Correlation Between Cadmium Concentration And Plaque Stability In Carotid Atherosclerotic Plaques

Objective:Case data of patients with symptomatic carotid stenosis undergoing carotid endarterectomy and surgical specimens of carotid atherosclerotic plaque were collected,and cadmium concentrations in different parts of CAP specimens were analyzed.To investigate whether the concentration of Cd in CAP is related to the accumulation of macrophages,and whether the accumulation of Cd is related to the stability of CAP.Methods:Twenty-seven patients who underwent CEA in the vascular surgery Department of the First Affiliated Hospital of Gannan Medical University were selected,and the time range was from January 2020 to December 2022.CAP specimens in this study were rapidly frozen in liquid nitrogen immediately after surgical resection and then stored at-80 °C in the Medical Big Data Center of the First Affiliated Hospital of Gannan Medical College.Preoperative carotid computed tomography angiography and carotid color ultrasound were performed to locate the largest carotid artery stenosis.The concentration of Cd in CAP(μg/g)was analyzed by inductively coupled plasma mass spectrometry in the collected carotid atherosclerotic plaque tissue samples.According to the experimental design,CAP specimens obtained after CEA surgery were divided into proximal,narrow and distal sections according to certain tissue structure.Cd concentrations in the three parts were measured respectively and the average Cd concentration of the whole CAP was calculated.Hematoxylin-eosin staining was used and the pathological features of CAP specimens were observed.All HE stained sections were classified according to the histopathological classification of atherosclerotic plaques by the American Heart Association.Immunohistochemical staining was used to observe the expression of CD68 in proximal,narrow and distal CAP sections.According to the average Cd concentration of the whole CAP from low to high,the cases were divided into three groups,which were low digit array,middle digit array and high digit array.The relative area of CD68 staining was used as an indicator to evaluate the density of macrophages.To compare the Cd concentration level and macrophage density in different plaques Relevance.Results:Average Cd concentrations across the CAP range from 0.016 to 0.33ug/g,with a median(25-75 th percentile)of 0.091(0.057-0.19)ug/g.In 25 of the 27 patients,Cd concentration was higher in the proximal segment than in the stenosis segment(92.6%),Z=4.541,P < 0.001;In 20 of the 27 patients,the concentration of Cd in the proximal segment was higher than that in the distal segment(74.1%),Z=4.541,P < 0.001,the difference was statistically significant.The prevalence of AHA type Ⅵ in all HE stained sections of CAP was 63% in proximal,40.7% in stenosis and 25.9% in distal.According to these results,we selected sections of the proximal heart segment and the stenosis segment,where the prevalence of AHA type Ⅵ lesions was high,for further study.According to the mean value of the relative area of CD68 staining in the proximal and narrow sections,the median of 19.7(17.8,26.8)% in the high-score array was higher than that of 13.2(11.1,15.5)% in the mid-score array and 4.2(3.7,7.5)% in the low-score array,H=22.296.P < 0.01,the difference was statistically significant.In multiple linear regression analysis,the mean relative area of 10 log CD68 staining at the proximal and stenosis sections was used as the dependent variable,and sex,age,history of smoking,hypertension,diabetes,history of statin therapy,clinical symptoms,and the ratio of LDL to HDL cholesterol(LDL-C/HDL-C,After low density lipoprotein cholesterol/ high density lipoprotein cholesterol(β coefficient was 6.242 [95% CI:4.67-7.813]),P < 0.01,the difference was still statistically significant.Conclusion:The concentration of Cd in CAP varies in organizational structure,and the highest concentration of Cd is found in CAP tissues near the heart,which is also the place where the CAP is most likely to break.The concentration of Cd in CAP was correlated with the amount of macrophages in CAP.High levels of Cd concentration in CAP may promote carotid atherosclerosis and lead to increased plaque instability,ultimately leading to clinical events.