Correlation Analysis Between Trace Element Levels And Carotid Atherosclerosis

Objective:To analyze the correlation between trace element levels and carotid atherosclerosis（CAS）,explore the risk factors of CAS,then speculate the mechanism of trace elements affecting CAS,and finally provide clinical ideas for early prevention and treatment of patients with carotid atherosclerosis.Method:People who underwent physical examination,and performed carotid artery ultrasonography,trace element detection（including iron,magnesium,zinc,and copper）and inflammatory factor detection（including interleukin 2（IL-2）,interleukin 4（IL-4）,interleukin 6（IL-6）,interleukin 10（IL-10）,and tumor necrosis factor α（TNF-α））were collected from January 2020 to February 2022 in the Physical Examination Center of the First Hospital of Jilin University.325 cases were selected in strict accordance with the inclusion and exclusion criteria,the subjects were classified into two groups according to carotid intima-media thickness（IMT）.There were 146 cases in the normal carotid artery group and 179 cases in the carotid atherosclerosis group.The methods of telephone,questionnaire survey and ect were used to collect the basic information（including age,gender,past history,drug history,smoking history,and drinking history,family history）of the subjects in detail;Chi-square test,t test and rank sum test were used to compare the differences in basic information,serum trace element levels,C-reactive protein（CRP）,inflammatory factors and blood biochemistry（including total cholesterol（TC）,triglyceride（TG）,high density lipoproteincholesterol（HDL-C）,low density lipoprotein-cholesterol（LDL-C））between the two groups;Spearman correlation analysis was used to explore the correlation between carotid IMT and trace elements,CRP and inflammatory factors;multivariate Logistic regression was used to analyze the risk factors of CAS;all tests were performed on two sides,and the difference was statistically significant at P<0.05.Result:（1）The age,waist circumference,carotid IMT,systolic blood pressure,prevalence rate of diabetes,the ratio of smoking,drinking and male in the carotid atherosclerosis group were higher than those in the normal carotid artery group,and the difference was statistically significant（P<0.05）.（2）There were statistical differences（P<0.05）in the contents of CRP,IL-6,iron,zinc,LDL-C,FBG and UA between the normal carotid artery group and the carotid atherosclerosis group.The contents of CRP,IL-6,iron,LDL-C,FBG and UA in the carotid atherosclerosis group were higher than those in the normal carotid group,and the zinc content in the carotid atherosclerosis group was lower than that in the normal carotid artery group.（3）The carotid atherosclerosis group was classified into two subgroups according to carotid intima-media thickness,intimal thickening and plaque formation,and the basic data,blood biochemistry,trace elements,CRP and inflammation makers were compared between the two groups.The results showed the ratio of smoking,drinking and CRP were significantly different（P<0.05）.（4）Carotid IMT was positively correlated with age（r=0.414,P<0.001）,waist circumference（r=0.290,P<0.001）,systolic blood pressure（r=0.213,P<0.001）,diastolic blood pressure（r=0.119,P= 0.032）,iron（r=0.135,P=0.015）,CRP（r=0.446,P<0.001）,IL-6（r=0.160,P=0.004）,triglycerides（r=0.150,P=0.007）,LDL-C（r=0.199,P<0.001）,fasting blood glucose（r=0.264,P<0.001）,uric acid（r=0.169,P=0.002）,while negatively correlated with zinc（r=-0.128,P=0.021）and ratio of zinc and copper（r=-0.172,P=0.022）.（5）The analysis on the correlation between trace elements iron,magnesium,zinc copper and CRP,inflammatory factors,fasting blood glucose and uric acid in the carotid atherosclerosis group showed that copper was negatively correlated（r=-0.208,P=0.005）,while positively correlated with triglycerides（r=0.195,P=0.009）and uric acid（r=0.251,P=0.001）;magnesium was negatively correlated with IL-10（r=-0.163,P=0.029）,while positively correlated with zinc（r=0.190,P=0.011）;the level of serum zinc was positively correlated with magnesium（r=0.190,P=0.011）,uric acid（r=0.160,P=0.032）;copper was negatively correlated with iron（r=-0.208,P=0.005）,while was positively correlated with CRP（r=0.301,P < 0.001）,IL-6（r=0.180,P=0.016）,cholesterol（r=0.178,P=0.017）,LDL-C（r=0.190,P=0.011）.The zinc/copper ratio was positively correlated with iron（r=0.191,P=0.010）,zinc（r=0.658,P<0.001）,UA（r=0.221,P=0.003）,and negatively correlated with copper（r=-0.713,P<0.001）,CRP（r=-0.226,P=0.002）,IL-6（r=-0.199,P=0.008）..（6）Multivariate Logistic regression analysis of carotid atherosclerosis,the results showed that age（OR=1.112,P<0.001,95%CI: 1.068 to 1.157）,gender（OR=2.540,P=0.026,95%CI: 1.116 to 5.781）,the ratio of smoking（OR=7.417,P<0.001,95%CI:2.499 to 22.018）、,the ratio of drinking（OR=2.538,P=0.043,95%CI:1.082 to 148.485）,CRP（OR=1.279,P= 0.039,95%CI: 1.013 to 1.616）,zinc（OR=0.860,P=0.036,95%CI: 0.746 to 0.990）,LDL-D（OR=1.631,P=0.010,95%CI: 1.124 to2.366）,and fasting blood glucose（OR=1.360,P=0.034,95%CI: 1.024 to 1.806）were risk factors for carotid atherosclerosis,and zinc was a protective factor for carotid atherosclerosis.Conclusion:Trace element iron is positively correlated with carotid IMT,and the higher its level is,the higher the risk of CAS;the trace element zinc is negatively correlated with carotid IMT,and the higher its level is,the lower the risk of CAS is;zinc is a protective factor for CAS.The level of trace elements is closely related to inflammation.It is speculated that trace elements may affect the development of CAS by participating in the inflammatory response.Maintaining the stability of the level of trace elements in the body can affect the level of inflammation in the body,thereby delaying the occurrence and development of CAS.