 to 1.63) and 1.22 (1.07 to 1.40), respectively. Linear concentration-response relationships between urinary and blood cadmium concentrations and all-cause mortality were also found. Our findings suggested that increased cadmium concentrations in both urine and blood significantly contributed to enhanced mortality risk in CKD patients, thus highlighting that efforts to reduce cadmium exposure may reduce mortality risk in high-risk populations with CKD.
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Affiliation(s)
- Jia Zhang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Xiao Wang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Zhibin Ma
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Ying Dang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Yaya Yang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Shuting Cao
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Changping Ouyang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Xiaoru Shi
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Jinhua Pan
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Xiaobin Hu
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China.
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11
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Disturbed Ratios between Essential and Toxic Trace Elements as Potential Biomarkers of Acute Ischemic Stroke. Nutrients 2023; 15:nu15061434. [PMID: 36986164 PMCID: PMC10058587 DOI: 10.3390/nu15061434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/09/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023] Open
Abstract
Background: Cadmium (Cd) and lead (Pb) are known to be two of the metal contaminants that pose the greatest potential threat to human health. The purpose of this research study was to compare the levels of toxic metals (Cd, Pb) in patients with acute ischemic stroke (AIS), with a control group in Podlaskie Voivodeship, Poland. The study also aimed to assess the correlations between toxic metals and clinical data in AIS patients, and to assess the potential effect of smoking. Materials and methods: The levels of mineral components in the collected blood samples were assessed by means of atomic absorption spectrometry (AAS). Results: The Cd blood concentration was significantly higher in AIS patients as compared to the control group. We found that the molar ratios of Cd/Zn and Cd/Pb were significantly higher (p < 0.001; p < 0.001, respectively), when the molar ratios of Se/Pb, Se/Cd, and Cu/Cd were significantly lower (p = 0.01; p < 0.001; p < 0.001, respectively), in AIS patients as compared to control subjects. However, there were no considerable fluctuations in relation to the blood Pb concentration or molar ratios of Zn/Pb and Cu/Pb between our AIS patients and the control group. We also found that patients with internal carotid artery (ICA) atherosclerosis, particularly those with 20–50% ICA stenosis, had higher concentrations of Cd and Cd/Zn, but lower Cu/Cd and Se/Cd molar ratios. In the course of our analysis, we observed that current smokers among AIS patients had significantly higher blood-Cd concentrations, Cd/Zn and Cd/Pb molar ratios, and hemoglobin levels, but significantly lower HDL-C concentrations, Se/Cd, and Cu/Cd molar ratios. Conclusions: Our research has shown that the disruption of the metal balance plays a crucial role in the pathogenesis of AIS. Furthermore, our results broaden those of previous studies on the exposure to Cd and Pb as risk factors for AIS. Further investigations are necessary to examine the probable mechanisms of Cd and Pb in the onset of ischemic stroke. The Cd/Zn molar ratio may be a useful biomarker of atherosclerosis in AIS patients. An accurate assessment of changes in the molar ratios of essential and toxic trace elements could serve as a valuable indicator of the nutritional status and levels of oxidative stress in AIS patients. It is critical to investigate the potential role of exposure to metal mixtures in AIS, due to its public health implications.
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Sasikumar S, Yuvraj S, Veilumuthu P, Godwin Christopher JS, Anandkumar P, Nagarajan T, Sureshkumar S, Selvam GS. Ascorbic acid attenuates cadmium-induced myocardial hypertrophy and cardiomyocyte injury through Nrf2 signaling pathways comparable to resveratrol. 3 Biotech 2023; 13:108. [PMID: 36875963 PMCID: PMC9978049 DOI: 10.1007/s13205-023-03527-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/17/2023] [Indexed: 03/05/2023] Open
Abstract
Chronic cadmium (Cd) exposure severely affects the structural integrity of the heart, leading to cardiovascular disease. This study investigates the protective role of ascorbic acid (AA) and resveratrol (Res) in cellular defense against Cd-induced cardiomyocyte damage and myocardial hypertrophy in H9c2 cardiomyocytes. Experimental results showed that AA and Res treatment significantly increased cell viability, reduced ROS production, attenuated lipid peroxidation, and increased antioxidant enzyme activity in Cd-induced H9c2 cells. AA and Res decreased the mitochondrial membrane permeability and protected the cells from Cd induced cardiomyocyte damage. This also suppressed the pathological hypertrophic response triggered by Cd, which increased the cell size of cardiomyocytes. Gene expression studies revealed that cells treated with AA and Res decreased the expression of hypertrophic genes ANP (two-fold), BNP (one-fold) and β- MHC (two-fold) compared to Cd exposed cells. AA and Res promoted the nuclear translocation of Nrf2 and increased the expression of antioxidant genes (HO-1, NQO1, SOD and CAT) during Cd mediated myocardial hypertrophy. This study proves that AA and Res play a significant role in improving Nrf2 signaling, thereby reversing stress-induced injury, and facilitating the regression of myocardial hypertrophy.
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Affiliation(s)
- Sundaresan Sasikumar
- Department of Biochemistry, Molecular Cardiology Unit, School of Biological Sciences, Madurai Kamaraj University, Madurai, 625021 India
| | - Subramani Yuvraj
- Department of Biochemistry, Molecular Cardiology Unit, School of Biological Sciences, Madurai Kamaraj University, Madurai, 625021 India
| | | | | | | | | | - Selvaraj Sureshkumar
- Department of Microbiology, Karpagam Academy of Higher Education, Coimbatore, Tamil Nadu India
| | - Govindan Sadasivam Selvam
- Department of Biochemistry, Molecular Cardiology Unit, School of Biological Sciences, Madurai Kamaraj University, Madurai, 625021 India
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13
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Dev P, Gupta P, Mahapatra A, Cyriac M, Kumar A, Singh VK, Mishra VN, Pathak A. Systematic Review and Meta-analysis of Environmental Toxic Metal Contaminants and the Risk of Ischemic Stroke. Ann Indian Acad Neurol 2022; 25:1159-1166. [PMID: 36911452 PMCID: PMC9996531 DOI: 10.4103/aian.aian_530_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/30/2022] [Accepted: 11/10/2022] [Indexed: 03/14/2023] Open
Abstract
Background Stroke is the second largest cause of mortality (WHO 2014) and long-lasting disability worldwide. Many risk factors are associated with stroke, such as age, gender, chronic illnesses, cardiovascular disease, lifestyle, and smoking. With global industrialization, the roles of environmental contaminants and their association with stroke are still unclear and have attracted much more attention. Materials and Methods We conducted a systematic review on the environmental toxic metal contaminants and the risk of ischemic stroke. A comprehensive literature search was carried out till June 30, 2021 from databases such as PubMed, Science Direct, Embase, and Scopus. The quality of all the articles which met our inclusion criteria was assessed using Newcastle-Ottawa scaling, and four eligible studies were included for our systematic review. Results The serum and urine cadmium concentrations were positively associated with the risk of ischemic stroke. There was an inverse association of serum and urine concentrations of mercury (Hg), serum concentration of gold and cerium with ischemic stroke, and the serum and urine concentrations of lead (Pb) had no association with ischemic stroke risk. Conclusion The study showed strong associations between heavy metals and ischemic stroke, but more studies are required to prove the associations.
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Affiliation(s)
- Priya Dev
- Department of Neurology, Institute of Medical Science, Varanasi, UP, India
| | - Priya Gupta
- Department of Zoology, Institute of Science, Banaras Hindu University, Varanasi, UP, India
| | - Archisman Mahapatra
- Department of Zoology, Institute of Science, Banaras Hindu University, Varanasi, UP, India
| | - Mareena Cyriac
- Department of Neurology, Institute of Medical Science, Varanasi, UP, India
| | - Amit Kumar
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Varun Kumar Singh
- Department of Neurology, Institute of Medical Science, Varanasi, UP, India
| | - Vijaya Nath Mishra
- Department of Neurology, Institute of Medical Science, Varanasi, UP, India
| | - Abhishek Pathak
- Department of Neurology, Institute of Medical Science, Varanasi, UP, India
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14
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Schaefer HR, Flannery BM, Crosby L, Jones-Dominic OE, Punzalan C, Middleton K. A systematic review of adverse health effects associated with oral cadmium exposure. Regul Toxicol Pharmacol 2022; 134:105243. [PMID: 35981600 DOI: 10.1016/j.yrtph.2022.105243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 10/15/2022]
Abstract
Scientific data characterizing the adverse health effects associated with dietary cadmium (Cd) exposure were identified in order to make informed decisions about the most appropriate toxicological reference value (TRV) for use in assessing dietary Cd exposure. Several TRVs are available for Cd and regulatory organizations have used epidemiologic studies to derive these reference values; however, risk of bias (RoB) evaluations were not included in the assessments. We performed a systematic review by conducting a thorough literature search (through January 4, 2020). There were 1714 references identified by the search strings and 328 studies identified in regulatory assessments. After applying the specific inclusion and exclusion criteria, 208 studies (Human: 105, Animal: 103) were considered eligible for further review and data extraction. For the epidemiologic and animal studies, the critical effects identified for oral Cd exposure from the eligible studies were a decrease in bone mineral density (BMD) and renal tubular degeneration. A RoB analysis was completed for 49 studies (30 epidemiological and 19 animal) investigating these endpoints. The studies identified through the SR that were considered high quality and low RoB (2 human and 5 animal) can be used to characterize dose-response relationships and inform the derivation of a Cd TRV.
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Affiliation(s)
- Heather R Schaefer
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA.
| | - Brenna M Flannery
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Lynn Crosby
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Olivia E Jones-Dominic
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Cecile Punzalan
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Karlyn Middleton
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
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15
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Huang A, Zhang J, Wu K, Liu C, Huang Q, Zhang X, Lin X, Huang Y. Exposure to multiple metals and the risk of dyslexia - A case control study in Shantou, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 307:119518. [PMID: 35618141 DOI: 10.1016/j.envpol.2022.119518] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/14/2022] [Accepted: 05/19/2022] [Indexed: 02/05/2023]
Abstract
Environmental heavy metal exposure has been considered to be the risk factor for neurodevelopmental disorders in children. However, the available data on the associations between multiple metals exposure and the risk of dyslexia in China are limited. The purpose of our study was to examine the associations between urinary metal concentrations and Chinese dyslexia risk. A total of 56 Chinese dyslexics and 60 typically developing children were recruited. The urinary concentration of 13 metals were measured by inductively coupled plasma-mass spectrometer (ICP-MS). Binary logistic regression and the Probit extension of Bayesian kernel machine regression (BKMR-P) were used to explore the associations between multiple metal exposure and the risk of Chinese dyslexia. Our results indicated that Co, Zn and Pb were significantly associated with Chinese dyslexia in the multiple-metal exposure model. After adjusting the covariates, a positive association was observed between Pb and the risk of Chinese dyslexia, with the odds ratio (OR) in the highest quartiles of 6.81 (95%CI: 1.07-43.19; p-trend = 0.024). Co and Zn were negatively associated with the risk of Chinese dyslexia. Compared to the lowest quartile, the ORs of Co and Zn in the highest quartile are 0.13 (95%CI: 0.02-0.72; p-trend = 0.026) and 0.18 (95%CI: 0.04-0.88; p-trend = 0.038), respectively. In addition, BKMR-P analysis indicated that with the cumulative level across Co, Zn and Pb increased, the risk of Chinese dyslexia gradually declined and then rebounded, albeit non-significantly, and Pb was the major contributor in this association. In general, the urinary concentrations of Co, Zn and Pb were significantly associated with Chinese dyslexia. More prospective studies are needed to confirm the health effects of multiple metals exposure in children with Chinese dyslexia.
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Affiliation(s)
- Anyan Huang
- Mental Health Center, Shantou University Medical College, North Taishan Road, Shantou, 515065, Guangdong Province, China
| | - Jingbing Zhang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong Province, China
| | - Kusheng Wu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong Province, China
| | - Caixia Liu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong Province, China
| | - Qingjun Huang
- Mental Health Center, Shantou University Medical College, North Taishan Road, Shantou, 515065, Guangdong Province, China
| | - Xuanzhi Zhang
- Mental Health Center, Shantou University Medical College, North Taishan Road, Shantou, 515065, Guangdong Province, China
| | - Xuecong Lin
- Mental Health Center, Shantou University Medical College, North Taishan Road, Shantou, 515065, Guangdong Province, China
| | - Yanhong Huang
- Mental Health Center, Shantou University Medical College, North Taishan Road, Shantou, 515065, Guangdong Province, China
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16
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Bao QJ, Zhao K, Guo Y, Wu XT, Yang JC, Yang MF. Environmental toxic metal contaminants and risk of stroke: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:32545-32565. [PMID: 35190994 DOI: 10.1007/s11356-022-18866-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/21/2022] [Indexed: 06/14/2023]
Abstract
The relationship between toxic metals in the environment and clinical stroke risk remains unclear, although their role as immunotoxicants and carcinogens has been well established. We conducted a systematic review of the relationship between five metals (arsenic, mercury, copper, cadmium, and lead) and stroke. First, we comprehensively searched 3 databases (Pubmed, EMBASE, and Cochrane) from inception until June 2021. Random-effects meta-analyses, pooled relative risks (RR) and 95% confidence intervals (CI) were applied to evaluate the effect value. We finally identified 38 studies involving 642,014 non-overlapping participants. Comparing the highest vs. lowest baseline levels, chronic exposure to lead (RR = 1.07; 95%CI,1.00-1.14), cadmium (RR = 1.30; 95%CI,1.13-1.48), and copper (RR = 1.19; 95%CI,1.04-1.36) were significantly associated with stroke risks. However, the other two metals (arsenic and mercury) had less effect on stroke risk. Further analysis indicated that the association was likely in a metal dose-dependent manner. The results may further support the possibility that environmental toxic metal contaminants in recent years are associated with the increased risk of stroke.
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Affiliation(s)
- Qiang-Ji Bao
- Graduate School, Qinghai University, Xining, 810016, Qinghai, China
| | - Kai Zhao
- Graduate School, Qinghai University, Xining, 810016, Qinghai, China
| | - Yu Guo
- Graduate School, Qinghai University, Xining, 810016, Qinghai, China
| | - Xin-Ting Wu
- Graduate School, Qinghai University, Xining, 810016, Qinghai, China
| | - Jin-Cai Yang
- Graduate School, Qinghai University, Xining, 810016, Qinghai, China
| | - Ming-Fei Yang
- Department of Neurosurgery, Qinghai Provincial People's Hospital, Xining, 810007, Qinghai, China.
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17
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Xu L, Liu Y, Zhao Q, Du H, Gao Y, Bai M, Lv J, Guo Y, Li L, Sun L, Lin X, Chen Z, Chen Y, Zong G. Urinary element profiles and associations with cardiometabolic diseases: A cross-sectional study across ten areas in China. ENVIRONMENTAL RESEARCH 2022; 205:112535. [PMID: 34896320 DOI: 10.1016/j.envres.2021.112535] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 12/04/2021] [Accepted: 12/05/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Existing evidence on the associations of urinary element profiles with related food intake and cardiometabolic diseases has been limited in China. OBJECTIVES To examine the associations of urinary toxic metals and other elements with food intakes and with the prevalence of cardiometabolic diseases. METHODS Inductively coupled plasma mass spectrometry was used to measure the concentrations of cadmium (Cd), arsenic (As), nickel (Ni), aluminum (Al), copper (Cu), and 16 other elements in spot urine samples collected from 19,380 adults in 10 geographically diverse areas of China during 2013-2014. The levels of creatinine-corrected elements were used to analyze their correlations with self-reported dietary intake and associations with prevalent diabetes (n = 1862), stroke (n = 1322) and ischemic heart disease (IHD) (n = 1690). RESULTS Overall, the mean (SD) age was 59.2 (10.1) years with a mean BMI of 24.2 (3.5) kg/m2. Of the 21 elements, the median (IQR) concentrations varied from 0.49 (0.31-0.82) μg/g creatinine for vanadium (V) to 1666 (1189-2321) mg/g creatinine for potassium (K). Nine urinary elements [Cd, As, Ni, lead (Pb), boron (B), magnesium (Mg), rubidium (Rb), strontium (Sr), and cesium (Cs); all rs > 0.20, p < 0.001] were positively correlated with staple food intake, five [Cd, As, selenium (Se), Rb, and Cs; all rs > 0.20, p < 0.001] with animal-sourced food group, and one (Cd; r = 0.21, p < 0.05) with pickled vegetable intake. For diabetes, adjusted prevalence ratios (PRs) per SD of specific element levels were 1.10 [95% confidence interval (CI): 1.03-1.18] for Cd, 1.24 (1.18-1.31) for As, 1.33 (1.27-1.39) for Ni, 1.14 (1.09-1.20) for Al, and 1.24 (1.18-1.30) for Cu. Cd was positively associated with stroke (PR per SD = 1.13, 1.04-1.23), while none of the elements were significantly associated with IHD. CONCLUSION In China, the urinary levels of several toxic metals were significantly associated with the consumption of specific food groups and the risk of cardiometabolic diseases including diabetes and stroke.
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Affiliation(s)
- Lijiao Xu
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China; School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China; University of Chinese Academy of Sciences, Beijing, 100864, China
| | - Yunan Liu
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Qianyu Zhao
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Huaidong Du
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX37LF, UK; Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX37LF, UK
| | - Ying Gao
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Meijuan Bai
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, Beijing, 100191, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, Beijing, 100191, China
| | - Liang Sun
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Xu Lin
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX37LF, UK
| | - Yan Chen
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China; School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China; University of Chinese Academy of Sciences, Beijing, 100864, China.
| | - Geng Zong
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China.
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18
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Xu Y, Zhao H, Wang Z, Gao H, Liu J, Li K, Song Z, Yuan C, Lan X, Pan C, Zhang S. Developmental exposure to environmental levels of cadmium induces neurotoxicity and activates microglia in zebrafish larvae: From the perspectives of neurobehavior and neuroimaging. CHEMOSPHERE 2022; 291:132802. [PMID: 34752834 DOI: 10.1016/j.chemosphere.2021.132802] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/15/2021] [Accepted: 11/04/2021] [Indexed: 06/13/2023]
Abstract
Cadmium (Cd) is a worldwide environmental pollutant that postures serious threats to humans and ecosystems. Over the years, its adverse effects on the central nervous system (CNS) have been concerned, whereas the underlying cellular/molecular mechanisms remain unclear. In this study, taking advantages of zebrafish model in high-throughput imaging and behavioral tests, we have explored the potential developmental neurotoxicity of Cd at environmentally relevant levels, from the perspectives of neurobehavior and neuroimaging. Briefly, Cd2+ exposure resulted in a general impairment of zebrafish early development. Zebrafish neurobehavioral patterns including locomotion and reactivity to environmental signals were significantly perturbed upon Cd2+ exposure. Importantly, a combination of in vivo two-photon neuroimaging, flow cytometry and gene expression analyses revealed notable neurodevelopmental disorders as well as neuroimmune responses induced by Cd2+ exposure. Both cell-cycle arrest and apoptosis contributed jointly to a significant decrease of neuronal density in zebrafish larvae exposed to Cd2+. The dramatic morphological alterations of microglia from multi-branched to amoeboid, the microgliosis, as well as the modulation of gene expression profiles demonstrated a strong activation of microglia and neuroinflammation triggered by environmental levels of Cd2+. Together, our study points to the developmental toxicity of Cd in inducing CNS impairment and neuroinflammation thereby providing visualized etiological evidence of this heavy metal induced neurodevelopmental disorders. It's tempting to speculate that this research model might represent a promising tool not only for understanding the molecular mechanisms of Cd-induced neurotoxicity, but also for developing pharmacotherapies to mitigate the neurological damage resulting from exposure to Cd, and other neurotoxicants.
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Affiliation(s)
- Yanyi Xu
- School of Life Sciences, Gansu Key Laboratory of Biomonitoring and Bioremediation for Environmental Pollution, Lanzhou University, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China
| | - Haiyu Zhao
- School of Life Sciences, Gansu Key Laboratory of Biomonitoring and Bioremediation for Environmental Pollution, Lanzhou University, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China.
| | - Zuo Wang
- School of Life Sciences, Gansu Key Laboratory of Biomonitoring and Bioremediation for Environmental Pollution, Lanzhou University, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China
| | - Hao Gao
- School of Life Sciences, Gansu Key Laboratory of Biomonitoring and Bioremediation for Environmental Pollution, Lanzhou University, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China
| | - Junru Liu
- School of Life Sciences, Gansu Key Laboratory of Biomonitoring and Bioremediation for Environmental Pollution, Lanzhou University, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China
| | - Kemin Li
- School of Life Sciences, Gansu Key Laboratory of Biomonitoring and Bioremediation for Environmental Pollution, Lanzhou University, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China
| | - Zan Song
- School of Life Sciences, Gansu Key Laboratory of Biomonitoring and Bioremediation for Environmental Pollution, Lanzhou University, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China
| | - Cong Yuan
- School of Life Sciences, Gansu Key Laboratory of Biomonitoring and Bioremediation for Environmental Pollution, Lanzhou University, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China
| | - Xianyong Lan
- Key Laboratory of Animal Genetics, Breeding and Reproduction of Shaanxi Province, College of Animal Science and Technology, Northwest A&F University, No. 22 Xinong Road, Yangling, 712100, Shaanxi Province, China
| | - Chuanying Pan
- Key Laboratory of Animal Genetics, Breeding and Reproduction of Shaanxi Province, College of Animal Science and Technology, Northwest A&F University, No. 22 Xinong Road, Yangling, 712100, Shaanxi Province, China
| | - Shengxiang Zhang
- School of Life Sciences, Gansu Key Laboratory of Biomonitoring and Bioremediation for Environmental Pollution, Lanzhou University, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China.
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19
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Tägt J, Helte E, Donat-Vargas C, Larsson SC, Michaëlsson K, Wolk A, Vahter M, Kippler M, Åkesson A. Long-term cadmium exposure and fractures, cardiovascular disease, and mortality in a prospective cohort of women. ENVIRONMENT INTERNATIONAL 2022; 161:107114. [PMID: 35114608 DOI: 10.1016/j.envint.2022.107114] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 01/13/2022] [Accepted: 01/23/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Cadmium (Cd) is a toxic metal, which the non-smoking population is mainly exposed to through diet. Current health-based guidance values are based on renal toxicity; however, emerging evidence suggests that bone and the cardiovascular system might be more sensitive to Cd exposure. OBJECTIVE To assess the association of urinary Cd (U-Cd) with incidence of fractures, myocardial infarction, heart failure, ischemic stroke and mortality in postmenopausal women. METHODS We used data from 4024 women, aged 56-85 in the population-based prospective Swedish Mammography Cohort-Clinical. U-Cd was measured by ICP-MS at baseline (2004-2009) and categorized into tertiles. Incident cases of the outcomes were ascertained via register linkage through 2019. Multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression. RESULTS The median U-Cd at baseline was 0.33 µg/g creatinine (cr) (5-95 percentiles 0.15-0.77). We ascertained the following incident cases: 903 first fracture of any type, 149 myocardial infarction, 174 heart failure, 162 ischemic stroke and 545 total deaths during the approximately 11 years of follow-up. U-Cd was dose-dependently associated with risk of any fracture (HR: 1.20, 95% CI: 1.01 to 1.43, ptrend: 0.04) and all-cause mortality (HR: 1.38, 95% CI: 1.10 to 1.74, ptrend: <0.01) when comparing the highest tertile of U-Cd (median 0.54 µg/g cr) with the lowest (median 0.20 µg/g cr). No clear associations were observed for myocardial infarction, heart failure or stroke. DISCUSSION Long-term Cd exposure might be associated with risk of fractures and all-cause mortality at lower levels than previously suggested.
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Affiliation(s)
- Jonas Tägt
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Emilie Helte
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Carolina Donat-Vargas
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Preventive Medicine, Autonomous University of Madrid, Madrid, Spain
| | - Susanna C Larsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Surgical Sciences, Unit of Medical Epidemiology, Uppsala University, Uppsala, Sweden
| | - Karl Michaëlsson
- Department of Surgical Sciences, Unit of Medical Epidemiology, Uppsala University, Uppsala, Sweden
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Surgical Sciences, Unit of Medical Epidemiology, Uppsala University, Uppsala, Sweden
| | - Marie Vahter
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Maria Kippler
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Agneta Åkesson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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20
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The preferential accumulation of cadmium ions among various tissues in mice. Toxicol Rep 2022; 9:111-119. [PMID: 35059304 PMCID: PMC8760390 DOI: 10.1016/j.toxrep.2022.01.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 12/08/2021] [Accepted: 01/04/2022] [Indexed: 12/18/2022] Open
Abstract
Cadmium (Cd) is hazardous to human health because of its toxicity and long half-life of clearance. Many studies have explored the relationship between chronic Cd exposure and different human diseases. However, most of the studies limited the study targets of Cd toxicity to two or three organ systems. The goal of this study was to establish a mouse model of Cd accumulation in most organ systems and to particularly investigate the potential toxic effects of Cd to the cardiovascular system. Mice were divided into three groups: the control group, Cd-100 group, and Cd-200 group. In the control group, Cd was detected in the kidney, lung, liver, heart and urine but was undetectable in the aorta, intestine, thigh bone, spinal bone and serum. Upon chronic exposure in the Cd-100 and Cd-200 groups, Cd accumulated in all tissues, with a dramatic increase in concentration. We confirmed that Cd could accumulate significantly in the heart and aorta upon chronic exposure. This finding might help to explain the potential toxic effects of Cd on these organs. In addition, the calcium concentration in the bones and kidney declined when the exposure to Cd increased. This finding aligned with the negative effects of Cd on bony mineralization and the potential direct toxic effects of Cd on bones. The impacts of Cd on the cardiovascular system were explored. Histologically, chronic Cd exposure led to myocytes hypertrophy and myocardial architecture disarray in the Cd-100 group compared to those in the control group. Our research confirms that Cd can accumulate in all of the organs studied upon chronic exposure, and suggests that the toxicity of Cd accumulation may play important roles in mediating the pathophysiologic effects in these target organs, especially the bone and heart.
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21
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Poulsen AH, Sears CG, Harrington J, Howe CJ, James KA, Roswall N, Overvad K, Tjønneland A, Wellenius GA, Meliker J, Raaschou-Nielsen O. Urinary cadmium and stroke - a case-cohort study in Danish never-smokers. ENVIRONMENTAL RESEARCH 2021; 200:111394. [PMID: 34062200 PMCID: PMC8403651 DOI: 10.1016/j.envres.2021.111394] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/21/2021] [Accepted: 05/22/2021] [Indexed: 06/10/2023]
Abstract
BACKGROUND and Purpose: Cadmium has been associated with risk of cardiovascular events, including stroke. Human cadmium exposure occurs primarily through diet and tobacco smoke. Recent cohort studies have found an association with stroke, but residual confounding from smoking, could not be ruled out. We therefore conducted a case-cohort study to evaluate whether cadmium is associated with stroke in never-smokers. METHODS The Danish Diet Cancer and Health cohort consists of Danes 50-64 years old, recruited in 1993-1997. From never-smoking cohort members without previous cancer or stroke we sampled a sub-cohort of 1200 persons. We also identified all (n = 534) cases in the cohort with a validated stroke diagnosis between baseline and 2009. We quantified cadmium and creatinine concentrations from baseline urine samples and used cadmium per creatinine as our main exposure metric. We used Cox proportional hazards models to estimate hazard ratios (HRs) with age as time scale and adjusting for BMI, education and urinary cotinine with and without stratification by sex. RESULTS The median urinary cadmium concentration was 0.21 μg cadmium/g creatinine in cases and 0.19 μg/g in the sub-cohort. The majority (83%) of stroke cases were diagnosed with ischemic stroke. The HR for stroke in the highest quartile of exposure (median 0.44 μg/g creatinine) was 1.11 (95% CI: 0.79-1.54) compared with the lowest quartile (median 0.10 μg/g creatinine). The HR per inter quartile range (IQR, 0.19 μg/g creatinine) was 1.02 (95% CI: 0.92-1.12). Among men, the HR per IQR higher levels of cadmium (0.16 μg/g creatinine) was 1.18 (95% CI: 0.92-1.52), and 1.00 (95% CI: 0.89-1.12) among women. Adjusting for creatinine or using osmolality instead of creatinine standardization generally attenuated observed relationships. CONCLUSIONS Our results do not support that low levels of cadmium exposure among never-smokers are strongly associated with risk of stroke, although results varied somewhat by sex and method of accounting for urinary dilution.
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Affiliation(s)
| | - Clara G Sears
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - James Harrington
- Center for Analytical Science, Research Triangle Institute, Research Triangle Park, NC, USA
| | - Chanelle J Howe
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Katherine A James
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, USA
| | - Nina Roswall
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kim Overvad
- Department of Public Health, Aarhus University, Aarhus, Denmark; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Public Health University of Copenhagen. Copenhagen, Denmark
| | - Gregory A Wellenius
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Department of Environmental Health, Boston University, Boston, MA, USA
| | - Jaymie Meliker
- Program in Public Health, Department of Family, Population, & Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Roskilde, Denmark
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22
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Mattern L, Chen C, McClure LA, Brockman J, Cushman M, Judd S, Kahe K. Serum Zinc Levels and Incidence of Ischemic Stroke: The Reasons for Geographic and Racial Differences in Stroke Study. Stroke 2021; 52:3953-3960. [PMID: 34412513 DOI: 10.1161/strokeaha.120.033187] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND PURPOSE Despite zinc's role as an antioxidant and anti-inflammatory agent, prospective studies relating zinc levels to ischemic stroke risk are lacking. To examine the association between serum zinc levels and incidence of ischemic stroke in a US population. METHODS Using a case-cohort study nested within the Reasons for Geographic and Racial Differences in Stroke cohort, participants were randomly selected from the Reasons for Geographic and Racial Differences in Stroke cohort to generate a sub-cohort (n=2346). All incident ischemic stroke cases as of September 2012 (n=660) were included, with 62 incident cases overlapping in the sub-cohort. Serum zinc levels were measured at baseline. Barlow-weighted Cox's proportional hazards regression models were used to calculate multivariable-adjusted hazard ratios and the corresponding 95% CI of ischemic stroke by serum zinc levels. RESULTS The median zinc level for the sub-cohort was 121.19 µg/dL (interquartile range, 104.86-140.39 µg/dL). Serum zinc levels were inversely associated with incidence of ischemic stroke after adjustment for potential confounders (quartile 4 versus quartile 1: hazard ratio, 0.78 [95% CI, 0.61-0.98], P=0.03 for trend). When stratified by prespecified factors (sex, race, region), only sex showed a significant modification (P=0.03 for interaction). The inverse association was more pronounced among females (quartile 4 versus quartile 1: hazard ratio, 0.58 [95% CI, 0.41-0.84], P<0.01 for trend) than males (quartile 4 versus quartile 1: hazard ratio, 1.08 [95% CI, 0.78-1.51], P=0.92 for trend). CONCLUSIONS Serum zinc concentration was inversely associated with incidence of ischemic stroke, especially among women, indicating that low zinc levels may be a risk factor for ischemic stroke.
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Affiliation(s)
- Lindsey Mattern
- Department of Anthropology, College of Arts and Sciences, Indiana University (L.M.)
| | - Cheng Chen
- Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, NY (C.C., K.K.).,Department of Epidemiology, Mailman School of Public Health, Columbia University, NY (C.C., K.K.)
| | - Leslie A McClure
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (L.A.M.)
| | - John Brockman
- Department of Chemistry, University of Missouri, Columbia (J.B.)
| | - Mary Cushman
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington (M.C.)
| | - Suzanne Judd
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham (S.J.)
| | - Ka Kahe
- Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, NY (C.C., K.K.).,Department of Epidemiology, Mailman School of Public Health, Columbia University, NY (C.C., K.K.)
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23
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Lin HC, Hao WM, Chu PH. Cadmium and cardiovascular disease: An overview of pathophysiology, epidemiology, therapy, and predictive value. Rev Port Cardiol 2021; 40:611-617. [PMID: 34392906 DOI: 10.1016/j.repce.2021.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 01/09/2021] [Indexed: 11/26/2022] Open
Abstract
Cadmium is a widely distributed toxic heavy metal that has been associated with many diseases including chronic renal dysfunction, osteomalacia, acute heart failure, secondary hypertension, and atherosclerosis. Although several studies have suggested that cadmium may affect multiple systems by inducing lipid per oxidation in cells and disturbing the antioxidant system, the mechanism by which cadmium affects the cardiovascular system remains unclear. Recent studies on heart failure and acute myocardial infarction have shown that cadmium has good predictive ability for mortality in patients with cardiovascular disease. In this study, we briefly review the role of cadmium in cardiovascular disease, which may prompt further studies to investigate the potential association between cadmium and mortality in patients with cardiovascular disease.
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Affiliation(s)
- Hung-Chen Lin
- Department of Cardiology, Huashan Hospital of Fudan University, Shanghai, China; Shanghai Medical College, Fudan University, Shanghai, China
| | - Wei-Ming Hao
- Shanghai Medical College, Fudan University, Shanghai, China; Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Pao-Hsien Chu
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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24
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Cadmium and cardiovascular disease: An overview of pathophysiology, epidemiology, therapy, and predictive value. Rev Port Cardiol 2021. [PMID: 34103231 DOI: 10.1016/j.repc.2021.01.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Cadmium is a widely distributed toxic heavy metal that has been associated with many diseases including chronic renal dysfunction, osteomalacia, acute heart failure, secondary hypertension, and atherosclerosis. Although several studies have suggested that cadmium may affect multiple systems by inducing lipid per oxidation in cells and disturbing the antioxidant system, the mechanism by which cadmium affects the cardiovascular system remains unclear. Recent studies on heart failure and acute myocardial infarction have shown that cadmium has good predictive ability for mortality in patients with cardiovascular disease. In this study, we briefly review the role of cadmium in cardiovascular disease, which may prompt further studies to investigate the potential association between cadmium and mortality in patients with cardiovascular disease.
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25
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García-Esquinas E, Téllez-Plaza M, Pastor-Barriuso R, Ortolá R, Olmedo P, Gil F, López-García E, Navas-Acien A, Rodríguez-Artalejo F. Blood cadmium and physical function limitations in older adults. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 276:116748. [PMID: 33639488 DOI: 10.1016/j.envpol.2021.116748] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Cadmium (Cd) is a toxic metal found in tobacco, air and food. Recent cross-sectional studies have suggested that Cd negatively impacts physical performance, but the prospective association is uncertain. METHODS We used data from 2548 older adults from the Seniors-ENRICA II cohort in Madrid, Spain. Whole blood Cd levels were measured at baseline using inductively coupled plasma-mass spectrometry. At baseline (2017) and follow-up (2019), overall physical function was evaluated using the physical component summary (PCS) of the SF 12-Item Health questionnaire, lower-extremity performance with the Short Physical Performance Battery (SPPB), muscle weakness with a hand dynamometer, and frailty with a Deficit Accumulation index. Mobility limitations and disability in instrumental activities of daily living (IADL) were ascertained with standardized questionnaires. Analyses were adjusted for relevant confounders, including tobacco smoke, number of cigarettes smoked per day and time since cessation in former smokers. RESULTS In cross-sectional analyses, odds ratios (95% confidence interval) per two-fold increase in blood Cd were 1.16 (1.03; 1.31) for low PCS scores, 1.08 (0.97; 1.20) for impaired lower-extremity performance, 1.10 (0.98; 1.23) for low grip strength, 1.11 (1.02; 1.20) for mobility limitations, 1.16 (1.02; 1.31) for frailty, and 1.26 (1.08; 1.47) for IADL disability. In longitudinal analyses, corresponding hazard ratios were 1.25 (1.03; 1.51) for low PCS scores, 1.14 (1.03; 1.27) for impaired lower-extremity performance, 1.02 (0.92; 1.13) for low grip strength, 1.03 (0.91; 1.16) for mobility limitations, and 1.16 (1.00; 1.35) for frailty. All the associations where consistent when current smokers were excluded from the analyses. CONCLUSIONS Our results support the role of Cd as a risk factor for physical function impairments in older adults.
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Affiliation(s)
- Esther García-Esquinas
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; IdiPaz (Hospital Universitario La Paz-Universidad Autónoma de Madrid), Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
| | - María Téllez-Plaza
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain; Biomedical Research Institute Hospital Clinic de Valencia (INCLIVA), Valencia, Valencia, Spain
| | - Roberto Pastor-Barriuso
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; IdiPaz (Hospital Universitario La Paz-Universidad Autónoma de Madrid), Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Pablo Olmedo
- Department of Legal Medicine, Toxicology, and Physical Anthropology, School of Medicine, University of Granada, Granada, Spain
| | - Fernando Gil
- Department of Legal Medicine, Toxicology, and Physical Anthropology, School of Medicine, University of Granada, Granada, Spain
| | - Esther López-García
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; IdiPaz (Hospital Universitario La Paz-Universidad Autónoma de Madrid), Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, USA
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; IdiPaz (Hospital Universitario La Paz-Universidad Autónoma de Madrid), Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain
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26
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Dennis KK, Judd SE, Alvarez JA, Kahe K, Jones DP, Hartman TJ. Plant food intake is associated with lower cadmium body burden in middle-aged adults. Eur J Nutr 2021; 60:3365-3374. [PMID: 33615415 DOI: 10.1007/s00394-021-02513-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 02/05/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Dietary intake is a primary source of cadmium (Cd) exposure in the non-smoking population. Plant foods containing metal-binding plant compounds such as polyphenols, phytates, and phytochelatins may reduce Cd bioavailability and result in lower Cd body burden. In this study, we investigated the association between plant food intake and urinary creatinine-adjusted Cd (uCd), a well-established marker of Cd body burden. METHODS Participants were from a cross-sectional sample of 1901 adults in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. Dietary intake was assessed with a food frequency questionnaire. We created a 12-point plant food score (PFS) based on reported intake across seven categories (fruits, vegetables, legumes, nuts/seeds, whole grains, tea, and wine). Higher scores indicated higher consumption and diversity of plant food intake. Multivariable linear regression models were used to estimate the association between PFS and uCd. Due to the influence of age and smoking on Cd status, stratified analyses were conducted. RESULTS Mean PFS was 5.4 (SD 2.2) and mean uCd was 0.53 µg/g creatinine (SD 0.39). In adjusted models, PFS was not associated with uCd (p > 0.05). In stratified analyses, PFS was inversely associated with uCd (p = 0.047) with a 1-point higher PFS associated with 0.018 µg/g lower uCd among middle-aged (45-59) adults. No significant association was observed between PFS and uCd in older (≥ 60) adults. The association of PFS and uCd did not differ by smoking status. CONCLUSION Our findings suggest higher plant food intake is associated with lower Cd body burden in middle-aged but not older adults.
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Affiliation(s)
- Kristine K Dennis
- Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA
| | - Suzanne E Judd
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jessica A Alvarez
- Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA.,Division of Endocrinology, Metabolism, and Lipids, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Ka Kahe
- Epidemiology and Obstetrics and Gynecology, Columbia University Irving Medical Center, New York City, NY, USA
| | - Dean P Jones
- Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA.,Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Terryl J Hartman
- Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA. .,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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27
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Jing D, Wu W, Deng X, Peng Y, Yang W, Huang D, Shao Z, Zheng D. FoxO1a mediated cadmium-induced annulus fibrosus cells apoptosis contributes to intervertebral disc degeneration in smoking. J Cell Physiol 2021; 236:677-687. [PMID: 32654176 PMCID: PMC7689722 DOI: 10.1002/jcp.29895] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 12/14/2022]
Abstract
Cadmium (Cd), a type of heavy metal that accumulates in the body because of smoking, mediates the toxic effect of smoking in many diseases, such as cardiovascular disease, osteoarthritis, and osteoporosis. However, the toxic effect of Cd on intervertebral disc tissues have not been reported. In the current study, we demonstrated that Cd induced the apoptosis of annulus fibrosus (AF) cells, which contributed to intervertebral disc degeneration (IVDD). Specifically, Cd induced the nuclear translocation of FoxO1a, which drives AF cells apoptosis through mitochondrial-related pathway. Phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signal pathway is also involved in this process. The combined use of LY29002, an inhibitor of PI3K, and small interfering RNA-targeting FoxO1a confirmed the relationship between the PI3K/AKT signal pathway and FoxO1a. In summary, present research explores the mechanism behind the contribution of smoking to IVDD and finds a new feasible target for preventing IVDD in smoking.
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Affiliation(s)
- Doudou Jing
- Department of Orthopaedics, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Wei Wu
- Department of Orthopaedics, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Xiangyu Deng
- Department of Orthopaedics, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Yizhong Peng
- Department of Orthopaedics, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Wenbo Yang
- Department of Orthopaedics, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Donghua Huang
- Department of Orthopedics, Musculoskeletal Tumor CenterThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Zengwu Shao
- Department of Orthopaedics, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Dong Zheng
- Department of Orthopaedics, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
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28
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Ruan Z, Qi J, Yin P, Qian Z(M, Liu J, Liu Y, Yang Y, Li H, Zhang S, Howard SW, Lin H, Wang L. Prolonged Life Expectancy for Those Dying of Stroke by Achieving the Daily PM 2.5 Targets. GLOBAL CHALLENGES (HOBOKEN, NJ) 2020; 4:2000048. [PMID: 33304609 PMCID: PMC7713556 DOI: 10.1002/gch2.202000048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Indexed: 05/11/2023]
Abstract
This time-series study collects data on stroke-related mortality, years of life lost (YLL), air pollution, and meteorological conditions in 96 Chinese cities from 2013 to 2016 and proposes a three-stage strategy to generate the national and regional estimations of avoidable YLL, gains in life expectancy and stroke-related population attributable fraction by postulating that the daily fine particulate matter (PM2.5) has been kept under certain standards. A total of 1 318 911 stroke deaths are analyzed. Each 10 µg m-3 increment in PM2.5 at lag03 is associated with a city-mean increase of 0.31 (95% CI: 0.19, 0.44) years of life lost from stroke. A number of 914.11 (95% CI: 538.28, 1288.94) years of city-mean life lost from stoke could be avoided by attaining the WHO's Air Quality Guidelines (AQG) (25 µg m-3). Moreover, by applying the AQG standard, 0.11 (0.08, 0.15) years of life lost might be prevented for each death, and about 0.91% (95% CI: 0.62%, 1.19%) of the total years of life lost from stroke might be explained by the daily excess PM2.5 exposure. This study indicates that stroke patients can have a longer life expectancy if stricter PM2.5 standards are put in place, especially ischemic stroke patients.
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Affiliation(s)
- Zengliang Ruan
- Department of EpidemiologySchool of Public HealthSun Yat‐Sen UniversityGuangzhou510080China
| | - Jinlei Qi
- National Center for Chronic and Noncommunicable Disease Control and PreventionChinese Center for Disease Control and PreventionBeijing100050China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and PreventionChinese Center for Disease Control and PreventionBeijing100050China
| | - Zhengmin (Min) Qian
- Department of Epidemiology and BiostatisticsCollege for Public Health & Social JusticeSaint Louis UniversitySaint LouisMO63104USA
| | - Jiangmei Liu
- National Center for Chronic and Noncommunicable Disease Control and PreventionChinese Center for Disease Control and PreventionBeijing100050China
| | - Yunning Liu
- National Center for Chronic and Noncommunicable Disease Control and PreventionChinese Center for Disease Control and PreventionBeijing100050China
| | - Yin Yang
- Department of EpidemiologySchool of Public HealthSun Yat‐Sen UniversityGuangzhou510080China
| | - Huan Li
- Department of EpidemiologySchool of Public HealthSun Yat‐Sen UniversityGuangzhou510080China
| | - Shiyu Zhang
- Department of EpidemiologySchool of Public HealthSun Yat‐Sen UniversityGuangzhou510080China
| | - Steven W. Howard
- Department of Health Management & PolicyCollege for Public Health & Social JusticeSaint Louis UniversitySaint LouisMO63104USA
| | - Hualiang Lin
- Department of EpidemiologySchool of Public HealthSun Yat‐Sen UniversityGuangzhou510080China
| | - Lijun Wang
- National Center for Chronic and Noncommunicable Disease Control and PreventionChinese Center for Disease Control and PreventionBeijing100050China
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Cadmium and Lead Exposure, Nephrotoxicity, and Mortality. TOXICS 2020; 8:toxics8040086. [PMID: 33066165 PMCID: PMC7711868 DOI: 10.3390/toxics8040086] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/07/2020] [Accepted: 10/11/2020] [Indexed: 12/11/2022]
Abstract
The present review aims to provide an update on health risks associated with the low-to-moderate levels of environmental cadmium (Cd) and lead (Pb) to which most populations are exposed. Epidemiological studies examining the adverse effects of coexposure to Cd and Pb have shown that Pb may enhance the nephrotoxicity of Cd and vice versa. Herein, the existing tolerable intake levels of Cd and Pb are discussed together with the conventional urinary Cd threshold limit of 5.24 μg/g creatinine. Dietary sources of Cd and Pb and the intake levels reported for average consumers in the U.S., Spain, Korea, Germany and China are summarized. The utility of urine, whole blood, plasma/serum, and erythrocytes to quantify exposure levels of Cd and Pb are discussed. Epidemiological studies that linked one of these measurements to risks of chronic kidney disease (CKD) and mortality from common ailments are reviewed. A Cd intake level of 23.2 μg/day, which is less than half the safe intake stated by the guidelines, may increase the risk of CKD by 73%, and urinary Cd levels one-tenth of the threshold limit, defined by excessive ß2-microglobulin excretion, were associated with increased risk of CKD, mortality from heart disease, cancer of any site and Alzheimer's disease. These findings indicate that the current tolerable intake of Cd and the conventional urinary Cd threshold limit do not provide adequate health protection. Any excessive Cd excretion is probably indicative of tubular injury. In light of the evolving realization of the interaction between Cd and Pb, actions to minimize environmental exposure to these toxic metals are imperative.
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Affiliation(s)
- George Howard
- From the Department of Biostatistics (G.H.), School of Public Health, University of Alabama at Birmingham
| | - Virginia J. Howard
- Department of Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham
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He K, Chen C. Author response: Urinary cadmium concentration and the risk of ischemic stroke. Neurology 2019; 92:1072. [PMID: 31133568 DOI: 10.1212/wnl.0000000000007586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Kawada T. Reader response: Urinary cadmium concentration and the risk of ischemic stroke. Neurology 2019; 92:1071-1072. [DOI: 10.1212/wnl.0000000000007588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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