Urinary cadmium concentration and the risk of ischemic stroke
| Autor: | Ka He, Cheng Chen, Pengcheng Xun, Cari Lewis Tsinovoi, Lisa M. Kamendulis, Leslie A. MacDonald, John D. Brockman, Mary Cushman, Jason Mackey, Jianwen Cai, Leslie A. McClure |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Population Black People 010501 environmental sciences 01 natural sciences Gastroenterology White People Article Brain Ischemia Random Allocation 03 medical and health sciences 0302 clinical medicine Risk Factors Interquartile range Internal medicine medicine Humans Prospective Studies Risk factor Prospective cohort study education Stroke Aged 0105 earth and related environmental sciences education.field_of_study business.industry Incidence (epidemiology) Hazard ratio Environmental Exposure Middle Aged medicine.disease Confidence interval Case-Control Studies Female Neurology (clinical) business Biomarkers 030217 neurology & neurosurgery Cadmium |
| Zdroj: | Neurology. 91:e382-e391 |
| ISSN: | 1526-632X 0028-3878 |
| Popis: | ObjectivesTo examine the association between urinary cadmium levels and the incidence of ischemic stroke and to explore possible effect modifications.MethodsA case-cohort study was designed nested in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, including 680 adjudicated incident cases of ischemic stroke and 2,540 participants in a randomly selected subcohort. Urinary creatinine–corrected cadmium concentration was measured at baseline. Multivariable-adjusted hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) were estimated with the Barlow weighting method for the Cox proportional hazards regression model.ResultsThe median urinary cadmium concentration was 0.42 (interquartile range 0.27–0.68) μg/g creatinine. After adjustment for potential confounders, urinary cadmium was associated with increased incidence of ischemic stroke (quintile 5 vs quintile 1: HR 1.50, 95% CI 1.01–2.22, p for trend = 0.02). The observed association was more pronounced among participants in the lowest serum zinc tertile (tertile 3 vs tertile 1: HR 1.82, 95% CI 1.06–3.11, p for trend = 0.004, p for interaction = 0.05) but was attenuated and became nonsignificant among never smokers (tertile 3 vs tertile 1: never smokers: HR 1.27, 95% CI 0.80–2.03, p for trend = 0.29; ever smokers: HR 1.60, 95% CI 1.06–2.43, p for trend = 0.07, p for interaction = 0.51).ConclusionsFindings from this study suggest that cadmium exposure may be an independent risk factor for ischemic stroke in the US general population. Never smoking and maintaining a high serum zinc level may ameliorate the potential adverse effects of cadmium exposure. |
| Databáze: | OpenAIRE |
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