Abstract

Background:

Arsenic and cadmium are known cardiovascular toxicants that pose disproportionate risk to rural communities where environmental exposures are high. American Indians have high vascular risk, which may be attributable in part to these exposures.

Objective:

We examined urine metal concentrations in association with magnetic resonance imaging findings of vascular brain injury or cerebral atrophy in adult American Indians.

Methods:

We measured arsenic and cadmium in American Indian participants from the Strong Heart Study (1989–1991) and evaluated these associations with later (2010–2013) measures of infarct, hemorrhage, white matter hyperintensity (WMH) grade, brain and hippocampal volume, and sulcal and ventricle atrophy using nested multivariate regression analyses.

Results:

Among participants with available data ($N=687$), the median urine arsenic:creatinine ratio was $7.54\mathrm{\mu }\mathrm{g}/\mathrm{g}$ [interquartile range (IQR): 4.90–11.93] and the cadmium:creatinine ratio was $0.96\mathrm{\mu }\mathrm{g}/\mathrm{g}$ (IQR: 0.61–1.51). Median time between metal measurement and brain imaging was 21 y (range: 18–25 y). Statistical models detected significant associations between arsenic and higher burden of WMH [$\text{grade increase}=0.014$ (95% CI: 0.000, 0.028) per 10% increase in arsenic]; and between cadmium and presence of lacunar infarcts [$\text{relative risk\hspace{0.17em}}\left(\text{RR}\right)=1.024$ (95% CI: 1.004, 1.045) per 10% increase in cadmium].

Discussion:

This population-based cohort of American Indian elders had measured values of urine arsenic and cadmium several times higher than previous population- and clinic-based studies in the United States and Mexico, and comparable values with European industrial workers. Our findings of associations for arsenic and cadmium exposures with vascular brain injury are consistent with established literature. Environmental toxicant accumulation is modifiable; public health policy may benefit from focusing on reductions in environmental metals. https://doi.org/10.1289/EHP6930

中文翻译：

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尿砷和镉与美洲印第安人头颅 MRI 发现的关联：来自强心研究的数据

摘要

背景：

砷和镉是已知的心血管毒物，对环境暴露高的农村社区构成不成比例的风险。美国印第安人的血管风险很高，这可能部分归因于这些暴露。

客观的：

我们检查了与成年美洲印第安人血管性脑损伤或脑萎缩的磁共振成像结果相关的尿金属浓度。

方法：

我们测量了强心研究 (1989-1991) 中美洲印第安人参与者的砷和镉，并评估了这些关联与后来 (2010-2013) 梗死、出血、白质高信号 (WMH) 分级、脑和海马体积以及使用嵌套多元回归分析脑沟和心室萎缩。

结果：

在有可用数据的参与者中（$ñ=687$)，中位尿砷：肌酐比值为$7.54\mathrm{\mu }\mathrm{G}/\mathrm{G}$[四分位距 (IQR)：4.90–11.93] 镉：肌酐比为$0.96\mathrm{\mu }\mathrm{G}/\mathrm{G}$（IQR：0.61–1.51）。金属测量和脑成像之间的中位时间为 21 岁（范围：18-25 岁）。统计模型检测到砷与更高的 WMH 负担之间存在显着关联 [$\text{等级增加}=0.014$(95% CI: 0.000, 0.028) 每增加 10% 的砷]；以及镉与腔隙性梗塞的存在之间[$\text{相对风险\hspace{0.17em}}\left(\text{RR}\right)=1.024$(95% CI: 1.004, 1.045) 每增加 10% 的镉]。

讨论：

这个以人群为基础的美国印第安老年人队列的尿砷和镉测量值比以前在美国和墨西哥的人口和临床研究高出数倍，并且与欧洲工业工人的值相当。我们关于砷和镉暴露与血管性脑损伤相关性的研究结果与既定文献一致。环境毒物积累是可以改变的；公共卫生政策可能受益于减少环境金属的关注。https://doi.org/10.1289/EHP6930