Blood Lead Levels and Risk of Atherosclerosis in the Carotid Artery: Results from a Swedish Cohort

Background: Lead exposure is a risk factor for increased blood pressure and cardiovascular disease, even when blood lead levels (BLLs) are within the normal range. Objective: This study aimed to investigate the association between BLL and coronary artery stenosis (CAS) in asymptomatic adults using 128-slice dual-source coronary computed tomography (CT) angiography. Methods: We analyzed medical records data from 2,193 adults (1,461 men and 732 women) who elected to complete a screening health examination, coronary CT angiography, and BLL measurement during 2011–2018 and had no history of CAS symptoms, cardiovascular disease, or occupational exposure to lead. Logistic regression models were used to estimate associations between moderate-to-severe CAS ( stenosis) and a increase in blood lead, with and without adjustment for age, sex, hypertension, diabetes mellitus, dyslipidemia, body mass index, regular exercise, smoking status, and alcohol drinking. Results: BLLs ranged from , with an arithmetic mean of . The arithmetic mean was higher for men than for women ( vs. , ) and higher in the moderate-to-severe CAS group than in the no-CAS or stenosis group ( vs. , ). Moderate-to-severe CAS was significantly associated with BLL before and after adjustment, with an adjusted odds ratio for a increase in BLL of 1.14 (95% CI: 1.02, 1.26), . Conclusions: BLL was positively associated with the prevalence of moderate-to-severe CAS in Korean adults who completed an elective screening examination for early cardiovascular disease, 94% of whom had a BLL of . More efforts and a strict health policy are needed to further reduce BLLs in the general population. https://doi.org/10.1289/EHP7351

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“…1988 ). A recent study reported an association between BLL and atherosclerotic plaque in the carotid artery ( Harari et al. 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Associations between Blood Lead Levels and Coronary Artery Stenosis Measured Using Coronary Computed Tomography Angiography

Kim

Kang

Cho

et al. 2021

Environ Health Perspect

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“…Carotid plaque rupture and thrombus formation are the main causes of ischemic stroke. Patients with unstable/vulnerable plaque AS (UA) are prone to rupture and thrombus formation, leading to cardiovascular or cerebrovascular events, such as acute coronary syndrome, ischemic stroke, and peripheral vascular disease ( 2 ). Therefore, identifying the properties of carotid plaques may help improve the prediction and prevention of cardiovascular and cerebrovascular events.…”

Section: Introductionmentioning

confidence: 99%

circRNA‑0006896‑miR1264‑DNMT1 axis plays an important role in carotid plaque destabilization by regulating the behavior of endothelial cells in atherosclerosis

et al. 2021

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Atherosclerosis (AS) is a chronic inflammatory disease of the vascular wall with multiple causes. AS is the primary pathological basis of cardiovascular disease and stroke. Moreover, carotid plaque rupture and thrombus formation are the main causes of ischemic stroke. Therefore, understanding the formation of carotid plaques may help improve the prediction and prevention of cardiovascular and cerebrovascular events. Endothelial cell dysfunction results in re-endothelialization and angiogenesis in atherosclerotic plaques, thus promoting plaque destabilization. The aim of the present study was to evaluate the effect of circular RNA (circRNA) molecules in serum exosomes (serum-Exos) from patients with stable plaque atherosclerosis (SA) and unstable/vulnerable plaque atherosclerosis (UA). Specifically, the effect of circRNA on human umbilical vein endothelial cell (HUVEC) behavior and the mechanisms underlying plaque destabilization in AS were evaluated. Serum-Exos were isolated, then identified using transmission electron microscopy, nanoparticle tracking analysis and western blotting. The serum-Exo-circRNA expression profile of patients with SA or UA was investigated using a circRNA array. The relationship between circRNA-006896 in serum-Exos and biochemical parameters of patients with SA and UA were analyzed using Spearman's correlation. In addition, HUVECs were incubated with serum-Exos for in vitro functional assays. The present study demonstrated that circRNAs expression profiles in SA and UA serum-Exos were significantly different, indicating a potential role for circRNAs in carotid plaque destabilization. The expression of circRNA-0006896 was positively correlated with triglyceride, low-density lipoprotein cholesterol (LDL-C) and C-reactive protein levels, and negatively correlated with albumin levels in patients with UA. However, circRNA-0006896 expression was positively correlated with LDL-C in patients with SA. Using bioinformatic analysis, a competing endogenous RNA (ceRNA) network was selected to study the regulatory roles of circRNA-0006896 in serum-Exos. Additionally, in HUVECs treated with serum-Exos derived from patients with UA, the expression of circRNA-0006896 in HUVECs was upregulated. This was accompanied by decreased expression of microRNA-1264 and SOCS3, increased levels of DNMT1 and phosphorylated STAT3. HUVEC proliferation and migration were significantly increased in the UA group, compared with the mock and SA groups. This finding indicates that the circRNA-0006896-miR-1264-DNMT1 axis plays an important role in carotid plaque destabilization by regulating the behavior of endothelial cells. Moreover, it suggests that circRNA-0006896 may represent a therapeutic target for controlling JNK/STAT3 signaling in HUVECs. Thus, this study may provide insight on potential interventions against vulnerable plaque formation in patients with AS.

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“…An association between lead and cardiovascular disease has been recognized and considered an established risk factor for oxidative stress, inflammation, and the triggering event of atherosclerosis [67].…”

Section: Heavy Metalsmentioning

confidence: 99%

Recent Updates and Advances in Winiwarter-Buerger Disease (Thromboangiitis Obliterans): Biomolecular Mechanisms, Diagnostics and Clinical Consequences

et al. 2021

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Thromboangiitis obliterans (TAO) or Buerger’s disease is a segmental inflammatory, thrombotic occlusive peripheral vascular disease with unknown aetiology that usually involves the medium and small-sized vessels of young male smokers. Due to its unknown aetiology and similarities with atherosclerosis and vasculitis, TAO diagnosis is still challenging. We aimed to review the status of biomolecular and laboratory para-clinical markers in TAO compared to atherosclerosis and vasculitis. We reported that, although some biomarkers might be common in TAO, atherosclerosis, and vasculitis, each disease occurs through a different pathway and, to our knowledge, there is no specific and definitive marker for differentiating TAO from atherosclerosis or vasculitis. Our review highlighted that pro-inflammatory and cell-mediated immunity cytokines, IL-33, HMGB1, neopterin, MMPs, ICAM1, complement components, fibrinogen, oxidative stress, NO levels, eNOS polymorphism, adrenalin and noradrenalin, lead, cadmium, and homocysteine are common markers. Nitric oxide, MPV, TLRs, MDA, ox-LDL, sST2, antioxidant system, autoantibodies, and type of infection are differential markers, whereas platelet and leukocyte count, haemoglobin, lipid profile, CRP, ESR, FBS, creatinine, d-dimer, hypercoagulation activity, as well as protein C and S are controversial markers. Finally, our study proposed diagnostic panels for laboratory differential diagnosis to be considered at first and in more advanced stages.

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Blood Lead Levels and Risk of Atherosclerosis in the Carotid Artery: Results from a Swedish Cohort

Cited by 36 publications

References 53 publications

Associations between Blood Lead Levels and Coronary Artery Stenosis Measured Using Coronary Computed Tomography Angiography

Associations between Blood Lead Levels and Coronary Artery Stenosis Measured Using Coronary Computed Tomography Angiography

circRNA‑0006896‑miR1264‑DNMT1 axis plays an important role in carotid plaque destabilization by regulating the behavior of endothelial cells in atherosclerosis

Recent Updates and Advances in Winiwarter-Buerger Disease (Thromboangiitis Obliterans): Biomolecular Mechanisms, Diagnostics and Clinical Consequences

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