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Partial Mediation by Cadmium Exposure of the Association between Tobacco Smoking and Atherosclerotic Plaques in the Carotid Artery

Andersson, Eva M.; Fagerberg, Björn; Sallsten, Gerd; Borné, Yan LU ; Hedblad, Bo LU ; Engström, Gunnar LU and Barregard, Lars (2018) In American Journal of Epidemiology 187(4). p.806-816
Abstract

Exposure to cadmium confers increased cardiovascular risk. Tobacco smoke contains cadmium, which, hypothetically, may mediate parts of the tobacco-associated risk of developing atherosclerotic plaques. Baseline data from the Swedish Malmö Diet and Cancer cohort (1991-1996) were used to test this hypothesis. Mediation analysis was used to examine associations between smoking and blood cadmium levels and the prevalence of ultrasound-assessed carotid atherosclerotic plaques. The total association with smoking status (never smokers, 2 categories of former smokers, and current smokers) was split into direct and indirect association, and the proportion mediated was estimated. The adjusted estimated plaque prevalence was approximately 27%... (More)

Exposure to cadmium confers increased cardiovascular risk. Tobacco smoke contains cadmium, which, hypothetically, may mediate parts of the tobacco-associated risk of developing atherosclerotic plaques. Baseline data from the Swedish Malmö Diet and Cancer cohort (1991-1996) were used to test this hypothesis. Mediation analysis was used to examine associations between smoking and blood cadmium levels and the prevalence of ultrasound-assessed carotid atherosclerotic plaques. The total association with smoking status (never smokers, 2 categories of former smokers, and current smokers) was split into direct and indirect association, and the proportion mediated was estimated. The adjusted estimated plaque prevalence was approximately 27% among never smokers. We identified both a direct and an indirect pathway between smoking and carotid plaques; the indirect association, through cadmium, was observed among current smokers and former smokers who had quit smoking less than 15 years before. For current smokers, the prevalence ratio for plaque was 1.5, with 60%-65% of the association with smoking being mediated through cadmium. Recent former smokers had a prevalence ratio of 1.3, and 40%-45% was mediated through cadmium. Long-time former smokers had a prevalence ratio of 1.2, but none of the association was mediated through cadmium. In conclusion, about two-thirds of the proatherosclerotic association with smoking was mediated by cadmium.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
atherosclerotic plaques, cadmium exposure, indirect effect, mediation, smoking
in
American Journal of Epidemiology
volume
187
issue
4
pages
11 pages
publisher
Oxford University Press
external identifiers
  • scopus:85045451581
ISSN
0002-9262
DOI
10.1093/aje/kwx306
language
English
LU publication?
yes
id
2f40e12f-4b3e-4da3-8adb-1a8860b25d8a
date added to LUP
2018-04-25 16:10:05
date last changed
2019-02-20 11:15:23
@article{2f40e12f-4b3e-4da3-8adb-1a8860b25d8a,
  abstract     = {<p>Exposure to cadmium confers increased cardiovascular risk. Tobacco smoke contains cadmium, which, hypothetically, may mediate parts of the tobacco-associated risk of developing atherosclerotic plaques. Baseline data from the Swedish Malmö Diet and Cancer cohort (1991-1996) were used to test this hypothesis. Mediation analysis was used to examine associations between smoking and blood cadmium levels and the prevalence of ultrasound-assessed carotid atherosclerotic plaques. The total association with smoking status (never smokers, 2 categories of former smokers, and current smokers) was split into direct and indirect association, and the proportion mediated was estimated. The adjusted estimated plaque prevalence was approximately 27% among never smokers. We identified both a direct and an indirect pathway between smoking and carotid plaques; the indirect association, through cadmium, was observed among current smokers and former smokers who had quit smoking less than 15 years before. For current smokers, the prevalence ratio for plaque was 1.5, with 60%-65% of the association with smoking being mediated through cadmium. Recent former smokers had a prevalence ratio of 1.3, and 40%-45% was mediated through cadmium. Long-time former smokers had a prevalence ratio of 1.2, but none of the association was mediated through cadmium. In conclusion, about two-thirds of the proatherosclerotic association with smoking was mediated by cadmium.</p>},
  author       = {Andersson, Eva M. and Fagerberg, Björn and Sallsten, Gerd and Borné, Yan and Hedblad, Bo and Engström, Gunnar and Barregard, Lars},
  issn         = {0002-9262},
  keyword      = {atherosclerotic plaques,cadmium exposure,indirect effect,mediation,smoking},
  language     = {eng},
  month        = {04},
  number       = {4},
  pages        = {806--816},
  publisher    = {Oxford University Press},
  series       = {American Journal of Epidemiology},
  title        = {Partial Mediation by Cadmium Exposure of the Association between Tobacco Smoking and Atherosclerotic Plaques in the Carotid Artery},
  url          = {http://dx.doi.org/10.1093/aje/kwx306},
  volume       = {187},
  year         = {2018},
}