Chromium Exposure and Risk of Cardiovascular Disease in High Cardiovascular Risk Subjects　― Nested Case-Control Study in the Prevention With Mediterranean Diet (PREDIMED) Study

• Published in: Circulation Journal 2017/07/25, Vol.81(8), pp.1183-1190
• Main Authors: Gutiérrez-Bedmar, Mario, Martínez-González, Miguel Ángel, Muñoz-Bravo, Carlos, Ruiz-Canela, Miguel, Mariscal, Alberto, Salas-Salvadó, Jordi, Estruch, Ramón, Corella, Dolores, Arós, Fernando, Fito, Monserrat, Lapetra, José, Serra-Majem, Lluís, Pintó, Xavier, Alonso-Gómez, Ángel, Portoles, Olga, Fiol, Miquel, Bulló, Mónica, Castañer, Olga, Ros, Emilio, Gómez-Gracia, Enrique
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Cardiovascular disease; Cardiovascular Diseases - chemically induced; Cardiovascular Diseases - diet therapy; Cardiovascular Diseases - epidemiology; Case-Control Studies; Chromium; Chromium - toxicity; Diabetes; Diet, Mediterranean; Female; Humans; Male; Middle Aged; PREDIMED; Risk Factors; Spain - epidemiology; Toenail biomarker
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-17-0032

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 “PREvención con DIeta MEDiterránea” (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; Ptrend=0.189) for the nested case-control study. On stratification for diabetes mellitus (DM), OR was 1.37 (95% CI: 0.54–3.46; Ptrend=0.364) for the DM group, and 0.25 (95% CI: 0.08–0.80; Ptrend=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. (Trial registration: www.controlled-trials.com; ISRCTN35739639.)