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Title: Chromium exposure and risk of cardiovascular disease in high cardiovascular risk subjects: Nested case-control study in the prevention with mediterranean diet (PREDIMED) study
Authors: Gutierrez-Bedmar, Mario
Martínez-González, Miguel Ángel
Muñoz-Bravo, Carlos
Ruiz-Canela, Miguel
Mariscal, Alberto
Salas-Salvadó, Jordi
Estruch, Ramón
Corella, Dolores
Arós, Fernando
Fitó, Montse
Lapetra, José
Serra-Majem, Lluis 
Pinto, Xavier
Alonso-Gómez, A.
Portolés, O.
Fiol, Miquel
Bulló, Mónica
Castaner, Olga
Ros, Emilio
Gómez-Gracia, Enrique
UNESCO Clasification: 3206 Ciencias de la nutrición
Keywords: Cardiovascular disease
Toenail biomarker
Issue Date: 2017
Journal: Circulation Journal 
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 "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.
ISSN: 1346-9843
DOI: 10.1253/circj.CJ-17-0032
Source: Circulation Journal [ISSN 1346-9843], v. 81 (8), p. 1183-1190
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