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Cadmium and atherosclerosis: A review of toxicological mechanisms and a meta-analysis of epidemiologic studies

机译：镉和动脉粥样硬化：毒理学机制和流行病学研究的荟萃分析

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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.
机译：尽管现有数据仍存在争议，但已提出镉是动脉粥样硬化发展的因素之一。本研究的主要目的是对研究进行回顾和荟萃分析，这些研究证明了Cd暴露与动脉粥样硬化之间的关联以及对这种关联的潜在机制的评论。我们使用MeSH术语镉，心血管疾病，动脉粥样硬化，冠状动脉疾病，心肌梗塞，中风，死亡率和人类进行了系统的搜索，直至2017年12月20日。尿Cd水平升高与死亡率增加相关心血管疾病（HR = 1.34，95％CI：1.07-1.67）以及血中Cd水平升高（HR = 1.78，95％CI：1.24-2.56）。仅限从未吸烟者的分析显示出相似但不精确的结果。一致地，我们还观察到Cd暴露标记（血液和尿液）与冠心病，中风和外周动脉疾病之间的相关性。此外，镉暴露与脂质分布的动脉粥样硬化有关。高Cd暴露与较高的TC水平（OR = 1.48，95％CI：1.10–2.01），较高的LDL-C水平（OR = 1.31，95％CI 0.99–1.73）和较低的HDL-C水平（OR = 1.96）相关，95％CI：1.09–3.55）。镉的致动脉粥样硬化作用机制可能涉及氧化应激，炎症，内皮功能障碍，脂质合成增强，粘附分子上调，前列腺素失衡以及糖胺聚糖合成改变。

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