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

Gutiérrez Bedmar, Mario; Martínez-González, Miguel Ángel, 1957-; Muñoz-Bravo, Carlos; Ruiz-Canela, Miguel; Mariscal, Alberto; Salas Salvadó, Jordi; Estruch, Ramón; Corella, Dolores; Arós, Fernando; Fitó Colomer, Montserrat; Lapetra, José; Serra-Majem, Luis; Ros, Emilio; Alonso-Gómez, Ángel; Portolés, Olga; Fiol, Miquel; Bulló, Mònica; Castañer, Olga; Pinto, Xavier; Gómez-Gracia, Enrique

doi:http://dx.doi.org/10.1253/circj.CJ-17-0032

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

Citation

Gutiérrez-Bedmar M, Martínez-González MÁ, Muñoz-Bravo C, Ruiz-Canela M, Mariscal A, Salas-Salvadó J. et al. Chromium Exposure and Risk of Cardiovascular Disease in High Cardiovascular Risk Subjects　- Nested Case-Control Study in the Prevention With Mediterranean Diet (PREDIMED) Study. Circ J. 2017 Jul 25;81(8):1183-1190. DOI: 10.1253/circj.CJ-17-0032

Abstract

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.).