Environmental heavy metals and risk of ischemic heart disease and stroke in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

巴西成人健康纵向研究 (ELSA-Brasil) 中的环境重金属与缺血性心脏病和中风的风险

• 批准号: 10380884
• 负责人: PAULO ANDRADE LOTUFO
• 金额: $ 17.39万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-21 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10380884
• 关键词: Adult; Affect; Arsenic; Biological Process; Biology; Biomedical Research; Blood; Blood Preservation; Brazil; Cadmium; Cardiovascular Diseases; Cardiovascular system; Case-Control Studies; Cessation of life; China; Chromium; Clinical; Cobalt; Collection; Consensus; Copper; Cross-Sectional Studies; Data; Developing Countries; Development; Diabetes Mellitus; Dietary Intervention; Disease; Disease Outcome; Environmental Exposure; Epidemic; Etiology; Europe; Event; Exposure to; Funding Opportunities; Health; Heavy Metals; Hypertension; Individual; International; Interview; Investments; Joints; Laboratories; Lead; Link; Longitudinal Studies; Magnesium; Manganese; Mediating; Mercury; Metal exposure; Metals; Molybdenum; Myocardial Ischemia; National Toxicology Program; Nested Case-Control Study; Nickel; Obesity; Outcome; Participant; Persons; Physical Examination; Play; Population; Portuguese; Positioning Attribute; Prospective Studies; Prospective cohort; Prospective cohort study; Public Health; Reporting; Research; Research Personnel; Resources; Risk; Risk Factors; Role; Sampling; Scientist; Selenium; Serum; Site; Smoking; South America; Stroke; Stroke prevention; Supplementation; Testing; Time; Toxic effect; Trace Elements; Trace metal; Tungsten; United States; Urine; Vanadium; Vascular Diseases; Vascular System; Woman; Work; Zinc; adjudicate; cardiometabolism; cardiovascular disorder prevention; cardiovascular disorder risk; case control; cohort; coronary artery calcium; coronary calcium scoring; cost efficient; data resource; design; diabetes risk; dietary; dietary trace element; disability; experience; follow-up; global health; interest; men; metal metabolism; nervous system disorder; physical inactivity; population based; population health; programs; toxic metal

PROJECT SUMMARY Environmental degradation and exposure to heavy metals (over which individuals often have little control) may have a direct impact on cardiovascular diseases (CVD) development, which have become one of the most pressing nemesis for individual- and population-health globally. Recent studies have provided provocative evidence linking environmental exposure to heavy metals to increased risk of diabetes and hypertension, which are strong CVD risk factors. In contrast, prospective cohort studies have shown that higher levels of dietary and serum essential trace metals are directly associated with lower CVD risk and that supplementation of which may have potential benefits by mitigating the effects of toxic metals on the cardiovascular system. However, very few studies have directly and comprehensively investigated exposure to multiple metals particularly their joint effects on affecting CVD risk (including stroke). The ongoing Brazilian Longitudinal Study of Adult Health (in Portuguese, ‘Estudo Longitudinal de Sau´ de do Adulto’, ELSA-Brasil), the only large prospective study established in South America to specifically investigate risk factors for cardiometabolic health, represents a unique resource to study the roles of multiple metal exposures and their interactions with dietary trace elements in affecting CVD risk. At baseline, 4,428 CVD-free participants at the ELSA-Brasil site in Sao Paulo completed 1) physical examinations; 2) clinical laboratory tests; 3) in-person interviews; 4) collections of blood and urine samples; and 5) a CT examination to quantify coronary artery calcium (CAC) score. To date, a total of 466 incident CVD (~150 stroke) cases have been adjudicated in the ELSA-Brasil cohort in the 10-year follow up. ln the current application aims to investigate, we will leverage these exceptional resources and the substantial investment of time and effort by ELSA-Brasil study investigators over the past ten years to investigate, in a most cost-efficient and timely manner, the roles of metals playing in CVD development. Specifically, the current application aims to utilize this ongoing prospective cohort study to not only determine whether heavy metal exposures increase CAC score and CVD risk, but also identify the optimal body levels of essential metals that could mitigate CVD risk from toxic metals. If antagonistic effects exist and optimal body levels of essential metals that could reduce toxic metal impacts are confirmed, this work would lead to simple, safe, readily-available, acceptable and highly-affordable nutritional intervention for CVD prevention that will have both clinical and public health significance worldwide.

项目摘要 环境降解和暴露于重金属（个人经常无法控制）可能 对心血管疾病（CVD）发育有直接影响，这已成为最大的一种 在全球范围内施加对个人和人口健康的仇敌。最近的研究提供了挑衅性的 将环境暴露与重金属接触的证据与糖尿病和高血压的风险增加有关 是强大的CVD风险因素。相比之下，前瞻性队列研究表明，饮食和 血清本质痕量金属与CVD风险直接相关，并且可以补充它 通过减轻有毒金属对心血管系统的影响具有潜在的好处。但是，很少 研究直接，全面地研究了对多种金属的暴露，特别是其关节效应 影响CVD风险（包括中风）。正在进行的巴西成人健康纵向研究（葡萄牙语， 'Estudo纵向de sau do do do do do do do'，elsa-brasil），这是在南方建立的唯一大型前瞻性研究 美国要专门研究心脏代谢健康的危险因素，代表了研究的独特资源 多种金属暴露的作用及其与饮食痕量元素的相互作用在影响CVD风险中的作用。 基线，圣保罗的Elsa-Brasil遗址的4,428名无CVD参与者完成了1）体格检查； 2）临床实验室测试； 3）面对面访谈； 4）血液和尿液样品的收集； 5）CT 量化冠状动脉钙（CAC）评分的检查。迄今为止，总共466个事件CVD（〜150杆） 在10年的随访中，已在Elsa-Brasil队列中调整了病例。在当前的申请目的 为了调查，我们将利用这些特殊资源以及时间和精力的大量投资 Elsa-Brasil研究研究人员在过去十年中，以最具成本效益和及时的方式调查 金属在CVD开发中发挥的作用。具体而言，当前的应用程序旨在利用这一持续的应用程序 前瞻性队列研究不仅要确定重金属暴露是否会增加CAC评分和CVD 风险，但也可以确定可以减轻有毒金属CVD风险的必需金属的最佳体型。 如果存在拮抗作用，并且可以减少有毒金属影响的必需金属的最佳体格是 确认，这项工作将导致简单，安全，易于获取，可接受且承诺高度的营养 CVD预防干预措施将在全球范围内具有临床和公共卫生意义。