Background

Tungsten (W) interferes with molybdenum (Mo) binding sites and has been associated with prevalent cardiovascular disease (CVD). We evaluated if (1) W exposure is prospectively associated with incident CVD and (2) the association between urinary W levels and incident CVD is modified by urinary Mo levels.

Methods

We estimated multi-adjusted hazard ratios (HRs) for incident CVD outcomes by increasing W levels for 2726 American Indian participants in the Strong Heart Study with urinary metal levels measured at baseline (1989–1991) and CVD events ascertained through 2008.

Results

Increasing levels of baseline urinary W were not associated with incident CVD. Fully-adjusted HRs (95% CIs) of incident CVD comparing a change in the IQR of W levels for those in the lowest and highest tertile of urinary Mo were 1.05 (0.90, 1.22) and 0.80 (0.70, 0.92), respectively (p-interaction = 0.02); for CVD mortality, the corresponding HRs were 1.05 (0.82, 1.33) and 0.73 (0.58, 0.93), respectively (p-interaction = 0.03).

Conclusions

The association between W and CVD incidence and mortality was positive although non-significant at lower urinary Mo levels and significant and inverse at higher urinary Mo levels. Although prior cross-sectional epidemiologic studies in the general US population found positive associations between urinary tungsten and prevalent cardiovascular disease, our prospective analysis in the Strong Heart Study indicates this association may be modified by molybdenum exposure.

中文翻译：

---

强心研究中的尿中钨和心血管疾病的发生：与尿中钼的相互作用。

背景

钨（W）会干扰钼（Mo）的结合位点，并与普遍的心血管疾病（CVD）相关。我们评估了（1）W暴露是否与入射CVD预期相关，以及（2）尿中W含量与入射CVD之间的关联是否被尿Mo含量改变。

方法

我们通过增加2726名参加强心研究的美国印第安人的W水平（在基线（1989-1991年）测量的尿中金属水平和到2008年确定的CVD事件）中，对事件CVD结果的多调整风险比（HRs）进行了估算。

结果

基线尿W水平的升高与心血管疾病的发生无关。相对于最低和最高尿液Mo含量的W的IQR变化，入射CVD的完全调整后的HR（95％CI）分别为1.05（0.90，1.22）和0.80（0.70，0.92）（p -互动= 0.02）；对于CVD死亡率，相应的HR分别为1.05（0.82，1.33）和0.73（0.58，0.93）（p相互作用= 0.03）。

结论

W和CVD发病率与死亡率之间的相关性为正，尽管在较低的尿Mo水平下不显着，而在较高的Mo Mo水平下显着而相反。尽管先前在美国普通人群中进行的横断面流行病学研究发现，尿钨与普遍的心血管疾病之间存在正相关，但我们在“强心研究”中进行的前瞻性分析表明，钼暴露可能会改变这种联系。