Chromium exposure and risk of cardiovascular disease in high cardiovascular risk subjects - nested case-control study in the prevention with Mediterranean Diet (PREDIMED) Study

Autores: Gutierrez-Bedmar, M.; Martínez González, Miguel Ángel; Muñoz-Bravo, C. ; Ruiz-Canela, Miguel; Mariscal, A.; Salas-Salvadó, J. ; Estruch, R.; Corella, D.; Arós, F.; Fito, M. ; Lapetra, J.; Serra-Majem, L.; Pintó, X.; Alonso-Gómez, A.; Portoles, O.; Fiol, M.; Bulló, M.; Castañer, O.; Ros, E.; Gómez-Gracia, E.
Título de la revista: CIRCULATION JOURNAL
ISSN: 1346-9843
Volumen: 81
Número: 8
Páginas: 1183 - 1190
Fecha de publicación: 2017
Lugar: WOS
Background: Epidemiological data on chromium (Cr) exposure and the risk of cardiovascular disease (CVD) are still limited. Toenail Cr level (TCL) provides a time-integrated measure reflecting long-term Cr exposure. We measured TCL to assess the hypothesis that long-term Cr exposure was inversely associated with incident CVD in a population at high risk for CVD. Methods and Results: The associations between TCL and CVD were evaluated in a case-control study nested within the "PREvencion con Dleta MEDiterranea" (PREDIMED) trial. We randomly selected 147 of the 288 patients diagnosed with CVD during follow-up and matched them on age and sex to 271 controls. Instrumental neutron activation analysis was used to assess TCL. In-person interviews, medical record reviews, and validated questionnaires were used to assess covariates. The fully adjusted OR for the highest vs. lowest quartile of toenail Cr was 0.54 (95% CI: 0.26-1.14; P-trend=0.189) for the nested case-control study. On stratification for diabetes mellitus (DM), OR was 1.37 (95% CI: 0.54-3.46; P-trend=0.364) for the DM group, and 0.25 (95% CI: 0.08-0.80; P-trend=0.030) for the non-DM group (P for interaction=0.078). Conclusions: The present findings, although not statistically significant, are consistent with previously reported inverse associations between TCL and CVD. These results, especially for non-DM patients, increase the limited epidemiological knowledge about the possible protective role of Cr against CVD.