PDF(Pubmed)
Abstract：
BACKGROUND: Copper exposure is reported to be associated with increased risk of stroke. However, the association of copper exposure with subclinical carotid atherosclerosis remains unclear.
RESULTS: This observational study included consecutive participants from Xinqiao Hospital between May 2020 and August 2021. Blood metals were measured using inductively coupled plasma mass spectrometry and carotid atherosclerosis was assessed using ultrasound. Modified Poisson regression was performed to evaluate the associations of copper and other metals with subclinical carotid plaque presence. Blood metals were analyzed as categorical according to the quartiles. Multivariable models were adjusted for age, sex, body mass index, education, smoking, drinking, hypertension, diabetes, dyslipidemia, estimated glomerular filtration rate, and coronary artery disease history. Bayesian Kernel Machine Regression was conducted to evaluate the overall association of metal mixture with subclinical carotid plaque presence. One thousand five hundred eighty-five participants were finally enrolled in our study, and carotid plaque was found in 1091 subjects. After adjusting for potential confounders, metal-progressively-adjusted models showed that blood copper was positively associated with subclinical carotid plaque (relative risk according to comparing quartile 4 to quartile 1 was 1.124 [1.021-1.238], relative risk according to per interquartile increment was 1.039 [1.008-1.071]). Blood cadmium and lead were also significantly associated with subclinical carotid plaque. Bayesian Kernel Machine Regression analyses suggested a synergistic effect of copper-cadmium-lead mixture on subclinical carotid plaque presence.
CONCLUSIONS: Our findings identify copper as a novel risk factor of subclinical carotid atherosclerosis and show the potential synergistic proatherogenic effect of copper, cadmium, and lead mixture.
RESULTS: This observational study included consecutive participants from Xinqiao Hospital between May 2020 and August 2021. Blood metals were measured using inductively coupled plasma mass spectrometry and carotid atherosclerosis was assessed using ultrasound. Modified Poisson regression was performed to evaluate the associations of copper and other metals with subclinical carotid plaque presence. Blood metals were analyzed as categorical according to the quartiles. Multivariable models were adjusted for age, sex, body mass index, education, smoking, drinking, hypertension, diabetes, dyslipidemia, estimated glomerular filtration rate, and coronary artery disease history. Bayesian Kernel Machine Regression was conducted to evaluate the overall association of metal mixture with subclinical carotid plaque presence. One thousand five hundred eighty-five participants were finally enrolled in our study, and carotid plaque was found in 1091 subjects. After adjusting for potential confounders, metal-progressively-adjusted models showed that blood copper was positively associated with subclinical carotid plaque (relative risk according to comparing quartile 4 to quartile 1 was 1.124 [1.021-1.238], relative risk according to per interquartile increment was 1.039 [1.008-1.071]). Blood cadmium and lead were also significantly associated with subclinical carotid plaque. Bayesian Kernel Machine Regression analyses suggested a synergistic effect of copper-cadmium-lead mixture on subclinical carotid plaque presence.
CONCLUSIONS: Our findings identify copper as a novel risk factor of subclinical carotid atherosclerosis and show the potential synergistic proatherogenic effect of copper, cadmium, and lead mixture.
摘要：
背景：据报道，铜暴露与卒中风险增加相关。然而,铜暴露与亚临床颈动脉粥样硬化的相关性尚不清楚.
结果：这项观察性研究包括2020年5月至2021年8月新桥医院的连续参与者。使用电感耦合等离子体质谱法测量血液金属，并使用超声评估颈动脉粥样硬化。进行改良泊松回归以评估铜和其他金属与亚临床颈动脉斑块存在的关联。根据四分位数对血液金属进行分类分析。多变量模型根据年龄进行了调整，性别,身体质量指数,教育,吸烟,饮酒,高血压,糖尿病,血脂异常,估计肾小球滤过率，冠心病病史。进行贝叶斯内核机回归以评估金属混合物与亚临床颈动脉斑块存在的总体关联。最终有一千五百八十五名参与者参加了我们的研究，1091名受试者发现颈动脉斑块。在调整了潜在的混杂因素后，金属渐进调整模型显示，血铜与亚临床颈动脉斑块呈正相关（根据四分位数4与四分位数1的比较，相对风险为1.124[1.021-1.238]，根据每四分位数增量的相对风险为1.039[1.008-1.071])。血镉和铅也与亚临床颈动脉斑块显著相关。贝叶斯内核机回归分析提示铜-镉-铅混合物对亚临床颈动脉斑块存在的协同作用。
结论：我们的研究发现铜是亚临床颈动脉粥样硬化的新危险因素，并显示了铜的潜在协同致动脉粥样硬化作用，镉,和铅混合物。
结果：这项观察性研究包括2020年5月至2021年8月新桥医院的连续参与者。使用电感耦合等离子体质谱法测量血液金属，并使用超声评估颈动脉粥样硬化。进行改良泊松回归以评估铜和其他金属与亚临床颈动脉斑块存在的关联。根据四分位数对血液金属进行分类分析。多变量模型根据年龄进行了调整，性别,身体质量指数,教育,吸烟,饮酒,高血压,糖尿病,血脂异常,估计肾小球滤过率，冠心病病史。进行贝叶斯内核机回归以评估金属混合物与亚临床颈动脉斑块存在的总体关联。最终有一千五百八十五名参与者参加了我们的研究，1091名受试者发现颈动脉斑块。在调整了潜在的混杂因素后，金属渐进调整模型显示，血铜与亚临床颈动脉斑块呈正相关（根据四分位数4与四分位数1的比较，相对风险为1.124[1.021-1.238]，根据每四分位数增量的相对风险为1.039[1.008-1.071])。血镉和铅也与亚临床颈动脉斑块显著相关。贝叶斯内核机回归分析提示铜-镉-铅混合物对亚临床颈动脉斑块存在的协同作用。
结论：我们的研究发现铜是亚临床颈动脉粥样硬化的新危险因素，并显示了铜的潜在协同致动脉粥样硬化作用，镉,和铅混合物。
