Mercury exposure and risk of cardiovascular disease: a nested case-control study in the PREDIMED (PREvention with MEDiterranean Diet) study

BMC Cardiovascular Disorders

Research Article

Montse Fitó¹  Miguel A. Muñoz¹  Fernando Arós²  Lluís Serra-Majem³  José Lapetra⁴  Ramon Estruch⁵  Miguel Ruiz-Canela⁶  Miguel A. Martínez-González⁶  Julia Warnberg⁷  Enrique Gómez-Gracia⁸  Jose V. Sorli⁹  Dolores Corella⁹  Miquel Fiol^1,10  Emilio Ros^1,11  Mario Gutierrez-Bedmar^1,12  Antonio García-Rodriguez^1,12  Meir Stampfer^1,13  Alfredo Gea^1,14  Mary K. Downer^1,15  Monica Bullo^1,16  Jordi Salas-Salvadó^1,16 

[1] CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain;Cardiovascular Risk and Nutrition (Regicor Study Group), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain;CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain;Department of Cardiology, University Hospital Araba, Vitoria, Spain;CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain;Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain;CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain;Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain;CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain;Department of Internal Medicine, August Pi i Sunyer Institute of Biomedical Research (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain;CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain;Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain;IdiSNA, Navarra Institute for Health Research, Pamplona, Spain;CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain;Department of Preventive Medicine, University of Malaga, Malaga, Spain;CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain;Department of Preventive Medicine, University of Malaga, Malaga, Spain;Campus Teatinos, Facultad de Medicina, 29071, Malaga, Spain;CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain;Department of Preventive Medicine, University of Valencia, Valencia, Spain;CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain;Institute of Health Sciences, University of Balearic Islands and Son Espases Hospital, Palma de Mallorca, Spain;CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain;Lipid Clinic, Endocrinology and Nutrition Service, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain;Department of Preventive Medicine, University of Malaga, Malaga, Spain;Harvard T.H. Chan School of Public Health, Boston, USA;Harvard T.H. Chan School of Public Health, Boston, USA;CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain;Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain;IdiSNA, Navarra Institute for Health Research, Pamplona, Spain;Harvard T.H. Chan School of Public Health, Boston, USA;Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain;Human Nutrition Unit, Faculty of Medicine and Health Sciences, IISPV, Rovira i Virgili University, Reus, Spain;CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain;

关键词: Mercury;    Fish;    Cardiovascular disease;    Mediterranean diet;    PREDIMED;    Toenail biomarker;   

DOI  :  10.1186/s12872-016-0435-8

 received in 2016-10-21, accepted in 2016-12-07,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundSubstantial evidence suggests that consuming 1–2 servings of fish per week, particularly oily fish (e.g., salmon, herring, sardines) is beneficial for cardiovascular health due to its high n-3 polyunsaturated fatty acid content. However, there is some concern that the mercury content in fish may increase cardiovascular disease risk, but this relationship remains unclear.MethodsThe PREDIMED trial included 7477 participants who were at high risk for cardiovascular disease at baseline. In this study, we evaluated associations between mercury exposure, fish consumption and cardiovascular disease. We randomly selected 147 of the 288 cases diagnosed with cardiovascular disease during follow-up and matched them on age and sex to 267 controls. Instrumental neutron activation analysis was used to assess toenail mercury concentration. In-person interviews, medical record reviews and validated questionnaires were used to assess fish consumption and other covariates. Information was collected at baseline and updated yearly during follow-up. We used conditional logistic regression to evaluate associations in the total nested case-control study, and unconditional logistic regression for population subsets.ResultsMean (±SD) toenail mercury concentrations (μg per gram) did not significantly differ between cases (0.63 (±0.53)) and controls (0.67 (±0.49)). Mercury concentration was not associated with cardiovascular disease in any analysis, and neither was fish consumption or n-3 fatty acids. The fully-adjusted relative risks for the highest versus lowest quartile of mercury concentration were 0.71 (95% Confidence Interval [CI], 0.34, 1.14; ptrend = 0.37) for the nested case-control study, 0.74 (95% CI, 0.32, 1.76; ptrend = 0.43) within the Mediterranean diet intervention group, and 0.50 (95% CI, 0.13, 1.96; ptrend = 0.41) within the control arm of the trial. Associations remained null when mercury was jointly assessed with fish consumption at baseline and during follow-up. Results were similar in different sensitivity analyses.ConclusionsWe found no evidence that mercury exposure from regular fish consumption increases cardiovascular disease risk in a population of Spanish adults with high cardiovascular disease risk and high fish consumption. This implies that the mercury content in fish does not detract from the already established cardiovascular benefits of fish consumption.Trial registrationISRCTN35739639.

【 授权许可】

CC BY   
© The Author(s). 2017