To examine the effects of fat composition and supplemental vitamin E (Vit E) and selenium (Se) on in vivo lipid peroxidation, diet-induced hypercholesterolemia, and glutathione (GSH) metabolism, male Syrian hamsters were fed for three weeks butter fat (BF-) or fish oil- (FO-)based diets supplemented with Vit E and/or Se. The effect of supplemental Vit E and Se on tissue lipid peroxidation (LPO), glutathione peroxidase (GSH-Px) activity and GSH concentrations differed between heart and liver and also was affected by dietary fat. The reduced glutathione/oxidized glutathione (GSH/GSSG) ratio was more consistently associated with tissue lipid peroxidation than was tissue Vit E content. Plasma lipids were lowered with supplemental Se and Vit E. Se supplementation, however, exerted a more potent hypolipidemic effect than Vit E. A pro-oxidative action of Se in hearts of FO-fed hamsters was noted, which was inhibited by supplemental Vit E. Hence, the combination of Vit E and Se may offer the most benefit against diet-induced oxidative stress and hyperlipidemia.

Two factorial experiments were conducted to determine if high dietary fluoride would inhibit selenite toxicity in rats. In each study, two levels of selenite (0.05 and 5 mg/kg diet) were matched against two levels of fluoride (1 and 150 mg/kg diet) for either 6 or 8 weeks. Fluoride failed to prevent the depressive effect of selenite on food intake and body weight gain in either study. Although liver selenium concentration was slightly (15%) but significantly (P < 0.005) reduced when the highest fluoride and selenium level were combined in the first study, this effect could not be repeated. These three measures therefore failed to provide evidence for a fluoride and selenium interaction. Fluoride, however, prevented hepatic necrosis seen in most of the selenite-toxic rats. Hepatic lesions seen histologically in selenite-toxic rats were not observed for either kidney or heart. With regard to a possible mechanism for the fluoride effect upon selenite liver pathology, fluoride partially (26%) but significantly (P < 0.025) reduced thiobarbituricreactive substances (an indicator of peroxidative cell membrane damage) in selenite-toxic rats, but there was no fluoride effect on an enzyme system (liver xanthine oxidase) that potentially could generate an initiator of lipid peroxidation. In agreement with results of others, fluoride deposition into bone was inconsistently affected by selenite, Overall, the protective effect of fluoride on selenite toxicity appears to be confined to liver pathology. The exact mechanism for this effect, however, remains unclear. / Graduation date: 1992

Trace elements, because they are effective in catalytic amounts, must be held in delicate balance with each other as well as with the macronutrients of the diet. Disturbances of these balances result in deficiency and toxicity symptoms. Toxic doses of selenium, lead, and zinc, for example, are known to cause anemia (1, 2, 3, 4) and growth depression (5, 3) in experimental animals.

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Male weanling inbred, mice were inoculated with fibrosarcoma cells (hindquarter) originally produced by 2-methylcholanthrene. Before inoculation, mice were randomly divided into three groups of 24 and one of 12 (control). After a one week acclimation period, each group was fed a diet containing either suboptimal vitamin B-6, 0.5 mg/kg diet; adequate, 7.0 mg/kg diet; or excess, 100 mg/kg diet. Controls were fed the adequate vitamin. B-6 diet. Twenty-four hours after tumor cell inoculation, a series of sodium selenite injections (0.5 μg/.10 mL) were given to half of each treatment group and all controls. Mice were sacrificed two wk after tumor inoculation. Tumors were excised and weighed. Selenium-treated mice had significantly smaller tumors as compared to untreated mice regardless of vitamin B-6 treatment. The smallest tumors were found in the selenium-treated group maintained on adequate B-6, while the largest tumors were developed by mice on the excess B-6 diet without selenium treatments. All groups had similar blood selenium levels as measured by gas chromatography. Tumor selenium levels, analyzed by atomic absorption, were significantly higher for untreated groups than selenium-treated groups (larger tumor size). The excess and adequate vitamin B-6 selenium-treated groups had significantly lower tumor selenium levels than the adequate vitamin B-6 untreated group. Plasma pyridoxal phosphate (concentrations) determined radiometrically and tumor vitamin B-6 levels determined microbiologically, related directly to dietary treatments. Sodium selenite injections and adequate vitamin B-6 diets reduced the size of fibrosarcomas in BALB/c inbred mice. / Master of Science

Numerous dietary factors have been shown to influence the fatty acid profiles (FAP) in breast milk from lactating women. However, few studies have evaluated the effect of trace minerals on milk FAP. Consequently, the purpose of this study was to determine the effect of selenium status on the FAP in breast milk. Subjects were lactating women from three different regions in China; Xichang (n=21), an area where selenium intakes are among the lowest in the world, Beijing (n=20), where there are adequate selenium intakes, and Enshi (n=19), where selenium intakes are among the highest in the world. Plasma and milk samples were obtained from women at birth of their baby and within 10 months postpartum and analyzed for selenium content, glutathione peroxidase (Gpx) activity and FAP. Plasma and breast milk selenium levels were significantly lower in the Xichang women and significantly higher in the Enshi women when compared to Beijing women. Despite the fact that the highest level of plasma selenium was measured in the samples from Enshi, the Gpx activity was greatest in the samples from Beijing; there was no effect of time of sampling on these samples. In breast milk, on the other hand, all the samples obtained at birth had similar activity of Gpx. The samples taken later, however, followed the same trend as plasma with the samples obtained from the women in Beijing having the highest activity. FAP indicated a significant difference in the amount of unsaturated fatty acids in both the plasma and milk for the Beijing women, when compared to the women from Xichang and Enshi. In particular, there were higher levels of linoleic acid, 18:2(n-6), in the plasma and milk of the women whose selenium intake was adequate. / Graduation date: 1997

Cardiovascular disease remains the leading causing of death worldwide. American Indians experience an elevated prevelance of cardiovascular disease (CVD) and chronic metal exposures. Determining the impact of metal exposures on CVD can inform prevention and exposure reduction strategies. This dissertation will advance environmental monitoring and biological monitoring of lead, uranium, and selenium exposures using both established biomarkers and novel epigenetic biomarkers to determine the associations of metals with CVD, leveraging the Strong Heart Study (SHS), a prospective cohort of CVD and its risk factors among American Indian adults from tribes and communities in Arizona, Oklahoma, North Dakota, and South Dakota. In Chapter 1, we discuss lead, uranium, and selenium, sources of exposure, and relevance to cardiovascular disease. This includes an overview of metal toxicokinetics and how we can assess these contaminants in both established biomarkers, including blood and urine, as well as in epigenetic biomarkers. In Chapter 2, we estimated urinary uranium concentrations from data on uranium in water among Strong Heart Family Study participants. These estimates were derived from relationships between urinary uranium and water uranium assessed in Strong Heart Family Study (SHFS) participants (n=1,356). Predictions were made using generalized linear models and included demographic and clinical participant characteristics in addition to other metal contaminants measured in water and urine. The root mean square error (RMSE) of the prediction model was 1.01, and predicted urine uranium levels were comparable (median: 0.04 μg/g creatinine, 25th-75th: 0.02-0.08 μg/g creatinine) to urine uranium measured in the SHFS (0.04 μg/g creatinine, 0.02-0.07 μg/g creatinine). These findings emphasize the contribution of uranium in water to urine uranium (reflecting internal dose), and demonstrate the relevance of estimating metal contaminants in urine for the SHS to inform relationships with health effects. In Chapter 3, we evaluated whether urinary uranium concentrations were associated with measures of cardiac geometry and functioning among 1,332 American Indian youth and young adults from the SHFS. Transthoracic echocardiography and blood pressure was assessed at baseline (2001-2003) and a follow-up visit (2006-2009). We estimated mean differences in measures of cardiac geometry and functioning at baseline and follow-up using linear mixed effect models with random intercept and slope over time. In fully adjusted models, a log-doubling of urinary uranium was positively associated with left ventricular (LV) mass index (mean difference: 0.49 g/m2, 95% CI: 0.07-0.92 g/m2), left atrial systolic diameter (0.02 cm, 0.01-0.03 cm), and stroke volume (0.66 mL, 0.25-1.08 mL) at baseline. At follow-up, uranium was associated with increases in left atrial diameter (0.02 cm, 0.01-0.03 cm), pulse pressure (0.28 mmHg, 0.05-0.52 mmHg), and incident LV hypertrophy (OR: 1.25, 95% CI: 1.06, 1.48). These findings support the need to determine the potential long-term clinical and subclinical cardiovascular effects of chronic uranium exposure in the general population, and the need for future strategies to reduce exposure. In Chapter 4, we evaluated if blood lead was associated with CVD incidence and mortality in 1,818 adult American Indian participants. This study estimated the risk of incident CVD and CVD deaths in models adjusted for demographic, lifestyle, and cardiovascular risk factors. Blood lead levels in American Indian adults were associated with increased risk of CVD and coronary heart disease (CHD) incidence and mortality. The hazard ratio (HR) (95% CI) of mortality per change across the 80th-20th quantiles in blood lead was 1.15 (1.02-1.30) for CVD overall and 1.22 (1.08-1.37) for CHD. The corresponding HR was 1.11 (1.01-1.22) for incident CVD and 1.12 (1.00-1.25) for incident CHD. These findings contribute to the evidence of lead as a CVD risk factor at low levels and highlight the importance of further reducing lead exposure in communities across the United States, including American Indian communities. In Chapter 5, we leveraged novel epigenetic biomarkers of lead exposure to investigate their association with cardiovascular disease (CVD) incidence and mortality among 2,231 participants of the Strong Heart Study. Blood DNA methylation was measured using the Illumina MethylationEPIC BeadChip at baseline (1989-1991) and epigenetic biomarkers of lead levels in blood, patella, and tibia were estimated using previously developed biomarkers of DNA methylation at specific CpG sites. In adjusted models, the hazard ratio (HR) (95% CI) of CVD mortality per doubling increase in lead epigenetic biomarkers were 1.42 (1.07-1.87) for tibia lead, 1.22 (0.93-1.60) for patella lead, and 1.57 (1.16-2.11) for blood lead. The corresponding HRs for incident CVD were 0.99 (0.83-1.19), 1.07 (0.89-1.29), and 1.06 (0.87-1.30). The association between the tibia lead epigenetic biomarker and CVD mortality was modified by sex (interaction p-value: 0.014), with men at increased risk (HR: 1.42, 95% CI:1.17-1.72) compared to women (HR: 1.04, 95% CI:0.89-1.22). These findings support that epigenetic biomarkers of lead exposure may capture some of the disease risk associated with lead exposure. In Chapter 6, we investigated the association between urinary selenium levels and DNA methylation (DNAm) among 1,357 participants free of CVD and diabetes in the SHS. Selenium concentrations were measured in urine (collected in 1989-1991) using inductively coupled plasma mass spectrometry. DNAm in whole blood was measured cross-sectionally using the Illumina Methylation EPIC BeadChip (850K) Array. We used epigenome-wide robust linear regressions and elastic net to identify differentially methylated CpG sites associated with urinary selenium levels. Across 788,368 CpG sites, five differentially methylated positions (DMP) (cg00163554, cg18212762, cg25194720, cg11270656, cg00886293) were significantly associated with Se in linear regressions after accounting for multiple comparisons (false discovery rate p-value: 0.10). The top associated DMP (cg00163554) was annotated to the Disco Interacting Protein 2 Homolog C (DIP2C) gene, which relates to transcription factor binding. Future analyses should explore these relationships prospectively and investigate the potential role of differentially methylated sites with disease endpoints. In Chapter 7, we evaluated if declines in blood lead were associated with changes in systolic and diastolic blood pressure in adult American Indian participants from the SHFS (n=285). Using generalized estimating equations, a significant non-linear association between declines in blood lead and declines in systolic blood pressure was detected, with significant linear associations where blood lead decline was 1 µg/L or higher. These findings suggest the need to further study the cardiovascular impacts of reducing lead exposures and the importance of lead exposure prevention. In conclusion, we find that established biomarkers of metal exposure reflecting internal dose such as blood and urine, as well as epigenetic biomarkers of metals exposures, were associated with subclinical CVD and CVD incidence and mortality. Findings concerning blood lead emphasize that low levels of lead remain relevant for CVD, and declines in blood lead even when small (1.0-10.0 µg/L), were associated with reductions in systolic blood pressure. Novelly, we present that urinary uranium levels were adversely associated with measures of cardiac geometry and left ventricular functioning among American Indian adults, and that future attention must be paid to investigating associations with subclinical disease. We also find utility in using epigenetic biomarkers to capture CVD risk, as tibia and blood epigenetic biomarkers of lead, were associated with increased risk of CVD mortality, and urinary selenium was associated with distinct changes in DNAm. Although further work must further validate these epigenetic biomarkers in different populations, future work must continue to investigate these epigenetic biomarkers given their potential to capture CVD risk.