Despite minor geographic shifts, the Stroke Belt, a region of highest stroke mortality in the Southeastern US identified a half century ago, still persists today. Recent studies have found that the stroke mortality is also higher among children in the Southeast, thus environmental factors have been hypothesized contributing to the Stroke Belt in addition to other hypotheses on lifestyle and social-economic status. For decades, it has been demonstrated outside the US that geographic variations in trace elements may play critical roles in the development of cardiovascular diseases. However, the geographic variation of trace element levels in relation to stroke risk remains unclear. The overall objectives of this project ae to examine the associations between trace element levels and stroke risk and to investigate whether geographic variation of trace element levels is related to the Stroke Belt. We propose a case-cohort study, which will include incident ischemic stroke cases (n=~620) and a sub-cohort (n=~2500) of non-stroke cases randomly sampled within region-race-sex stratum from the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study, an ongoing US national population-based, general population cohort of 30,239 African American and Caucasian adults, aged 45 and older at baseline (2003-2007). The proposed study will focus on arsenic, cadmium, mercury, magnesium and selenium. Specifically, we will characterize the distribution of trace element levels measured in urine or serum according to demographic and geographic characteristics of study participants; and to examine prospective associations between trace element levels and risk of stroke. This research will help identify at-risk individuals for stroke, thus providing important data identifying whether stroke risk can be reduced by dietary, supplemental, lifestyle or environmental interventions that modify trace element patterns.

Public Health Relevance

Despite minor geographic shifts, the 'Stroke Belt', a region of highest stroke mortality in the Southeastern US identified a half century ago, still persists today It has been demonstrated in other countries that geographic variations in trace elements may play critical roles in the development of cardiovascular diseases. This project is to investigate whether geographic variation of trace element levels contributes to the 'Stroke Belt'. Data from this research will help identify at-risk individuals for stroke development, thus providing important data identifying whether stroke risk can be reduced by dietary, supplemental, lifestyle or environmental interventions that modify trace element patterns.

Agency
National Institute of Health (NIH)
Institute
National Institute of Environmental Health Sciences (NIEHS)
Type
Research Project (R01)
Project #
4R01ES021735-05
Application #
9052192
Study Section
Cardiovascular and Sleep Epidemiology Study Section (CASE)
Program Officer
Joubert, Bonnie
Project Start
2012-08-17
Project End
2017-04-30
Budget Start
2016-05-01
Budget End
2017-04-30
Support Year
5
Fiscal Year
2016
Total Cost
Indirect Cost
Name
Indiana University Bloomington
Department
Type
Schools of Public Health
DUNS #
006046700
City
Bloomington
State
IN
Country
United States
Zip Code
47401
Chen, Cheng; Xun, Pengcheng; McClure, Leslie A et al. (2018) Serum mercury concentration and the risk of ischemic stroke: The REasons for Geographic and Racial Differences in Stroke Trace Element Study. Environ Int 117:125-131
Chen, Cheng; Xun, Pengcheng; Tsinovoi, Cari et al. (2018) Urinary cadmium concentration and the risk of ischemic stroke. Neurology 91:e382-e391
Tsinovoi, Cari L; Xun, Pengcheng; McClure, Leslie A et al. (2018) Arsenic Exposure in Relation to Ischemic Stroke: The Reasons for Geographic and Racial Differences in Stroke Study. Stroke 49:19-26
Quan, Minghui; Xun, Pengcheng; Chen, Cheng et al. (2017) Walking Pace and the Risk of Cognitive Decline and Dementia in Elderly Populations: A Meta-analysis of Prospective Cohort Studies. J Gerontol A Biol Sci Med Sci 72:266-270
Merrill, Peter D; Ampah, Steve B; He, Ka et al. (2017) Association between trace elements in the environment and stroke risk: The reasons for geographic and racial differences in stroke (REGARDS) study. J Trace Elem Med Biol 42:45-49
Rembert, Nicole; He, Ka; Judd, Suzanne E et al. (2017) The geographic distribution of trace elements in the environment: the REGARDS study. Environ Monit Assess 189:84
Wu, Jiang; Xun, Pengcheng; Tang, Qingya et al. (2017) Circulating magnesium levels and incidence of coronary heart diseases, hypertension, and type 2 diabetes mellitus: a meta-analysis of prospective cohort studies. Nutr J 16:60
Kim, Yong-Seok; Xun, Pengcheng; Iribarren, Carlos et al. (2016) Intake of fish and long-chain omega-3 polyunsaturated fatty acids and incidence of metabolic syndrome among American young adults: a 25-year follow-up study. Eur J Nutr 55:1707-16
Park, Jong Suk; Xun, Pengcheng; Li, Jing et al. (2016) Longitudinal association between toenail zinc levels and the incidence of diabetes among American young adults: The CARDIA Trace Element Study. Sci Rep 6:23155
Kim, Yong-Seok; Xun, Pengcheng; He, Ka (2015) Fish consumption, long-chain omega-3 polyunsaturated fatty acid intake and risk of metabolic syndrome: a meta-analysis. Nutrients 7:2085-100

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