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. Author manuscript; available in PMC: 2018 Feb 7.
Published in final edited form as: Curr Environ Health Rep. 2016 Dec;3(4):416–433. doi: 10.1007/s40572-016-0117-9

Table 3.

Studies of chromium biomarkers and clinical cardiovascular disease outcomes (5 studies available)

Study,
year		 Population Men
(%)		 Age
Range
(yrs)		 Biomarker Exposed
vs. Reference		 Endpoint
Ascertainment		 Outcome (s) No. of
cases /
non-cases		 Relative
Risk estimate (95% CI)		 Adjustment
Factors
Cross-sectional study
Lind et al. 2012[59] Subjects of Uppsala, (Sweden) PIVUS Study (N=1016) 49.8 = 70

  • Whole blood (0.05µg /L)

  • Median:

    Men: 0.62 µg /L

    Women: 0.61 µg /L

  • Per log 0.05µg /L

 Local thickening of the IMT more than 50% thicker than the surrounding IMT, measured by external B-mode ultrasound imaging Plaque presence prevalence

  • NR

  • 0.96 (0.77–1.19)

    p= 0.88*

  • (Odds ratio)

 Gender, waist circumference, BMI, fasting blood glucose, systolic and diastolic blood pressure, high and low-density lipoprotein cholesterol, serum triglycerides, smoking, antihypertensive treatment and statin use.
Rajpathak et al. 2004 [64] The Health Professionals Follow-up Study N=886 100 40–75

  • Toenails (µg/g)

  • Mean:

    DM: 0.52

    DM-CVD: 0.52

  • Quartiles 1 (<0.35) vs 2 to 5 (0.36–0.68, 0.69–1.35, 1.36–26.3 µg/g)

 Self-report and medical record review Prevalent CVD: Myocardial infarction, coronary artery bypass graft (CABG), percutaneous transluminal coronary angioplasty (PTCA), or stroke

  • DM-CVD vs DM-only

    (198/688)

  • Q2

    Q3

    Q4

  • 0.85 (0.54–1.33)

    0.64 (0.40–1.03)

    0.68 (0.42–1.10)

    (Odds ratio)

    p=0.06

 Age, BMI, alcohol intake, smoking status, family history of myocardical infarction, physical activity, high cholesterol, hypertension, dietary score, toenail levels of selenium and mercury.
Case-control study
Alissa et al. 2009 [106] Inpatients of coronary care unit of King Fahd Military Hospital and King Abdulaziz University Hospital (Kingdom of Saudi Arabia) N=260 100 ≥43,4

  • Serum (nmol/L)

    Mean:

    Cases: 6.30

    Controls: 18.54

  • Urine (nmol/mol creatinine)

    Mean:

    Cases: 4.29

    Controls: 28.88

  • Per nmol/L

  • Per nmol/mol

 Review of hospital records Myocardial infarction

  • 130/130

  • 0.99 (0.985–0.995)

    p <0.0001

    (Odds ratio)

  • 0.988 (0.981–0.995)

    P< 0.001

    (Odds ratio)

 Height, smoking status, oral hypoglycemic drugs, serum triglycerides. Urinary Cr levels divided by urinary creatinine.
Guallar et al. 2005[108] Incident case-control Inpatients of coronary care unit of EURAMIC Study (N=1408) 100 ≤70

  • Toenail (µg/g)

  • GM: 1.30 µg/g (95% CI 1.21–1.40).

  • Quintiles 1 vs 2–5 (levels NR)

 Review of hospital records Incident acute coronary heart disease

  • Q2 (139/145)

    Q3 (143/144)

    Q4 (97/145)

    Q5 (118/145)

  • 0.82 (0.52–1.31)

    0.68 (0.43–1.08)

    0.60 (0.37–0.97)

    0.59 (0.37–0.95)

    (Odds ratio)

 Age, study center, smoking, alcohol drinking, BMI, high density lipoprotein cholesterol, diabetes, history of hypertension, family history of coronary heart disease, toenail selenium adipose tissue levels of α-tocopherol, β-carotene, and lycopene, and major fatty acid peaks.
Niskanen et al. 1986 [107]a Finland Social Insurance Survey participants from Jamsankoski and Jamsa,1966–1972 N=96 92 Mean=49.7

  • Urine (0.46 µg /g)

  • Mean:

    Cases: 0.02 µg /g

    Controls: 0.03 µg /g

  • Per IQR (0.03 µg /g)

 Review of hospital records Coronary heart disease mortality

  • 25/75

  • 0.69 (0.36, 1.35)

    (Odds ratio)

 Matching by age, sex, place of residence, and smoking status
Prospective study
Rajpathak et al. 2004 [64] Nested case-control (incidence density sampling) from The Health Professionals Follow-up Study (N=563) 100 40–75

  • Toenails (µg/g)

  • Mean:

    Control: 0.71 µg/g

    DM-incident CVD: 0.60 µg/g

  • Quartiles 1 (<0.35) vs 2 to 5 (0.36–0.68, 0.69–1.35, 1.36–26.3 µg/g)

 Self-report and medical record review Incident CVD: Myocardial infarction, coronary artery bypass graft (CABG), percutaneous transluminal coronary angioplasty (PTCA), or stroke

  • DM-CVD vs Control

    (202/361)

  • Q2

    Q3

    Q4

  • 0.75 (0.42–1.36)

    0.75 (0.42–1.33)

    0.65 (0.36–1.17)

    p=0.16

  • (Odds ratio)

 Age, BMI, alcohol intake, smoking status, family history of myocardical infarction, physical activity, high cholesterol, hypertension, dietary score, toenail levels of selenium and mercury. Cr levels divided by urinary creatinine.

BMI: body mass index; IQR: interquartile range; NR: not reported

a

Only mean Cr levels for cases and controls were originally reported; we derived the IQR, RR, and 95% CI via the linear discrimination method [157].