American Journal of Epidemiology Advance Access originally published online on June 22, 2005
American Journal of Epidemiology 2005 162(2):157-164; doi:10.1093/aje/kwi180
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
ORIGINAL CONTRIBUTIONS |
Low Toenail Chromium Concentration and Increased Risk of Nonfatal Myocardial Infarction
1 Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
2 National School of Public Health, Institute of Health Carlos III, Madrid, Spain
3 Medical Department, AstraZeneca, Madrid, Spain
4 Division of Human Nutrition, Graduate School of Food Technology, Agrobiotechnology, Nutrition and Health Sciences, Wageningen University, Wageningen, the Netherlands
5 Interfaculty Reactor Institute, Delft University of Technology, Delft, the Netherlands
6 Cardiovascular Research Unit, College of Medicine, University of Edinburgh, Edinburgh, United Kingdom
7 Department of Medical Physiology, Faculty of Medicine, University of Tromsø, Tromsø, Norway
8 Department of Preventive Medicine, Faculty of Medicine, University of Málaga, Málaga, Spain
9 Nordic School of Public Health, Göteborg, Sweden
10 Epidemiology Unit, Hadassah Medical Organization, Jerusalem, Israel
11 Hadassah School of Public Health and Community Medicine, Hebrew University, Jerusalem, Israel
12 Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA
13 Department of Preventive Medicine and Public Health, Faculty of Medicine and Odontology, Universidad de Valencia, Valencia, Spain
Correspondence to Dr. Eliseo Guallar, Welch Center for Prevention, Epidemiology and Clinical Research, 2024 East Monument Street, Room 2-639, Baltimore, MD 21205-2223 (e-mail: eguallar{at}jhsph.edu).
Chromium intake may increase insulin sensitivity, glucose tolerance, and the ratio of high density lipoprotein cholesterol to low density lipoprotein cholesterol. However, the epidemiologic evidence on the association between chromium and cardiovascular disease is very limited. To determine whether low toenail chromium concentrations were associated with risk of nonfatal myocardial infarction, the authors conducted an incident, population-based, case-control study in eight European countries and Israel in 1991–1992. Cases (n = 684) were men with a first diagnosis of myocardial infarction recruited from the coronary units of participating hospitals. Controls (n = 724) were men selected randomly from population registers (five study centers) or through other sources, such as hospitalized patients (three centers), general practitioners' practices (one center), or relatives or friends of cases (one center). Toenail chromium concentration was assessed by neutron activation analysis. Average toenail chromium concentrations were 1.10 µg/g in cases (95% confidence interval: 1.01, 1.18) and 1.30 µg/g in controls (95% CI: 1.21, 1.40). Multivariate odds ratios for quintiles 2–5 were 0.82 (95% CI: 0.52, 1.31), 0.68 (95% CI: 0.43, 1.08), 0.60 (95% CI: 0.37, 0.97), and 0.59 (95% CI: 0.37, 0.95). Toenail chromium concentration was inversely associated with the risk of a first myocardial infarction in men. These results add to an increasing body of evidence that points to the importance of chromium for cardiovascular health.
case-control studies; chromium; metals, heavy; myocardial infarction; neutron activation analysis
Abbreviations: CI, confidence interval; EURAMIC, EURopean Multicenter Case-Control Study on Antioxidants, Myocardial Infarction, and Cancer of the Breast