尿中的金属水平与心力衰竭之间的关联:多队列分析
Irene Martinez-Morata1, Arce Domingo-Relloso2, Melanie Mayer2
1Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA.
JACC. Heart failure
|June 18, 2025
概括
环境金属暴露,包括,和,与心力衰竭 (HF) 风险增加有关. 减少接触这些金属可能会降低HF的发生率.
科学领域:
- 环境健康 环境健康
- 心血管流行病学心血管流行病学
- 毒理学 毒理学 毒理学
背景情况:
- 环境金属是已确定的心血管疾病风险因素.
- 金属暴露对心力衰竭 (HF) 风险的具体贡献尚未得到充分理解.
- 调查不同人群中的金属暴露对公共卫生至关重要.
研究的目的:
- 为了前性地评估尿液金属水平和事件HF之间的关联.
- 分析来自三个不同的队列的数据:动脉样硬化多民族研究 (MESA),强心研究 (SHS) 和霍尔特加研究.
- 为了评估与HF风险相关的单个金属和金属混合物.
主要方法:
- 对6601名 (MESA),2917名 (SHS) 和1300名 (Hortega) 成年人进行长度随访,长达20年.
- 在基线测量尿液金属面板,并对尿液稀释进行调整.
- 考克斯比例危险和考克斯弹性网模型的应用,用于多次调整的危险比率估计,包括聚合的元分析.
主要成果:
- 共有1001名参与者发生了HF事件.
- 尿液中,和含量升高与高血压风险的增加显著相关 (每剂量翻倍的HR总值分别为1.15,1.13和1.22).
- 多金属混合物也与更高的HF发病率有关,特别是在MESA和SHS队列中.
结论:
- 在不同的人群中,尿液中的金属水平是心力衰竭的重要危险因素.
- 这些发现支持公共卫生战略,即减少环境金属暴露,以减轻HF风险.
- 进一步的研究应该集中在将特定金属与高频率病理生理学联系起来的机制上.
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