鉛,カドミウム,喫煙,および外周動脈疾患のリスクの増加
Ana Navas-Acien1, Elizabeth Selvin, A Richey Sharrett
1Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md, USA.
Circulation
|June 9, 2004
まとめ
慢性的な低用量の鉛とカドミウムへの曝露は,外周動脈疾患のリスクの増加と関連しています. 安全基準を下回るレベルでさえ,カドミウムが喫煙を媒介する可能性があると,重要な関連性を示しています.
科学分野:
- 環境衛生 環境衛生 環境衛生
- 心血管疾患の流行病学について
- 毒理学 毒理学 毒理学
背景:
- 動脈硬化症は,鉛とカドミウムへの曝露によって促進されることがあります.
- 慢性的な低用量被曝の心血管への影響は,ほとんど不明のままです.
- 周辺動脈疾患 (PAD) は,重要な心血管疾患のアウトカムである.
研究 の 目的:
- 血液中の鉛とカドミウム濃度と周辺動脈疾患 (PAD) の関連性を評価する.
- 慢性的な低用量重金属曝露が心血管健康に与える影響を調査する.
- 米国の人口におけるPADの流行に重金属の寄与を評価する.
主な方法:
- 40歳以上の2125人の参加者を対象に,1999~2000年に実施された国家健康栄養調査 (NHANES) を分析した.
- 周辺動脈疾患 (PAD) は,足首-腕指数<0.9.9によって定義されます.
- 血中の鉛とカドミウム濃度は,原子吸収スペクトロメトリを用いて測定された. 統計分析は混同因子に調整された.
主要な成果:
- 血中鉛 (P傾向=0.02) とカドミウム (P傾向=0.01) の高四分位数に関連したPADの確率比 (ORs) の増加.
- 血中鉛とカドミウム濃度が現在の安全基準を下回った場合でも,PADの高度のORが観察されました.
- 喫煙は,PADのより高いORを示し,鉛とカドミウムレベルを調整した後に減少しました.
結論:
- 血中の鉛とカドミウムは,米国一般人口のPADの罹患率の増加と関連しています.
- これらの団体は,現在の安全基準を下回るレベルで存在しています.
- カドミウムは,周辺動脈疾患 (PAD) に対する喫煙の有害な効果を部分的に媒介する可能性があります.
関連する概念動画
Coronary Artery Disease I: Introduction
Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
Coronary Artery Disease II: Pathophysiology
Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
Peripheral Artery Disease I: Introduction
Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
Peripheral Artery Disease III: Interprofessional Care
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
Chronic Obstructive Pulmonary Disease I: Introduction
Chronic obstructive pulmonary disease is a common, preventable, and treatable respiratory disorder characterized by persistent symptoms and progressive airflow limitation. This limitation results from a combination of small-airway disease (obstructive bronchiolitis) and parenchymal destruction (emphysema), both driven by chronic inflammation from exposure to harmful particles or gases.The disease includes two main pathological entities: emphysema, marked by destruction of alveolar walls and...


