Abstract
The relationship between toxic metals in the environment and clinical stroke risk remains unclear, although their role as immunotoxicants and carcinogens has been well established. We conducted a systematic review of the relationship between five metals (arsenic, mercury, copper, cadmium, and lead) and stroke. First, we comprehensively searched 3 databases (Pubmed, EMBASE, and Cochrane) from inception until June 2021. Random-effects meta-analyses, pooled relative risks (RR) and 95% confidence intervals (CI) were applied to evaluate the effect value. We finally identified 38 studies involving 642,014 non-overlapping participants. Comparing the highest vs. lowest baseline levels, chronic exposure to lead (RR = 1.07; 95%CI,1.00–1.14), cadmium (RR = 1.30; 95%CI,1.13–1.48), and copper (RR = 1.19; 95%CI,1.04–1.36) were significantly associated with stroke risks. However, the other two metals (arsenic and mercury) had less effect on stroke risk. Further analysis indicated that the association was likely in a metal dose-dependent manner. The results may further support the possibility that environmental toxic metal contaminants in recent years are associated with the increased risk of stroke.
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All data generated or analyzed during this study can be found at the 3 databases (PubMed, EMBASE, and Cocrane).
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This research was funded by the Science and Technology Department of Qinghai Province (No. 2020-ZJ-774).
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B-Q-J: Study concept and design, acquisition of data, analysis and interpretation, critical revision of the manuscript for important intellectual content; Z.K: Obtain data, analyze and interpret, and provide key insights into the research; G.Y: Data conversion and paper review; W-X-T: Manuscripts of important knowledge content are analyzed and interpreted; Y-M-F: Study supervision, critical revision of the manuscript for important intellectual content. All authors contributed to the article and approved the submitted version.
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Bao, QJ., Zhao, K., Guo, Y. et al. Environmental toxic metal contaminants and risk of stroke: a systematic review and meta-analysis. Environ Sci Pollut Res 29, 32545–32565 (2022). https://doi.org/10.1007/s11356-022-18866-z
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DOI: https://doi.org/10.1007/s11356-022-18866-z