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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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Liang D, Liu C, Yang M. Blood Cadmium and Abdominal Aortic Calcification in Population with Different Weight Statuses: a Population-Based Study. J Cardiovasc Transl Res 2023; 16:1425-1438. [PMID: 37468727 DOI: 10.1007/s12265-023-10414-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 07/05/2023] [Indexed: 07/21/2023]
Abstract
The aim of our study was to assess the effect of blood cadmium levels (B-Cd) on abdominal aortic calcification (AAC). We used the data from the 2013-2014 NHANES database. A total of 1530 participants were included in our study, with a mean AAC score of 1.40 ± 0.10, and a prevalence of severe AAC of 7.98%. Participants with higher B-Cd quartiles showed a higher prevalence of severe AAC. B-Cd was positively associated with higher AAC scores and increased risk of severe AAC. In the obese population, blood cadmium levels showed a positive association with the risk of severe AAC. There may be a positive correlation between B-Cd levels and AAC scores and risk of severe AAC, and this correlation is more pronounced in the obese population. Therefore, the cadmium load in AAC patients in the obese population should be considered in clinical work.
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Affiliation(s)
- Dan Liang
- Department of Endocrine, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Chang Liu
- School of Medicine, Nankai University, Tianjin, China
| | - Mei Yang
- Department of Endocrine, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China.
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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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Wan Y, Mo L, Huang H, Mo L, Zhu W, Li W, Yang G, Chen L, Wu Y, Song J, Yang X. Cadmium contributes to atherosclerosis by affecting macrophage polarization. Food Chem Toxicol 2023; 173:113603. [PMID: 36639048 DOI: 10.1016/j.fct.2023.113603] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/26/2022] [Accepted: 01/04/2023] [Indexed: 01/12/2023]
Abstract
Chronic cadmium (Cd) exposure contributes to the progression of atherosclerosis, but the direct role of Cd and its mechanisms in atherosclerosis remains incompletely understood. Atherosclerosis is a chronic inflammatory disease promoting macrophage polarization to M1 phenotype and producing pro-inflammations that are vital in regulating the inflammatory response. Herein, through a case-control study, we found that Cd exposure may promote the occurrence of carotid plaque via inflammation, where interleukin-6 (IL-6) may play an important role. We also combined in vivo and in vitro experiments to explore the underlying mechanism of Cd-promoted plaque formation and the production of IL-6. With or without cadmium chloride (CdCl2) fed ApoE-/- mouse and treated RAW264.7 cells, we found Cd accumulated in the aortas which significantly increased the plaque area in atherosclerotic mice, macrophage accumulation, and lipid accumulation, and Cd promoted M1 phenotype macrophage polarization reflected by the increased expression of CD86 which produced tumor necrosis factor-α (TNF-α) and IL-6. However, the influences on M2 phenotype and anti-inflammatory cytokines interleukin-4 (IL-4) and interferon-γ (IFN-γ) were non-significant. Moreover, we found that JAK2/STAT3 pathway was greatly activated in the plaques and CdCl2-treated macrophages. The inhibition of JAK2/STAT3 substantially reversed the Cd-stimulated macrophage M1 phenotype macrophage polarization and the expression of pro-inflammatory cytokines including TNF-α and IL-6. Altogether, Cd intensifies atherosclerosis by modulating macrophage polarization via JAK2/STAT3 to up-regulated the expression of IL-6.
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Affiliation(s)
- Yu Wan
- Food Safety and Health Research Center, Guangdong Provincial Key Laboratory of Tropical Disease Research, Guangdong-Hongkong-Macao Joint Laboratory for Contaminants Exposure and Health, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Lijun Mo
- Food Safety and Health Research Center, Guangdong Provincial Key Laboratory of Tropical Disease Research, Guangdong-Hongkong-Macao Joint Laboratory for Contaminants Exposure and Health, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Haibin Huang
- Food Safety and Health Research Center, Guangdong Provincial Key Laboratory of Tropical Disease Research, Guangdong-Hongkong-Macao Joint Laboratory for Contaminants Exposure and Health, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Lifen Mo
- Food Safety and Health Research Center, Guangdong Provincial Key Laboratory of Tropical Disease Research, Guangdong-Hongkong-Macao Joint Laboratory for Contaminants Exposure and Health, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Wei Zhu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, 510440, China
| | - Wenxue Li
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, 510440, China
| | - Guangyu Yang
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, 510440, China
| | - Linquan Chen
- Food Safety and Health Research Center, Guangdong Provincial Key Laboratory of Tropical Disease Research, Guangdong-Hongkong-Macao Joint Laboratory for Contaminants Exposure and Health, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Yongning Wu
- NHC Key Laboratory of Food Safety Risk Assessment, Chinese Academy of Medical Science Research Unit (2019RU014 Food Safety), China National Center for Food Safety Risk Assessment, Beijing, 100021, China
| | - Jia Song
- Food Safety and Health Research Center, Guangdong Provincial Key Laboratory of Tropical Disease Research, Guangdong-Hongkong-Macao Joint Laboratory for Contaminants Exposure and Health, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China.
| | - Xingfen Yang
- Food Safety and Health Research Center, Guangdong Provincial Key Laboratory of Tropical Disease Research, Guangdong-Hongkong-Macao Joint Laboratory for Contaminants Exposure and Health, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China.
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Mao Q, Zhou D, Sun Y, Zhao J, Xu S, Zhao X. Independent association of blood cadmium with subclinical lower extremity atherosclerosis: An observational study based on dose-response analysis. CHEMOSPHERE 2023; 313:137441. [PMID: 36470359 DOI: 10.1016/j.chemosphere.2022.137441] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Atherosclerosis is an increasingly public health issue globally. Previous studies have showed a causal link between heavy metal exposure and atherosclerosis. However, the association of cadmium concentration with subclinical lower extremity atherosclerosis (SLEA) remains unclear. AIMS To investigate the association of blood cadmium with SLEA and its extent, and further analyze the potential dose-response relationship. METHODS Blood cadmium concentration was measured using inductively coupled plasma mass spectrometry. SLEA and its extent were assessed by ultrasound diagnosis system. Multivariate models were applied to evaluate the association of blood cadmium with SLEA and its extent. Restricted cubic splines were performed to explore the potential dose-response relationship. RESULTS This observational study consisted of 1664 participants from cardiovascular outpatient, with an average age of 62.4 years and 1218 (73.2%) men. When blood cadmium was included as a categorical variable in multivariate models, logistic regression analysis showed that high quartile in blood cadmium was an independent risk factor of SLEA (OR = 2.704, 95%CI 1.866-3.919). After log-transformed for SLEA extent parameters, linear regression analysis indicated that high quartile in blood cadmium was significantly associated with higher Crouse score (GMR = 1.21, 95%CI 1.15-1.28), plaque maximum thickness (GMR = 1.13, 95%CI 1.09-1.18) and diseased vessel count (GMR = 1.14, 95%CI 1.10-1.19), respectively. When blood cadmium was used as a continuous variable in restricted cubic splines, the dose-response relationship presented a positive progression in SLEA (P = 0.302), plaque maximum thickness (P = 0.145) and diseased vessel count (P = 0.055) apparently that did not deviate from linearity. CONCLUSIONS Blood cadmium exhibited an independent association with SLEA, and this dose-response relationship was progressive without significant departure from linearity.
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Affiliation(s)
- Qi Mao
- Department of Cardiology, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China.
| | - Denglu Zhou
- Department of Cardiology, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China.
| | - Yapei Sun
- School of Public Health, Nanjing Medical University, Nanjing 211166, China; Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing 400060, China; Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing 400060, China.
| | - Jianhua Zhao
- Department of Cardiology, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China.
| | - Shangcheng Xu
- School of Public Health, Nanjing Medical University, Nanjing 211166, China; Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing 400060, China; Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing 400060, China.
| | - Xiaohui Zhao
- Department of Cardiology, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China.
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Diesel exhaust particles induce human umbilical vein endothelial cells apoptosis by accumulation of autophagosomes and caspase-8 activation. Sci Rep 2022; 12:16492. [PMID: 36192481 PMCID: PMC9529885 DOI: 10.1038/s41598-022-21044-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 09/22/2022] [Indexed: 11/13/2022] Open
Abstract
Diesel exhaust particles (DEP) are risk factors for endothelial cells (ECs) dysfunction. However, the mechanism by which DEP induce ECs apoptosis remains unclear. Here, we investigated how DEP induce death of human umbilical vein ECs (HUVECs), with a focus on the autophagy-mediated apoptotic pathway. DEP induced dose-dependent HUVECs death and exposure to the IC50 concentration of DEP (70 µg/ml) led to apoptosis. DEP phosphorylated Beclin-1 (Ser93) and increased protein levels of p62 and LC3BII and the number of LC3B puncta, indicating autophagy initiation. DEP increased expression of pro- and mature forms of cathepsin D, which increases lysosomal activity. However, DEP suppressed expression of the soluble N-ethylmaleimide-sensitive factor attachment protein receptor proteins (STX17, VAMP8, SNAP29, YKT6, and STX7) to inhibit autolysosome formation, resulting in accumulation of autophagosomes. LC3B, p62, and caspase-8 form a tertiary complex in accumulated autophagosomes, which is known to serve as a platform for caspase-8 activation. Indeed, DEP activates caspase-8 and pretreatment with a caspase-8 inhibitor suppressed DEP-induced apoptosis. Furthermore, depletion of p62 decreased caspase-8 and caspase-3 activation and inhibited the DEP-induced apoptosis. Taken together, these findings demonstrated that DEP induced HUVECs apoptosis by inhibiting autophagosome maturation and identified caspase-8 as a novel mediator of DEP-induced ECs apoptosis.
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Liu N, Feng Y, Zhan Y, Ma F. Relationship between blood cadmium and abdominal aortic calcification: NHANES 2013-2014. J Trace Elem Med Biol 2022; 72:126975. [PMID: 35344900 DOI: 10.1016/j.jtemb.2022.126975] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 02/27/2022] [Accepted: 03/17/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND Cadmium is a common toxic heavy metal in the environment and can cause irreversible damage to the human body. It is well established that cadmium has direct cardiovascular toxicity, but the relationship between cadmium exposure and abdominal aortic calcification (AAC) is not clear. METHODS This was a cross-sectional study that aimed to assess the relationship between blood cadmium (B-Cd) and AAC in U.S. adults ≥ 40 years old. We obtained data from the 2013-2014 National Health and Nutrition Examination Survey. The AAC score was quantified by the Kauppila score system, whereas severe AAC was defined as an AAC score ≥ 6. We performed multivariate regressions, correlated subgroup analyses, and interaction terms to evaluate the relationship between B-Cd and AAC score and severe AAC. RESULTS For 1530 enrolled participants, the mean AAC score was 1.52 ± 3.32, and the prevalence of severe AAC was 8.95%. Participants with higher B-Cd levels showed higher AAC scores (β = 0.36, 95% CI: 0.03, 0.70, P = 0.0323) and an increased risk of severe AAC (OR=1.61, 95% CI: 1.01, 2.56, P = 0.0432). However, these associations were weakened after adjusting for serum cotinine to define smoking exposure. Subgroup analyses and correlated interaction terms indicated that the relationship between B-Cd and AAC was generally similar in different population settings, except for males, nonsmokers, and participants with a normal body mass index (BMI). The interaction terms indicated that smoking exposure status defined by serum cotinine interacted with the relationship between B-Cd and AAC condition (P for interaction=0.0413). CONCLUSIONS There might be positive associations between B-Cd levels and AAC scores and the risk of severe AAC, while these associations were partially explained by smoking exposure. However, more well-designed studies are still needed to validate this relationship.
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Affiliation(s)
- Nuozhou Liu
- West China Hospital, West China School of Medicine, Sichuan University, Chengdu 610041, China
| | - Ying Feng
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Yuejuan Zhan
- West China Hospital, West China School of Medicine, Sichuan University, Chengdu 610041, China
| | - Fang Ma
- Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, China; Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610041, China.
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Yang J, Lo K, Yang A. Trends in Urinary and Blood Cadmium Levels in U.S. Adults with or without Comorbidities, 1999-2018. Nutrients 2022; 14:nu14040802. [PMID: 35215454 PMCID: PMC8880632 DOI: 10.3390/nu14040802] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 12/10/2022] Open
Abstract
Although cadmium (Cd) exposure has been declining in the United States (U.S.) over the years, the level of exposure for people with pre-existing comorbidities is unclear. This study characterized the trends of blood Cd levels (bCd) (n = 44,498) and urinary Cd levels (uCd) (n = 15,107) by pre-existing comorbidities among adults participating in the U.S. National Health and Nutrition Examination Survey. We calculated age- and sex-standardized annual geometric mean (GM) levels, and used aJoinpoint regression model to examine the trends over time. The GM levels of bCd declined from 1999–2000 to 2017–2018 survey cycles (from 0.49 to 0.33 μg/L), while women and current smokers had higher levels. Participants with comorbidities had higher bCd and declined over time: cardiovascular disease (CVD) (0.50 to 0.42 μg/L), hypertension (0.49 to 0.35 μg/L), chronic kidney disease (CKD) (0.54 to 0.37 μg), and cancer (0.57 to 0.38 μg) versus those without these comorbidities. We observed the similar pattern of changes for uCd and participants with CVD, CKD, and cancer had higher levels. To conclude, the trend in urinary and blood Cd levels in U.S adults decreased in the past 20 years, and the levels varied by sex, smoking status, and comorbidities.
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Affiliation(s)
- Jingli Yang
- College of Earth and Environmental Sciences, Lanzhou University, Lanzhou 730000, China;
| | - Kenneth Lo
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong SAR, China
- Correspondence: (K.L.); (A.Y.)
| | - Aimin Yang
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
- Correspondence: (K.L.); (A.Y.)
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Fagerberg B, Barregard L. Review of cadmium exposure and smoking-independent effects on atherosclerotic cardiovascular disease in the general population. J Intern Med 2021; 290:1153-1179. [PMID: 34157165 DOI: 10.1111/joim.13350] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Exposure to cadmium (Cd) via food and smoking is associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD). Blood and urine levels of Cd are established biomarkers of exposure. OBJECTIVES To review (1) the smoking-independent associations between Cd exposure and ASCVD, including the possible presence of a nonlinear dose-response relationship with Cd exposure and (2) the causal effects of Cd exposure on different stages of atherosclerosis. METHODS Narrative review. RESULTS Cd confers increased risk of ASCVD and asymptomatic atherosclerosis in the carotid and coronary arteries above B-Cd >0.5 μg/L or U-Cd >0.5 μg/g creatinine, but it has not been shown below a threshold of these exposure levels. Adjustment for smoking does not exclude the possibility of residual confounding, but several studies in never-smoking cohorts have shown associations between Cd and ASCVD, and experimental studies have demonstrated pro-atherosclerotic effects of Cd. Cd accumulates in arterial walls and atherosclerotic plaques, reaching levels shown to have proatherosclerotic effects. Suggested early effects are increased subendothelial retention of atherogenic lipoproteins, which become oxidized, and endothelial dysfunction and damage with increased permeability for monocytes, which in the intima turn to macrophages and then to foam cells. Later, Cd may contribute to plaque rupture and erosion by endothelial apoptosis and degradation of the fibrous cap. Finally, by having prothrombotic and antifibrinolytic effects, the CVD risk may be further increased. CONCLUSIONS There is strong evidence that Cd causes ASCVD above a suggested exposure level via mechanisms in early as well as the late stages of atherosclerotic disease.
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Affiliation(s)
- Björn Fagerberg
- Wallenberg Laboratory for Cardiovascular and Metabolic Research, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Barregard
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
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Immunomodulation by heavy metals as a contributing factor to inflammatory diseases and autoimmune reactions: Cadmium as an example. Immunol Lett 2021; 240:106-122. [PMID: 34688722 DOI: 10.1016/j.imlet.2021.10.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 08/10/2021] [Accepted: 10/20/2021] [Indexed: 12/22/2022]
Abstract
Cadmium (Cd) represents a unique hazard because of the long biological half-life in humans (20-30 years). This metal accumulates in organs causing a continuum of responses, with organ disease/failure as extreme outcome. Some of the cellular and molecular alterations in target tissues can be related to immune-modulating potential of Cd. This metal may cause adverse responses in which components of the immune system function as both mediators and effectors of Cd tissue toxicity, which, in combination with Cd-induced alterations in homeostatic reparative activities may contribute to tissue dysfunction. In this work, current knowledge concerning inflammatory/autoimmune disease manifestations found to be related with cadmium exposure are summarized. Along with epidemiological evidence, animal and in vitro data are presented, with focus on cellular and molecular immune mechanisms potentially relevant for the disease susceptibility, disease promotion, or facilitating development of pre-existing pathologies.
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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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Barregard L, Sallsten G, Harari F, Andersson EM, Forsgard N, Hjelmgren O, Angerås O, Fagman E, Persson M, Lundh T, Borné Y, Fagerberg B, Engström G, Bergström G. Cadmium Exposure and Coronary Artery Atherosclerosis: A Cross-Sectional Population-Based Study of Swedish Middle-Aged Adults. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:67007. [PMID: 34160297 PMCID: PMC8221368 DOI: 10.1289/ehp8523] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND The general population is ubiquitously exposed to the toxic metal cadmium through the diet and smoking. Cadmium exposure is associated with increased morbidity and mortality in myocardial infarction and stroke. Atherosclerosis is the main underlying mechanism of myocardial infarction. However, associations between cadmium and coronary artery atherosclerosis have not been examined. OBJECTIVES Our study sought to examine the hypothesis that blood cadmium (B-Cd) is positively associated with coronary artery calcification, as a measure of coronary artery atherosclerosis in the population-based Swedish SCAPIS study. METHODS Our analysis included 5,627 individuals (51% women), age 50-64 y, enrolled from 2013 to 2018. The coronary artery calcium score (CACS) was obtained from computed tomography. Blood cadmium was determined by inductively coupled plasma mass spectrometry (ICP-MS). Associations between B-Cd and coronary artery calcium score (CACS Agatston score) were evaluated using prevalence ratios (PRs) in models adjusted for sex, age, smoking, hypertension, diabetes, low-density cholesterol/high-density cholesterol ratio, and family history. RESULTS The median B-Cd concentration was 0.24μg/L. The prevalence of positive coronary artery calcium (CACS>0) was 41% and the prevalence of CACS≥100 was 13%. Relative to the lowest quartile (Q) of B-Cd (<0.16μg/L), the highest quartile (median 0.63μg/L) was associated with a small but significant increase in CACS>0 (PR 1.1; 95% CI: 1.0, 1.3), and a greater relative increase in CACS≥100 (PR 1.6; 95% CI: 1.3, 2.0). When restricted to 2,446 never-smokers, corresponding PRs were 1.1 (95% CI 0.9, 1.3) for CACS>0 (63 cases in Q4) and 1.7 (95% CI 1.1, 2.7) for CACS≥100 (17 cases in Q4). DISCUSSION Blood cadmium in the highest quartile was associated with CACS in a general population sample with low to moderate cadmium exposure. This supports the hypothesis that atherosclerosis is an important mechanism underlying the associations between cadmium and incident cardiovascular disease. The findings suggest that public health measures to reduce cadmium exposure are warranted. https://doi.org/10.1289/EHP8523.
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Affiliation(s)
- Lars Barregard
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gerd Sallsten
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Florencia Harari
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Eva M. Andersson
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Niklas Forsgard
- Department of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ola Hjelmgren
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Oskar Angerås
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Erika Fagman
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Margaretha Persson
- Department of Clinical Sciences in Malmö, CRC, Lund University and Skåne University Hospital, Malmö, Sweden
| | - Thomas Lundh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University and Skåne University Hospital, Lund, Sweden
| | - Yan Borné
- Department of Clinical Sciences in Malmö, CRC, Lund University and Skåne University Hospital, Malmö, Sweden
| | - Björn Fagerberg
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, CRC, Lund University and Skåne University Hospital, Malmö, Sweden
| | - Göran Bergström
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Wu L, Song J, Xue J, Xiao T, Wei Q, Zhang Z, Zhang Y, Li Z, Hu Y, Zhang G, Xia H, Li J, Yang X, Liu Q. MircoRNA-143-3p regulating ARL6 is involved in the cadmium-induced inhibition of osteogenic differentiation in human bone marrow mesenchymal stem cells. Toxicol Lett 2020; 331:159-166. [DOI: 10.1016/j.toxlet.2020.06.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/16/2020] [Accepted: 06/03/2020] [Indexed: 12/20/2022]
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Ilmiawati C, Reza M, Yanni M, Rusjdi DA. Blood Cd levels and carotid intima-media thickness in young adults living in Padang, Indonesia. BMC Res Notes 2020; 13:202. [PMID: 32252819 PMCID: PMC7137246 DOI: 10.1186/s13104-020-05042-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 03/25/2020] [Indexed: 02/08/2023] Open
Abstract
Objective Cd exposure is a non-traditional risk factor of cardiovascular disease and mortality by promoting the development of atherosclerosis. The development of atherosclerosis can be monitored non-invasively by measuring carotid intima-media thickness (CIMT). This study aimed to measure the level of blood Cd and other factors known to be associated with CIMT, measured at the segment of common carotid artery (CCA) and of internal carotid artery (ICA), in young adults from Padang, West Sumatera, Indonesia, and we analyzed whether blood Cd is a predictor of CIMT. Results We recruited 156 subjects. Median blood Cd level was 0.61 μg/L (range 0.01–5.96 μg/L), with no difference in male compared to female subjects (Mann–Whitney U test, p = 0.60). Multiple regression analysis showed that sex is the predictor of CCA IMT (adjusted R2 = 0.219; β = −0.438 [95% CI − 0.662, − 0.214]; p < 0.001) and ICA IMT (adjusted R2 = 0.165; β = − 0.529 [95% CI − 0.761, − 0.297]; p < 0.001). Blood Cd was not a predictor of CCA IMT (adjusted R2 = 0.219; β = − 0.101 [95% CI − 0.257, 0.055]; p = 0.203) and ICA IMT (adjusted R2 = 0.165; β = − 0.055 [95% CI − 0.217, 0.107]; p = 0.503) in young adults from Padang, Indonesia.
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Affiliation(s)
- Cimi Ilmiawati
- Department of Pharmacology, Faculty of Medicine, Andalas University, Padang, West Sumatra, Indonesia. .,Division of Environmental Toxicology, Department of Pharmacology, Faculty of Medicine, Andalas University, Main Campus at Limau Manis, Gedung A Lantai 1, Pauh, Padang, West Sumatra, 25166, Indonesia.
| | - Mohamad Reza
- Department of Biology, Faculty of Medicine, Andalas University, Padang, West Sumatra, Indonesia
| | - Mefri Yanni
- Department of Cardiology, Faculty of Medicine, Andalas University, Padang, West Sumatra, Indonesia
| | - Dina Arfiani Rusjdi
- Department of Radiology, Faculty of Medicine, Andalas University, Padang, West Sumatra, Indonesia
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Söderholm M, Borné Y, Hedblad B, Persson M, Barregard L, Engström G. Blood cadmium concentration and risk of subarachnoid haemorrhage. ENVIRONMENTAL RESEARCH 2020; 180:108826. [PMID: 31654906 DOI: 10.1016/j.envres.2019.108826] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 10/08/2019] [Accepted: 10/14/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Cadmium is a toxic metal and exposure is mainly from diet and tobacco smoke. Cadmium is accumulated in blood vessels and may reduce synthesis of procollagen and inhibit proliferation of vascular smooth muscle cells. High blood cadmium has been associated with increased risk of myocardial infarction, stroke and unruptured intracranial aneurysms. We examined whether blood cadmium increase the risk of subarachnoid haemorrhage (SAH). METHODS The Malmö Diet and Cancer cohort (n = 28,449) was examined in 1991-1996 and blood samples were taken. Incidence of SAH was followed up to 2014. Cadmium was measured in stored blood samples from incident SAH cases and matched controls (n = 93 vs n = 276) and odds ratio (OR) for SAH was assessed in a nested case control design. RESULTS Subjects with cadmium concentration in the highest quartile had increased risk of SAH compared to those in the first quartile (OR: 3.22, 95%CI: 1.67-6.22). However, after adjusting for smoking, results were weakened and non-significant (OR: 1.57, 95%CI: 0.51-4.80). CONCLUSIONS Cadmium concentration was associated with increased risk of SAH but this association was largely explained by smoking. Whether cadmium in tobacco may contribute to the vascular pathology and increased risk of SAH in smokers should be further studied.
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Affiliation(s)
- Martin Söderholm
- Department of Clinical Science, Lund University, Malmö, Sweden; Department of Neurology, Skåne University Hospital, Malmö, Sweden.
| | - Yan Borné
- Department of Clinical Science, Lund University, Malmö, Sweden
| | - Bo Hedblad
- Department of Clinical Science, Lund University, Malmö, Sweden
| | | | - Lars Barregard
- Occupational and Environmental Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Gunnar Engström
- Department of Clinical Science, Lund University, Malmö, Sweden
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Harari F, Barregard L, Östling G, Sallsten G, Hedblad B, Forsgard N, Borné Y, Fagerberg B, Engström G. Blood Lead Levels and Risk of Atherosclerosis in the Carotid Artery: Results from a Swedish Cohort. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:127002. [PMID: 31808705 PMCID: PMC6957277 DOI: 10.1289/ehp5057] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Lead exposure has been associated with increased incidence of adverse clinical cardiovascular outcomes. Atherosclerosis has been suggested as one of the underlying mechanisms, and findings from experimental studies support this, but human data are scarce. OBJECTIVES Our objective was to determine the association between environmental lead exposure based on blood lead (B-Pb) concentrations and the prevalence of atherosclerotic plaque in the carotid artery. METHODS We used cross-sectional data from the Malmö Diet and Cancer Study cardiovascular cohort (MDCS-CC; recruitment in 1991-1994) covering 4,172 middle-aged men and women. B-Pb at baseline, measured by inductively coupled plasma mass spectrometry, was used as the exposure biomarker. The presence of atherosclerotic plaque in the carotid artery was determined by B-mode ultrasonography. We used logistic regression to estimate odds ratios (ORs) for prevalence of plaque in the carotid artery according to B-Pb quartiles. RESULTS The median B-Pb was 25μg/L (range: 1.5-258), and 36% of the cohort had any atherosclerotic plaque. After controlling for confounders and known cardiovascular risk factors, the OR for prevalence of plaque in the highest quartile (Q4) of B-Pb compared with the lowest quartile (Q1) was 1.35 (95% CI: 1.09, 1.66) in the total group, 1.58 (95% CI: 1.20, 2.08) among women, and 1.18 (95% CI: 0.83, 1.69) among men. Among women, associations were limited to those who were postmenopausal [OR for Q4 vs. Q1=1.72 (95% CI: 1.26, 2.34) vs. OR=0.96 (95% CI: 0.49, 1.89 in premenopausal women)]. Associations were weak and nonsignificant in never-smokers [OR for Q4 vs. Q1=1.14 (95% CI: 0.81, 1.61)]. DISCUSSION Our study shows an association between B-Pb concentrations and occurrence of atherosclerotic plaque in the carotid artery, adding evidence for an underlying pro-atherogenic role of lead in cardiovascular disease. Associations appeared to be limited to postmenopausal (vs. premenopausal) women. https://doi.org/10.1289/EHP5057.
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Affiliation(s)
- Florencia Harari
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden
| | - Lars Barregard
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden
| | - Gerd Östling
- Department of Clinical Sciences in Malmö, CRC, Lund University and Skåne University Hospital, Malmö, Sweden
| | - Gerd Sallsten
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden
| | - Bo Hedblad
- Department of Clinical Sciences in Malmö, CRC, Lund University and Skåne University Hospital, Malmö, Sweden
| | - Niklas Forsgard
- Department of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Yan Borné
- Department of Clinical Sciences in Malmö, CRC, Lund University and Skåne University Hospital, Malmö, Sweden
| | - Björn Fagerberg
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory for Cardiovascular and Metabolic Research, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, CRC, Lund University and Skåne University Hospital, Malmö, Sweden
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Teng X, Zhang W, Song Y, Wang H, Ge M, Zhang R. Protective effects of Ganoderma lucidum triterpenoids on oxidative stress and apoptosis in the spleen of chickens induced by cadmium. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:23967-23980. [PMID: 31222655 DOI: 10.1007/s11356-019-05638-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 05/29/2019] [Indexed: 06/09/2023]
Abstract
Cadmium (Cd) is a heavy metal that poses a huge potential threat to human and animal health. Therefore, it is necessary to study its damage mechanism. In the present study, we have examined the protective effects of Ganoderma lucidum triterpenoids on oxidative stress and apoptosis in the spleen of chickens induced by Cd. One hundred and twenty healthy Hailan white chickens (7-day-old) were randomly divided into the following four groups: control group, Cd group, triterpenoid group, and Cd-triterpenoid group. The chickens were euthanized on the 20th, 40th, and 60th days, and the spleens were removed. Cd and malondialdehyde (MDA) content, antioxidant enzyme (superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px)) activities, and inflammatory factor (tumor necrosis factor alpha (TNF-α) and interleukin (IL-1β and IL-6)) and apoptotic factor (caspase-3, BAX, and Bcl-2) expressions were detected. The results showed that Ganoderma lucidum triterpenoids could reduce the content of Cd and MDA; increase the antioxidant enzyme activities (SOD and GSH-Px); decrease the expression of inflammatory factors (TNF-α) and interleukin (IL-1β and IL-6); increase the expression of apoptotic factor (Bcl-2); and decrease the expression of apoptotic factors (caspase-3 and Bax). It showed that the triterpenoids of Ganoderma lucidum had significant protective effects on oxidative stress and apoptosis of chicken spleen, which provided a theoretical basis for further prevention and treatment of cadmium poisoning.
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Affiliation(s)
- Xiangqi Teng
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, 150030, China
- Key Laboratory of the Provincial Education, Department of Heilongjiang for Common Animal Disease Prevention and Treatment, Northeast Agricultural University, Harbin, 150030, China
| | - Weiqian Zhang
- Quality and Standard Research Center, Chinese Academy of Fishery Sciences, Beijing, 100141, China
| | - Yangyang Song
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, 150030, China
- Key Laboratory of the Provincial Education, Department of Heilongjiang for Common Animal Disease Prevention and Treatment, Northeast Agricultural University, Harbin, 150030, China
| | - Haibin Wang
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, 150030, China
- Key Laboratory of the Provincial Education, Department of Heilongjiang for Common Animal Disease Prevention and Treatment, Northeast Agricultural University, Harbin, 150030, China
| | - Ming Ge
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, 150030, China.
- Key Laboratory of the Provincial Education, Department of Heilongjiang for Common Animal Disease Prevention and Treatment, Northeast Agricultural University, Harbin, 150030, China.
| | - Ruili Zhang
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, 150030, China.
- Key Laboratory of the Provincial Education, Department of Heilongjiang for Common Animal Disease Prevention and Treatment, Northeast Agricultural University, Harbin, 150030, China.
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Li H, Fagerberg B, Sallsten G, Borné Y, Hedblad B, Engström G, Barregard L, Andersson EM. Smoking-induced risk of future cardiovascular disease is partly mediated by cadmium in tobacco: Malmö Diet and Cancer Cohort Study. Environ Health 2019; 18:56. [PMID: 31200698 PMCID: PMC6570857 DOI: 10.1186/s12940-019-0495-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 05/31/2019] [Indexed: 05/27/2023]
Abstract
BACKGROUND Smoking is a strong risk factor for cardiovascular disease (CVD) and causes exposure to cadmium, which is a pro-atherosclerotic metal. Cadmium exposure has also been shown to increase the risk of CVD, even after adjustment for smoking. Our hypothesis was that part of the risk of CVD in smokers may be mediated by cadmium exposure from tobacco smoke. We examined this hypothesis in a mediation analysis, trying to assess how much of the smoking-induced CVD risk could be explained via cadmium. METHODS We used prospective data on CVD (incidence and mortality) in a Swedish population-based cohort of 4304 middle-aged men and women (the Malmö Diet and Cancer Study). Blood cadmium was analyzed in base-line samples from 1991, and clinical events were followed up for 16-19 years based on registry data. Mediation analysis was conducted to evaluate the indirect effect (via cadmium) of smoking on CVD. Survival was analyzed by the accelerated failure time (AFT) model and the Aalen additive hazard model. RESULTS The mean blood cadmium level in the study population was 0.43 μg/L (median 0.24 μg/L) and increased with recent and current smoking. As expected, shorter survival time (AFT model) and higher incidence rate (Aalen model) were found in current smokers for all CVD outcomes and this effect seemed to be partly mediated by cadmium. For the sum of acute myocardial infarction, bypass grafts and percutaneous coronary intervention, and death in ischemic heart disease, about half of the increased risk of such events in current smokers was mediated via cadmium, with similar results for the AFT and Aalen models. CONCLUSIONS Cadmium plays an important role in smoking-induced CVDs. This provides evidence for mechanisms and is of importance for both individuals and policy makers.
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Affiliation(s)
- Huiqi Li
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, P.O. Box 414, 405 30 Gothenburg, Sweden
| | - Björn Fagerberg
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory for Cardiovascular and Metabolic Research, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gerd Sallsten
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, P.O. Box 414, 405 30 Gothenburg, Sweden
| | - Yan Borné
- Cardiovascular Epidemiology, Department of Clinical Sciences in Malmö, Lund University and Skåne University Hospital, Malmö, Sweden
| | - Bo Hedblad
- Cardiovascular Epidemiology, Department of Clinical Sciences in Malmö, Lund University and Skåne University Hospital, Malmö, Sweden
| | - Gunnar Engström
- Cardiovascular Epidemiology, Department of Clinical Sciences in Malmö, Lund University and Skåne University Hospital, Malmö, Sweden
| | - Lars Barregard
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, P.O. Box 414, 405 30 Gothenburg, Sweden
| | - Eva M. Andersson
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, P.O. Box 414, 405 30 Gothenburg, Sweden
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Olcay A, Tezcan E, Canturk E, İnan B, Karaoglu H, Kucuk C, Akdemir B, Yolay O. Multiple Non-Essential Transition Metals Are Accumulated in Carotid Atherosclerotic Plaques: Missing Link in Atherosclerosis? Biol Trace Elem Res 2019; 189:420-425. [PMID: 30120677 DOI: 10.1007/s12011-018-1481-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 08/10/2018] [Indexed: 01/07/2023]
Abstract
Population studies revealed that metal exposure through food, environment, and smoking was related with increased risk of cardiovascular disease. In this study, we determined complex chemical elements in surgical carotid endarterectomy specimens and carotid tissues from autopsies without atherosclerosis. Atherosclerotic plaques from 41 endarterectomies and normal carotid tissue from 30 autopsies were collected and elemental composition was determined by inductively coupled plasma optical emission spectrometry (ICP-OES) method. Eleven (26.8%) patients never smoked in carotid endarterectomy group. One patient was brass souvenir worker and one was goldsmith and others did not have direct contact with metals in the carotid endarterectomy group. Na, Cu, Mn, Bi, Co, Mo, Ni, Pb, Sb, Se, Sn, Ti, and W levels were not different between two groups. Bi, Co, Mo, Pb, Ti, and W were below the detection limit of ICP-OES in both groups. Concentrations of Mg, K, Ca, P, Fe, B, Zn, Al, As, Cr, Pt, and Hg were significantly higher in carotid endarterectomies than normal carotid tissue samples. Cd and S values were significantly higher in autopsy samples. There is significant multiple non-essential transition metal accumulation in atherosclerotic carotid endarterectomy plaques. The cardiovascular consequences of metal toxicity have not been researched adequately due to large emphasis on the role of cholesterol in atherosclerosis. High level of non-essential transition metal elements in the carotid atherosclerotic plaques may add the missing link of atherogenesis and may necessitate new treatment and prevention strategies in carotid disease if confirmed by further research.
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Affiliation(s)
- Ayhan Olcay
- Department of Cardiology, İstanbul Aydin University Medical School, Beşyol Mahallesi, İnönü Cd. No:38, 34295, Küçükçekmece, İstanbul, Turkey.
| | - Erdem Tezcan
- Department of Nutrition and Dietetics, İstanbul Gedik University, İstanbul, Turkey
| | - Emir Canturk
- Department of Cardiovascular Surgery, Bezmialem Vakif University, İstanbul, Turkey
| | - Bekir İnan
- Department of Cardiovascular Surgery, Bezmialem Vakif University, İstanbul, Turkey
| | - Hasan Karaoglu
- İstanbul Institute of Forensic Medicine, İstanbul, Turkey
| | - Ceyhun Kucuk
- İstanbul Institute of Forensic Medicine, İstanbul, Turkey
| | - Baris Akdemir
- Department of Cardiology, İstanbul Aydin University Medical School, Beşyol Mahallesi, İnönü Cd. No:38, 34295, Küçükçekmece, İstanbul, Turkey
| | - Onur Yolay
- Faculty of Health Sciences, Department of Nutrition and Dietetics, İstanbul Aydin University, İstanbul, Turkey
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Borné Y, Fagerberg B, Sallsten G, Hedblad B, Persson M, Melander O, Nilsson J, Orho-Melander M, Barregard L, Engström G. Biomarkers of blood cadmium and incidence of cardiovascular events in non-smokers: results from a population-based proteomics study. Clin Proteomics 2019; 16:21. [PMID: 31114450 PMCID: PMC6518646 DOI: 10.1186/s12014-019-9231-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/23/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cadmium is a toxic metal with multiple adverse health effects, including risk of cardiovascular disease (CVD). The mechanistic link between cadmium and CVD is unclear. Our aim was to examine the associations between blood cadmium (B-Cd) and 88 potential protein biomarkers of CVD. METHODS B-Cd and 88 plasma proteins were measured in a community-based prospective cohort, the Malmö Diet and Cancer study. The primary analysis was performed in never smokers (n = 1725). Multiple linear regression was used with adjustments for age and sex, and correction for multiple comparisons using the false discovery rate method. Proteins significantly associated with B-Cd were replicated in long-term former smokers (n = 782). Significant proteins were then studied in relation to incidence of CVD (i.e., coronary events or ischemic stroke) in never smokers. RESULTS Fifteen proteins were associated with B-Cd in never smokers. Eight of them were replicated in long-term former smokers. Kidney injury molecule-1, fibroblast growth factor-23 (FGF23), tumor necrosis factor receptor-2, matrix metalloproteinase-12, cathepsin L1, urokinase plasminogen activator receptor, C-C motif chemokine-3 (CCL3), and chemokine (C-X3-C motif) ligand-1 were associated with B-Cd both in never smokers and long-term former smokers. Except for CCL3 and FGF23, these proteins were also significantly associated with incidence of CVD. CONCLUSIONS B-Cd in non-smokers was associated with eight potential plasma biomarkers of CVD and kidney injury. The results suggest pathways for the associations between B-Cd and CVD and kidney injury.
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Affiliation(s)
- Yan Borné
- Department of Clinical Sciences in Malmö, CRC, Lund University, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
| | - Björn Fagerberg
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory for Cardiovascular and Metabolic Research, Sahlgrenska University Hospital, University of Gothenburg, 413 45 Gothenburg, Sweden
| | - Gerd Sallsten
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, University of Gothenburg, 413 45 Gothenburg, Sweden
| | - Bo Hedblad
- Department of Clinical Sciences in Malmö, CRC, Lund University, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
| | - Margaretha Persson
- Department of Clinical Sciences in Malmö, CRC, Lund University, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
| | - Olle Melander
- Department of Clinical Sciences in Malmö, CRC, Lund University, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
| | - Jan Nilsson
- Department of Clinical Sciences in Malmö, CRC, Lund University, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
| | - Marju Orho-Melander
- Department of Clinical Sciences in Malmö, CRC, Lund University, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
| | - Lars Barregard
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, University of Gothenburg, 413 45 Gothenburg, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, CRC, Lund University, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
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Oliveira TF, Batista PR, Leal MA, Campagnaro BP, Nogueira BV, Vassallo DV, Meyrelles SS, Padilha AS. Chronic Cadmium Exposure Accelerates the Development of Atherosclerosis and Induces Vascular Dysfunction in the Aorta of ApoE -/- Mice. Biol Trace Elem Res 2019; 187:163-171. [PMID: 29707746 DOI: 10.1007/s12011-018-1359-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 04/18/2018] [Indexed: 01/04/2023]
Abstract
Cadmium exposure is related to cardiovascular diseases, including hypertension, atherosclerosis, increased oxidative stress, endothelial dysfunction, and specific biochemical changes induced by this metal. Thus, we aimed to investigate whether cadmium exposure induces endothelial dysfunction, accelerates atherosclerotic plaque formation in the aorta, and enhances oxidative stress in apolipoprotein E knockout (ApoE-/-) mice. Experiments were performed in 14-week-old male wild-type and ApoE-/- mice. ApoE-/- mice received cadmium (CdCl2 100 mg/L in drinking water for 28 days) or vehicle (distilled water). After treatment, vascular reactivity to phenylephrine, acetylcholine, and sodium nitroprusside was analyzed using isolated aorta. Bone marrow cells were isolated to assess the production of nitric oxide and reactive oxygen and nitrogen species. ApoE-/- cadmium-treated mice had higher cholesterol levels than non-exposed mice. Cadmium exposure decreased the vasodilatation response to acetylcholine in aortic ring of ApoE-/- mice, though no changes in phenylephrine or sodium nitroprusside responses were observed. L-NAME reduced vasodilator responses to acetylcholine; this effect was lower in ApoE-/- cadmium-treated mice, suggesting reduction in nitric oxide (NO) bioavailability. Moreover, in bone marrow cells, cadmium decreased cytoplasmic levels of NO and increased superoxide anions, hydrogen peroxide, and peroxynitrite in ApoE-/- mice. Morphological analysis showed that cadmium exposure increased plaque deposition in the aorta by approximately 3-fold. Our results suggest that cadmium exposure induces endothelial dysfunction in ApoE-/- mice. Moreover, cadmium increased total cholesterol levels, which may promote the early development of atherosclerosis in the aorta of ApoE-/- mice. Our findings support the hypothesis that cadmium exposure might increase the risk of atherosclerosis.
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Affiliation(s)
- T F Oliveira
- Physiological Sciences Graduate Program, Health Sciences Center, Universidade Federal do Espírito Santo CCS/UFES, Av. Marechal Campos, 1468, Maruípe, Vitoria, ES, 29040-091, Brazil
| | - P R Batista
- Physiological Sciences Graduate Program, Health Sciences Center, Universidade Federal do Espírito Santo CCS/UFES, Av. Marechal Campos, 1468, Maruípe, Vitoria, ES, 29040-091, Brazil
- Escola Superior de Ciências da Santa Casa de Misericórdia de Vitoria (EMESCAM), Vitória, ES, Brazil
| | - M A Leal
- Physiological Sciences Graduate Program, Health Sciences Center, Universidade Federal do Espírito Santo CCS/UFES, Av. Marechal Campos, 1468, Maruípe, Vitoria, ES, 29040-091, Brazil
| | - B P Campagnaro
- Pharmaceutical Sciences Graduate Program, Universidade de Vila Velha (UVV), Vila Velha, ES, Brazil
| | - B V Nogueira
- Department of Morphology, Health Sciences Center, Universidade Federal do Espírito Santo, Vitoria, ES, Brazil
| | - D V Vassallo
- Physiological Sciences Graduate Program, Health Sciences Center, Universidade Federal do Espírito Santo CCS/UFES, Av. Marechal Campos, 1468, Maruípe, Vitoria, ES, 29040-091, Brazil
- Escola Superior de Ciências da Santa Casa de Misericórdia de Vitoria (EMESCAM), Vitória, ES, Brazil
| | - S S Meyrelles
- Physiological Sciences Graduate Program, Health Sciences Center, Universidade Federal do Espírito Santo CCS/UFES, Av. Marechal Campos, 1468, Maruípe, Vitoria, ES, 29040-091, Brazil
| | - Alessandra Simão Padilha
- Physiological Sciences Graduate Program, Health Sciences Center, Universidade Federal do Espírito Santo CCS/UFES, Av. Marechal Campos, 1468, Maruípe, Vitoria, ES, 29040-091, Brazil.
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Andersson EM, Fagerberg B, Sallsten G, Borné Y, Hedblad B, Engström G, Barregard L. Partial Mediation by Cadmium Exposure of the Association Between Tobacco Smoking and Atherosclerotic Plaques in the Carotid Artery. Am J Epidemiol 2018; 187:806-816. [PMID: 29020130 DOI: 10.1093/aje/kwx306] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 08/23/2017] [Indexed: 12/20/2022] Open
Abstract
Exposure to cadmium confers increased cardiovascular risk. Tobacco smoke contains cadmium, which, hypothetically, may mediate parts of the tobacco-associated risk of developing atherosclerotic plaques. Baseline data from the Swedish Malmö Diet and Cancer cohort (1991-1996) were used to test this hypothesis. Mediation analysis was used to examine associations between smoking and blood cadmium levels and the prevalence of ultrasound-assessed carotid atherosclerotic plaques. The total association with smoking status (never smokers, 2 categories of former smokers, and current smokers) was split into direct and indirect association, and the proportion mediated was estimated. The adjusted estimated plaque prevalence was approximately 27% among never smokers. We identified both a direct and an indirect pathway between smoking and carotid plaques; the indirect association, through cadmium, was observed among current smokers and former smokers who had quit smoking less than 15 years before. For current smokers, the prevalence ratio for plaque was 1.5, with 60%-65% of the association with smoking being mediated through cadmium. Recent former smokers had a prevalence ratio of 1.3, and 40%-45% was mediated through cadmium. Long-time former smokers had a prevalence ratio of 1.2, but none of the association was mediated through cadmium. In conclusion, about two-thirds of the proatherosclerotic association with smoking was mediated by cadmium.
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Affiliation(s)
- Eva M Andersson
- Authors affiliations: Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Björn Fagerberg
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory for Cardiovascular and Metabolic Research, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gerd Sallsten
- Authors affiliations: Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Yan Borné
- Department of Clinical Sciences in Malmö, Cardiovascular Epidemiology, Clinical Research Centre, Lund University, Malmö, Sweden
| | - Bo Hedblad
- Department of Clinical Sciences in Malmö, Cardiovascular Epidemiology, Clinical Research Centre, Lund University, Malmö, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, Cardiovascular Epidemiology, Clinical Research Centre, Lund University, Malmö, Sweden
| | - Lars Barregard
- Authors affiliations: Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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23
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Tinkov AA, Filippini T, Ajsuvakova OP, Skalnaya MG, Aaseth J, Bjørklund G, Gatiatulina ER, Popova EV, Nemereshina ON, Huang PT, Vinceti M, Skalny AV. Cadmium and atherosclerosis: A review of toxicological mechanisms and a meta-analysis of epidemiologic studies. ENVIRONMENTAL RESEARCH 2018; 162:240-260. [PMID: 29358116 DOI: 10.1016/j.envres.2018.01.008] [Citation(s) in RCA: 141] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 01/05/2018] [Accepted: 01/10/2018] [Indexed: 05/20/2023]
Abstract
Cadmium has been proposed to be the one of the factors of atherosclerosis development, although the existing data are still controversial. The primary objective of the present study is the review and the meta-analysis of studies demonstrating the association between Cd exposure and atherosclerosis as well as review of the potential mechanisms of such association. We performed a systematic search in the PubMed-Medline database using the MeSH terms cadmium, cardiovascular disease, atherosclerosis, coronary artery disease, myocardial infarction, stroke, mortality and humans up through December 20, 2017. Elevated urinary Cd levels were associated with increased mortality for cardiovascular disease (HR = 1.34, 95% CI: 1.07-1.67) as well as elevated blood Cd levels (HR = 1.78, 95% CI: 1.24-2.56). Analysis restricted to never smokers showed similar, though more imprecise, results. Consistently, we also observed an association between Cd exposure markers (blood and urine) and coronary heart disease, stroke, and peripheral artery disease. Moreover, Cd exposure was associated with atherogenic changes in lipid profile. High Cd exposure was associated with higher TC levels (OR = 1.48, 95% CI: 1.10-2.01), higher LDL-C levels (OR = 1.31, 95% CI 0.99-1.73) and lower HDL-C levels (OR = 1.96, 95% CI: 1.09-3.55). The mechanisms of atherogenic effect of cadmium may involve oxidative stress, inflammation, endothelial dysfunction, enhanced lipid synthesis, up-regulation of adhesion molecules, prostanoid dysbalance, as well as altered glycosaminoglycan synthesis.
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Affiliation(s)
- Alexey A Tinkov
- Yaroslavl State University, Yaroslavl, Russia; Peoples' Friendship University of Russia (RUDN University), Moscow, Russia; Institute of Cellular and Intracellular Symbiosis, Russian Academy of Sciences, Orenburg, Russia.
| | - Tommaso Filippini
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Modena, Italy
| | - Olga P Ajsuvakova
- All-Russian Research Institute of Phytopathology, Odintsovo, Moscow Region, Russia
| | | | - Jan Aaseth
- Faculty of Public Health, Inland Norway University of Applied Sciences, Elverum, Norway; Research Department, Innlandet Hospital Trust, Brumunddal, Norway
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway
| | | | - Elizaveta V Popova
- St. Joseph University in Tanzania, St. Joseph College of Health Sciences, Dar es Salaam, Tanzania
| | | | | | - Marco Vinceti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Modena, Italy
| | - Anatoly V Skalny
- Yaroslavl State University, Yaroslavl, Russia; Peoples' Friendship University of Russia (RUDN University), Moscow, Russia; Orenburg State University, Orenburg, Russia; Trace Element Institute for UNESCO, Lyon, France
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24
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Borné Y, Fagerberg B, Persson M, Östling G, Söderholm M, Hedblad B, Sallsten G, Barregard L, Engström G. Cadmium, Carotid Atherosclerosis, and Incidence of Ischemic Stroke. J Am Heart Assoc 2017; 6:JAHA.117.006415. [PMID: 29197829 PMCID: PMC5778998 DOI: 10.1161/jaha.117.006415] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Exposure to cadmium has been associated with carotid plaques, inflammation in carotid plaques, and increased risk of ischemic stroke. This study examined the separate and interacting effects of blood cadmium levels and carotid plaques on the risk of incident ischemic stroke. Methods and Results Cadmium levels were measured in 4156 subjects (39.2% men; mean±SD age 57.3±5.9 years) without history of stroke, from the Malmö Diet and Cancer cohort. The right carotid artery was examined using B‐mode ultrasound examination at baseline. Incidence of ischemic stroke was monitored over a mean follow‐up of 16.7 years. Carotid plaque was present in 34.5% of participants. Cadmium was significantly higher in subjects with plaque (mean±SD: 0.53±0.58 μg/L versus 0.42±0.49 μg/L; P<0.001). A total of 221 subjects had ischemic stroke during the follow‐up. Incidence of ischemic stroke was associated both with carotid plaque (hazard ratio 1.44, 95% confidence interval, 1.09–1.90, P=0.009) and cadmium (hazard ratio for quartile [Q] 4 versus Q1–3: 1.95, confidence interval, 1.33–2.85, P=0.001), after adjustment for risk factors. There was a significant interaction between cadmium and plaque with respect to risk of ischemic stroke (P=0.011). Adjusted for risk factors, subjects with plaque and cadmium in Q4 had a hazard ratio of 2.88 (confidence interval, 1.79–4.63) for ischemic stroke, compared with those without plaque and cadmium in Q1 to Q3. Conclusions Cadmium was associated with incidence of ischemic stroke, both independently and in synergistic interaction with carotid plaques. This supports the hypothesis that cadmium promotes vulnerability of carotid plaques, thereby increasing the risk of rupture and ischemic stroke.
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Affiliation(s)
- Yan Borné
- Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Björn Fagerberg
- Molecular and Clinical Medicine, Wallenberg Laboratory for Cardiovascular and Metabolic Research, Sahlgrenska University Hospital University of Gothenburg, Sweden
| | | | - Gerd Östling
- Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | | | - Bo Hedblad
- Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Gerd Sallsten
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Sweden
| | - Lars Barregard
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Sweden
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25
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Ngu NLY, McEvoy M. Environmental tobacco smoke and peripheral arterial disease: A review. Atherosclerosis 2017; 266:113-120. [DOI: 10.1016/j.atherosclerosis.2017.09.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 09/04/2017] [Accepted: 09/21/2017] [Indexed: 12/14/2022]
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Wu M, Song J, Zhu C, Wang Y, Yin X, Huang G, Zhao K, Zhu J, Duan Z, Su L. Association between cadmium exposure and diabetes mellitus risk: a prisma-compliant systematic review and meta-analysis. Oncotarget 2017; 8:113129-113141. [PMID: 29348892 PMCID: PMC5762577 DOI: 10.18632/oncotarget.21991] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 09/21/2017] [Indexed: 12/16/2022] Open
Abstract
Cadmium (Cd) is a pollutant with multiple adverse health effects: cancer, renal dysfunction, osteoporosis and fracture, and cardiovascular disease. Several population-based studies found an association between Cd and diabetes mellitus (DM), but this association is inconsistent with other research. We conducted meta-analysis to examine relationship between urinary/blood Cd exposure and DM risk. Pertinent studies were identified by searching PubMed and Embase databases, and combined odds ratio (OR) and corresponding 95% confidence interval (CI) were applied to evaluate said association. Meta-analysis showed that high U-Cd exposure is not correlated with DM risk (OR = 1.19; 95% CI = 0.83–1.71), and high B-Cd exposure is also not associated with increased risk of DM (OR = 1.16; 95% CI = 0.84-1.62) in the general population. Subgroup and sensitivity analysis proved similar results, with little evidence of publication bias. This meta-analysis suggests that high U-Cd/B-Cd exposure may not be risk factor for DM in general populations. However, large prospective studies are needed to confirm this finding.
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Affiliation(s)
- Ming Wu
- Department of Emergency Medicine, Guizhou Provincial People's Hospital, Guizhou, China
| | - Jukun Song
- Department of Oral and Maxillofacial Surgery, Guizhou Provincial People's Hospital, Guizhou, China
| | - Chen Zhu
- Guiyang Hospital of Stomatology, Medical College, Zunyi Medical College, Guiyang, China
| | - Yadong Wang
- Department of Oral and Maxillofacial Surgery, Guizhou Provincial People's Hospital, Guizhou, China
| | - Xinhai Yin
- Department of Oral and Maxillofacial Surgery, Guizhou Provincial People's Hospital, Guizhou, China
| | - Guanglei Huang
- Department of Oral and Maxillofacial Surgery, Guizhou Provincial People's Hospital, Guizhou, China
| | - Ke Zhao
- Department of Oral and Maxillofacial Surgery, Guizhou Provincial People's Hospital, Guizhou, China
| | - Jianguo Zhu
- Department of Urology, Guizhou Provincial People's Hospital, Guizhou, China
| | - Zhuhui Duan
- Affiliated Hospital of Stomatology, Medical College, Zhejiang University, Hangzhou, China
| | - Lingkai Su
- Affiliated Hospital of Stomatology, Medical College, Zhejiang University, Hangzhou, China
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27
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Arenas IA, Navas-Acien A, Ergui I, Lamas GA. Enhanced vasculotoxic metal excretion in post-myocardial infarction patients following a single edetate disodium-based infusion. ENVIRONMENTAL RESEARCH 2017; 158:443-449. [PMID: 28689036 DOI: 10.1016/j.envres.2017.06.039] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 06/29/2017] [Accepted: 06/29/2017] [Indexed: 05/10/2023]
Abstract
UNLABELLED Toxic metals have been associated with cardiovascular mortality and morbidity. We have hypothesized that enhanced excretion of vasculotoxic metals might explain the positive results of the Trial to Assess Chelation Therapy (TACT). The purpose of this study was to determine whether a single infusion of the edetate disodium- based infusion used in TACT led to enhanced excretion of toxic metals known to be associated with cardiovascular events. METHODS Twenty six patients (post-MI, age > 50 years, serum creatinine ≤ 2.0mg/dL) were enrolled in this open-label study. Urinary levels of 20 toxic metals normalized to urinary creatinine concentrations were measured at baseline in overnight urine collections, for 6h following a placebo infusion of 500mL normal saline and 1.2% dextrose, and for 6h following a 3g edetate disodium-based infusion. Self-reported metal exposure, smoking status, food frequency, occupational history, drinking water source, housing and hobbies were collected at baseline by a metal exposure questionnaire. RESULTS The mean age was 65 years (range 51-81 years). All patients were male. 50% had diabetes mellitus and 58% were former smokers. Mean (SD) serum creatinine was 0.95 (0.31) mg/dL. Toxic metals were detected in the baseline urine of >80% of patients. After placebo infusion there were no significant changes in total urinary metal levels. After edetate infusion, total urinary metal level increased by 71% compared to baseline (1500 vs. 2580µg/g creatinine; P<0.0001). The effect of edetate was particularly large for lead (3835% increase) and cadmium (633% increase). CONCLUSIONS Edetate disodium-based infusions markedly enhanced the urinary excretion of lead and cadmium, toxic metals with established epidemiologic evidence and mechanisms linking them to coronary and vascular events.
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Affiliation(s)
- Ivan A Arenas
- The Columbia University Division of Cardiology at Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Ana Navas-Acien
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Ian Ergui
- The Columbia University Division of Cardiology at Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Gervasio A Lamas
- The Columbia University Division of Cardiology at Mount Sinai Medical Center, Miami Beach, FL, USA.
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28
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Fagerberg B, Borné Y, Sallsten G, Smith JG, Acosta S, Persson M, Melander O, Forsgard N, Gottsäter A, Hedblad B, Barregard L, Engström G. Circulating cadmium concentration and risk of aortic aneurysms: A nested case-control study within the Malmö Diet and Cancer cohort. Atherosclerosis 2017; 261:37-43. [DOI: 10.1016/j.atherosclerosis.2017.04.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 03/13/2017] [Accepted: 04/07/2017] [Indexed: 12/31/2022]
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29
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Fagerberg B, Borné Y, Barregard L, Sallsten G, Forsgard N, Hedblad B, Persson M, Engström G. Cadmium exposure is associated with soluble urokinase plasminogen activator receptor, a circulating marker of inflammation and future cardiovascular disease. ENVIRONMENTAL RESEARCH 2017; 152:185-191. [PMID: 27792942 DOI: 10.1016/j.envres.2016.10.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 09/26/2016] [Accepted: 10/19/2016] [Indexed: 05/19/2023]
Abstract
BACKGROUND Diet and smoking are the main sources of cadmium exposure in the general population. Cadmium increases the risk of cardiovascular diseases, and experimental studies show that it induces inflammation. Blood cadmium levels are associated with macrophages in human atherosclerotic plaques. Soluble urokinase-type plasminogen activator receptor (suPAR) is an emerging biomarker for cardiovascular events related to inflammation and atherosclerotic plaques. The aim was to examine whether blood cadmium levels are associated with circulating suPAR and other markers of inflammation. METHODS A population sample of 4648 Swedish middle-aged women and men was examined cross-sectionally in 1991-1994. Plasma suPAR was assessed by ELISA, leukocytes were measured by standard methods, and blood cadmium was analysed by inductively coupled plasma mass spectrometry. Prevalent cardiovascular disease, ultrasound-assessed carotid plaque occurrence, and several possible confounding factors were recorded. RESULTS After full adjustment for risk factors and confounding variables, a 3-fold increase in blood cadmium was associated with an 10.9% increase in suPAR concentration (p<0.001). In never-smokers, a 3-fold increase in blood cadmium was associated with a 3.7% increase in suPAR concentration (p<0.01) after full adjustment. Blood cadmium was not associated with C-reactive protein, white blood cell count and Lp-PLA2 but with neutrophil/lymphocyte ratio in one of two statistical models. CONCLUSIONS Exposure to cadmium was associated with increased plasma suPAR in the general population, independently of smoking and cardiovascular disease. These results imply that cadmium is a possible cause for raised levels of this inflammatory marker.
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Affiliation(s)
- Björn Fagerberg
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory for Cardiovascular and Metabolic Research, University of Gothenburg, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
| | - Yan Borné
- Department of Clinical Sciences in Malmö, Cardiovascular Epidemiology, CRC, Jan Waldenströms gata 35, Lund University, Skåne University Hospital, Malmö, SE-205 02 Malmö, Sweden
| | - Lars Barregard
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, SE-413 45 Gothenburg, Sweden
| | - Gerd Sallsten
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, SE-413 45 Gothenburg, Sweden
| | - Niklas Forsgard
- Department of Clinical Chemistry, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
| | - Bo Hedblad
- Department of Clinical Sciences in Malmö, Cardiovascular Epidemiology, CRC, Jan Waldenströms gata 35, Lund University, Skåne University Hospital, Malmö, SE-205 02 Malmö, Sweden
| | - Margaretha Persson
- Department of Clinical Sciences in Malmö, Cardiovascular Epidemiology, CRC, Jan Waldenströms gata 35, Lund University, Skåne University Hospital, Malmö, SE-205 02 Malmö, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, Cardiovascular Epidemiology, CRC, Jan Waldenströms gata 35, Lund University, Skåne University Hospital, Malmö, SE-205 02 Malmö, Sweden
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30
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Nie X, Wang N, Chen Y, Chen C, Han B, Zhu C, Chen Y, Xia F, Cang Z, Lu M, Meng Y, Jiang B, D Jensen M, Lu Y. Blood cadmium in Chinese adults and its relationships with diabetes and obesity. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:18714-23. [PMID: 27312901 DOI: 10.1007/s11356-016-7078-2] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 06/13/2016] [Indexed: 05/18/2023]
Abstract
The aim of this study is to evaluate blood cadmium levels (BCLs) in Chinese adults and explore whether blood cadmium is associated with diabetes or obesity. This study included 5544 adults from a cross-sectional SPECT-China study. BCL and blood lead level (BLL) was measured by atomic absorption spectrometry. Fasting plasma glucose (FPG) was used to define prediabetes and diabetes. Overweight and obesity were defined by body mass index (BMI). The associations of BCL with prediabetes, diabetes, overweight, and obesity were analyzed by multinomial logistic regression analyses. Medians (interquartile range) of BCL were 1.97 μg/L (0.60-3.82) in men and 1.59 μg/L (0.54-3.51) in women. Subjects in low-economic-status areas and urban areas had significantly higher BCL. BCL in current smokers was significantly higher than in current non-smokers. In the adjusted model, a mild positive relationship between BCL and FPG was found. Meanwhile, the prevalence of prediabetes was increased according to the increase in BCL tertiles. Surprisingly, BCL had a negative relationship with prevalence of overweight. In conclusion, BCL in Chinese adults was much higher than in other developed countries and was influenced by gender, smoking, and residential area. BCL was positively related to prediabetes while negatively related to overweight.
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Affiliation(s)
- Xiaomin Nie
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Chi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Bing Han
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Chunfang Zhu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yingchao Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Fangzhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Zhen Cang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Meng Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Ying Meng
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Boren Jiang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
| | - Michael D Jensen
- Endocrine Research Unit, Mayo Clinic, 5-194 Joseph, Rochester, MN55905, USA.
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
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Han H, Chen Y, Zhu J, Ni J, Sun J, Zhang R. Atorvastatin attenuates p‑cresyl sulfate‑induced atherogenesis and plaque instability in ApoE knockout mice. Mol Med Rep 2016; 14:3122-8. [PMID: 27574007 PMCID: PMC5042741 DOI: 10.3892/mmr.2016.5626] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 06/29/2016] [Indexed: 12/15/2022] Open
Abstract
p-cresyl sulfate (PCS) is a protein-bound uremic toxin retained in the blood of patients with chronic kidney disease (CKD) As atherosclerosis is a primary cardiovascular complication for patients with CKD, the aim of the present study was to investigate the mechanisms underlying the aggravation of atherosclerosis by PCS. In addition, the effect of atorvastatin was assessed in reversing the effects of PCS. PCS was revealed to promote the initiation and progression of atherosclerosis. Following treatment with atorvastatin, apolipoprotein E knockout mice demonstrated a reduction in PCS-induced atherogenesis and plaque vulnerability. In addition, atorvastatin decreased the protein expression levels of vascular cell adhesion molecule-1 and intercellular cell adhesion molecule-1, and the interaction between leukocytes and endothelia. The plasma lipid profiles of mice were not significantly affected by gavage of low-dose atorvastatin. The results of the present study indicate that PCS promotes plaque growth and instability by enhancing leukocyte-endothelium interaction, and that these effects may be attenuated by atorvastatin treatment.
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Affiliation(s)
- Hui Han
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, P.R. China
| | - Yanjia Chen
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, P.R. China
| | - Jinzhou Zhu
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, P.R. China
| | - Jingwei Ni
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, P.R. China
| | - Jiateng Sun
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, P.R. China
| | - Ruiyan Zhang
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, P.R. China
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Lamas GA, Ergui I. Chelation therapy to treat atherosclerosis, particularly in diabetes: is it time to reconsider? Expert Rev Cardiovasc Ther 2016; 14:927-38. [PMID: 27149141 PMCID: PMC5105603 DOI: 10.1080/14779072.2016.1180977] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Case reports and case series have suggested a possible beneficial effect of chelation therapy in patients with atherosclerotic disease. Small randomized trials conducted in patients with angina or peripheral artery disease, however, were not sufficiently powered to provide conclusive evidence on clinical outcomes. AREAS COVERED The Trial to Assess Chelation Therapy (TACT) was the first randomized trial adequately powered to detect the effects of chelation therapy on clinical endpoints. We discuss results and future research. Expert commentary: Chelation reduced adverse cardiovascular events in a post myocardial infarction (MI) population. Patients with diabetes demonstrated even greater benefit, with a number needed to treat of 6.5 patients to prevent a cardiac event over 5 years, with a 41% relative reduction in risk of a cardiac event (p = 0.0002). These results led to the revision of the ACC/AHA guideline recommendations for chelation therapy, changing its classification from class III to class IIb. TACT2, a replicative trial, will assess the effects of chelation therapy on cardiovascular outcomes in diabetic patients with a prior myocardial infarction. We are seeking participating sites for TACT2.
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Affiliation(s)
- Gervasio A Lamas
- a The Columbia University Division of Cardiology at Mount Sinai Medical Center , Miami Beach , FL , USA
| | - Ian Ergui
- a The Columbia University Division of Cardiology at Mount Sinai Medical Center , Miami Beach , FL , USA
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Hecht EM, Arheart KL, Lee DJ, Hennekens CH, Hlaing WM. Interrelation of Cadmium, Smoking, and Cardiovascular Disease (from the National Health and Nutrition Examination Survey). Am J Cardiol 2016; 118:204-9. [PMID: 27316775 DOI: 10.1016/j.amjcard.2016.04.038] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 04/27/2016] [Accepted: 04/27/2016] [Indexed: 11/30/2022]
Abstract
Cadmium biomarker levels are associated with both cigarette smoking and cardiovascular disease. In this cross-sectional survey, we explore whether the association between cadmium and cardiovascular disease differs between cigarette smoking states. A cross-sectional analysis using the National Health and Nutrition Examination Survey in 2003 to 2012 was performed accounting for the nationally representative complex sampling design. All participants 45 to 79 years old with blood and urinary cadmium levels were included (n = 12,511). We explored the inter-relationships of blood and urine cadmium levels with cigarette smoking and a composite cardiovascular outcome that included self-reported myocardial infarction or stroke or both. We used multivariable logistic regressing models to further adjust for age, income, gender, hypercholesterolemia, body mass index, diabetes, smoking intensity, and time period of smoking cessation. Of the 12,511 participants, 1,330 (8.5%) had previous myocardial infarction or stroke or both. The crude prevalence ratio (PR) comparing those in the lowest tertile of blood cadmium with those in the highest tertile for the composite outcome was 1.73 (95% confidence interval [CI] 1.49 to 2.01). After adjustment for age, gender, income, self-reported diabetes, self-reported hypercholesterolemia, body mass index, and smoking status, the PR was 1.54 (95% CI 1.30 to 1.84). The adjusted PRs for each smoking subgroup were 1.54 (95% CI 1.09 to 2.18) for never-smokers, 1.57 (95% CI 1.11 to 2.23) for current smokers, and 1.31 (95% CI 0.96 to 1.78) for former smokers. These descriptive data from a nationally representative sample suggest that cadmium is related to cardiovascular outcomes even after adjustment for smoking status.
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Affiliation(s)
- Eric M Hecht
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida.
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - David J Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Charles H Hennekens
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida; Department of Preventive Medicine, Nova Southeastern University, Fort Lauderdale, Florida; Department of Family Medicine and Community Health, University of Miami Miller School of Medicine, Miami, Florida
| | - WayWay M Hlaing
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
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Abstract
The Trial to Assess Chelation Therapy (TACT) was a randomized double-blind placebo-controlled trial enrolling patients age ≥50 years with prior myocardial infarction. TACT used a 2 × 2 factorial design to study ethylene diamine tetraacetic acid (EDTA) chelation and high-dose vitamin supplementation. Chelation provided a modest but significant reduction in cardiovascular endpoints. The benefit was stronger and significant among participants with diabetes but absent in those without diabetes. Mechanisms by which chelation might reduce cardiovascular risk in persons with diabetes include the effects of EDTA chelation on transition and toxic metals. Transition metals, particularly copper and iron, play important roles in oxidative stress pathways. Toxic metals, in particular cadmium and lead, are toxic for the cardiovascular system. This review discusses the epidemiologic evidence and animal and human studies supporting the role of these metals in the development of diabetes and ischemic heart disease and potential ways by which EDTA chelation could confer cardiovascular benefit.
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Santos-Gallego CG, Jialal I. Cadmium and atherosclerosis: Heavy metal or singing the blues? Atherosclerosis 2016; 249:230-2. [DOI: 10.1016/j.atherosclerosis.2016.01.041] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 01/26/2016] [Indexed: 12/15/2022]
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Barregard L, Sallsten G, Fagerberg B, Borné Y, Persson M, Hedblad B, Engström G. Blood Cadmium Levels and Incident Cardiovascular Events during Follow-up in a Population-Based Cohort of Swedish Adults: The Malmö Diet and Cancer Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:594-600. [PMID: 26517380 PMCID: PMC4858401 DOI: 10.1289/ehp.1509735] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 10/20/2015] [Indexed: 05/20/2023]
Abstract
BACKGROUND Cadmium exposure may increase the risk of cardiovascular disease. The only published longitudinal study on cadmium and incident cardiovascular disease was performed in American Indians with relatively high cadmium exposure. OBJECTIVES Our aim was to examine the association between blood cadmium at baseline and incident cardiovascular events in a population-based study of Swedish men and women with cadmium levels similar to those of most European and U.S. METHODS A Swedish population-based cohort (n = 6,103, age 46-67 years) was recruited between 1991 and 1994. After we excluded those with missing data on smoking, 4,819 participants remained. Acute coronary events, other major cardiac events, stroke, and cardiovascular mortality were followed until 2010. Associations with blood cadmium (estimated from cadmium in erythrocytes) were analyzed using Cox proportional hazards regression including potential confounders and important cardiovascular risk factors. RESULTS Hazard ratios for all cardiovascular end points were consistently increased for participants in the 4th blood cadmium quartile (median, 0.99 μg/L). In models that also included sex, smoking, waist circumference, education, physical activity, alcohol intake, serum triglycerides, HbA1c, and C-reactive protein, the hazard ratios comparing the highest and lowest quartiles of exposure were 1.8 (95% CI: 1.2, 2.7) for acute coronary events, and 1.9 (1.3, 2.9) for stroke. Hazard ratios in never-smokers were consistent with these estimates. CONCLUSIONS Blood cadmium in the highest quartile was associated with incident cardiovascular disease and mortality in our population-based samples of Swedish adults. The consistent results among never-smokers are important because smoking is a strong confounder. Our findings suggest that measures to reduce cadmium exposures are warranted, even in populations without unusual sources of exposure. CITATION Barregard L, Sallsten G, Fagerberg B, Borné Y, Persson M, Hedblad B, Engström G. 2016. Blood cadmium levels and incident cardiovascular events during follow-up in a population-based cohort of Swedish adults: the Malmö Diet and Cancer Study. Environ Health Perspect 124:594-600; http://dx.doi.org/10.1289/ehp.1509735.
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Affiliation(s)
- Lars Barregard
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden
| | - Gerd Sallsten
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden
| | - Björn Fagerberg
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory for Cardiovascular and Metabolic Research, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Yan Borné
- Cardiovascular Epidemiology, Department of Clinical Sciences in Malmö, Lund University, and Skåne University Hospital, Malmö, Sweden
| | - Margaretha Persson
- Cardiovascular Epidemiology, Department of Clinical Sciences in Malmö, Lund University, and Skåne University Hospital, Malmö, Sweden
| | - Bo Hedblad
- Cardiovascular Epidemiology, Department of Clinical Sciences in Malmö, Lund University, and Skåne University Hospital, Malmö, Sweden
| | - Gunnar Engström
- Cardiovascular Epidemiology, Department of Clinical Sciences in Malmö, Lund University, and Skåne University Hospital, Malmö, Sweden
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Messner B, Türkcan A, Ploner C, Laufer G, Bernhard D. Cadmium overkill: autophagy, apoptosis and necrosis signalling in endothelial cells exposed to cadmium. Cell Mol Life Sci 2016; 73:1699-713. [PMID: 26588916 PMCID: PMC4805700 DOI: 10.1007/s00018-015-2094-9] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 10/23/2015] [Accepted: 11/09/2015] [Indexed: 12/31/2022]
Abstract
Apoptosis, necrosis, or autophagy-it is the mode of cell demise that defines the response of surrounding cells and organs. In case of one of the most toxic substances known to date, cadmium (Cd), and despite a large number of studies, the mode of cell death induced is still unclear. As there exists conflicting data as to which cell death mode is induced by Cd both across various cell types and within a single one, we chose to analyse Cd-induced cell death in primary human endothelial cells by investigating all possibilities that a cell faces in undergoing cell death. Our results indicate that Cd-induced death signalling starts with the causation of DNA damage and a cytosolic calcium flux. These two events lead to an apoptosis signalling-related mitochondrial membrane depolarisation and a classical DNA damage response. Simultaneously, autophagy signalling such as ER stress and phagosome formation is initiated. Importantly, we also observed lysosomal membrane permeabilization. It is the integration of all signals that results in DNA degradation and a disruption of the plasma membrane. Our data thus suggest that Cd causes the activation of multiple death signals in parallel. The genotype (for example, p53 positive or negative) as well as other factors may determine the initiation and rate of individual death signals. Differences in the signal mix and speed may explain the differing results recorded as to the Cd-induced mode of cell death thus far. In human endothelial cells it is the sum of most if not all of these signals that determine the mode of Cd-induced cell death: programmed necrosis.
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Affiliation(s)
- Barbara Messner
- Cardiac Surgery Research Laboratory, Department of Surgery, Medical University of Vienna, AKH, Level 8 G9.03, Währinger Gürtel 18-20, 1090, Vienna, Austria.
| | - Adrian Türkcan
- Cardiac Surgery Research Laboratory, Department of Surgery, Medical University of Vienna, AKH, Level 8 G9.03, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Christian Ploner
- Plastic, Reconstructive and Aesthetic Surgery Innsbruck, Department of Operative Medicine, Innsbruck Medical University, Innsbruck, Austria
| | - Günther Laufer
- Cardiac Surgery Research Laboratory, Department of Surgery, Medical University of Vienna, AKH, Level 8 G9.03, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - David Bernhard
- Cardiac Surgery Research Laboratory Innsbruck, University Clinic for Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria
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Fagerberg B, Kjelldahl J, Sallsten G, Barregard L, Forsgard N, Österberg K, Hultén LM, Bergström G. Cadmium exposure as measured in blood in relation to macrophage density in symptomatic atherosclerotic plaques from human carotid artery. Atherosclerosis 2016; 249:209-14. [PMID: 27156912 DOI: 10.1016/j.atherosclerosis.2016.01.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 11/12/2015] [Accepted: 01/08/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS The general population is exposed to cadmium through diet and smoking. Cadmium is pro-atherogenic and pro-inflammatory in experimental and observational studies. Cadmium levels in blood and carotid plaque endarterectomies correlate. Cadmium concentrations are much higher in plaque-areas that most frequently rupture. Here we investigated if blood cadmium concentrations are associated with macrophage density and the accumulation of CD14 as indicator of macrophage activation by lipopolysaccharide (LPS) in endarterectomies from patients with symptomatic carotid plaques. METHODS Endarterectomies from ninety nine patients were fixed in formalin, embedded in paraffin, serially sectioned and stained for assessment of morphology. As predefined, the two section levels with most prevalent plaque rupture were used for further analyses. Macrophages were assessed as area of staining for CD68 (%). Blood cadmium was measured with ICP-MS. RESULTS The CD68 median [25,75 percentiles] from the average of both sections were higher in cadmium tertile 3 than in tertile 1 (9.8 [4.9,16.1] % and 3.8 (0.6,12.4) %, p = 0.017). This difference remained in a multiple linear regression analysis with (10)log meanCD68 as dependent variable and adjustment for sex, age, smoking, statin treatment, index event, time between event and surgery (beta coefficient 0.44 [95% CI 0.05-0.87]. CD14 was not associated with blood cadmium. CONCLUSIONS The results showed that blood cadmium was associated with proinflammatory macrophage density in the sections of carotid plaques with most frequent rupture, previously shown to contain most cadmium. No association between cadmium and LPS-mediated macrophage-activation was found. Cadmium exposure may promote plaque inflammation.
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Affiliation(s)
- Björn Fagerberg
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory for Cardiovascular and Metabolic Research, University of Gothenburg, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
| | - Josefin Kjelldahl
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory for Cardiovascular and Metabolic Research, University of Gothenburg, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
| | - Gerd Sallsten
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, SE 413 45 Gothenburg, Sweden.
| | - Lars Barregard
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, SE 413 45 Gothenburg, Sweden.
| | - Niklas Forsgard
- Department of Clinical Chemistry, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
| | - Klas Österberg
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory for Cardiovascular and Metabolic Research, University of Gothenburg, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
| | - Lillemor Mattsson Hultén
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory for Cardiovascular and Metabolic Research, University of Gothenburg, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden; Department of Clinical Chemistry, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
| | - Göran Bergström
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory for Cardiovascular and Metabolic Research, University of Gothenburg, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
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