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Cheng T, Yu D, Li G, Chen X, Zhou L, Wen Z. Association between exposure to urinary metal and all-cause and cardiovascular mortality in US adults. PLoS One 2024; 19:e0316045. [PMID: 39729492 DOI: 10.1371/journal.pone.0316045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 12/04/2024] [Indexed: 12/29/2024] Open
Abstract
BACKGROUND Further evidence is required regarding the influence of metal mixture exposure on mortality. Therefore, we employed diverse statistical models to evaluate the associations between eight urinary metals and the risks of all-cause and cardiovascular mortality. METHODS We measured the levels of 8 metals in the urine of adults who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Based on follow-up data, we determined whether they died and the reasons for their deaths. We estimated the association between urine metal exposure and all-cause mortality using Cox regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) models. Additionally, we used a competing risk model to estimate the relationship between metal exposure and cardiovascular mortality. RESULTS Among the 14,305 individuals included in our final analysis, there were 2,066 deaths, with 1,429 being cardiovascular-related. Cox regression analysis showed that cobalt (Co) (HR: 1.21; 95% CI: 1.13, 1.30) and antimony (Sb) (HR: 1.26; 95% CI: 1.12, 1.40) were positively associated with all-cause mortality (all P for trend <0.001). In the competing risk model, Co (HR: 1.29; 95% CI: 1.12, 1.48), lead (Pb) (HR: 1.18; 95% CI: 1.03, 1.37), and Sb (HR: 1.44; 95% CI: 1.18, 1.75) were significantly associated with an increased risk of cardiovascular mortality (all P for trend <0.001). Sb, Pb, cadmium (Cd), and molybdenum (Mo) had the highest weight rankings in the final WQS model. All metals showed a complex non-linear relationship with all-cause mortality, with high posterior inclusion probabilities (PIPs) in the final BKMR models. CONCLUSIONS Combining all models, it is possible that Sb may have a more stable impact on all-cause and cardiovascular mortality. Meaningful metal effects in individual statistical models still require careful attention.
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Affiliation(s)
- Ting Cheng
- Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Dongdong Yu
- Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Geng Li
- Guangdong Provincial Hospital of Chinese Medicine (Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Xiankun Chen
- Guangdong Provincial Hospital of Chinese Medicine (Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Li Zhou
- Guangdong Provincial Hospital of Chinese Medicine (Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Zehuai Wen
- Guangdong Provincial Hospital of Chinese Medicine (Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
- Science and Technology Innovation Center of Guangzhou University of Chinese Medicine, Guangzhou, China
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Zhang W, Chen W, Lu D, Nie J, Hu Z, Xian C. Interactive association of metals and Life's Essential 8 with mortality in U.S. adults: a prospective cohort study from the NHANES dataset. BMC Public Health 2024; 24:3073. [PMID: 39506744 PMCID: PMC11542460 DOI: 10.1186/s12889-024-20580-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 10/30/2024] [Indexed: 11/08/2024] Open
Abstract
BACKGROUND Life's Essential 8 (LE8) is a novel assessment of cardiovascular health (CVH) by evaluating lifestyle, and reports of the associations between LE8 and urinary metals on mortality have been very limited. This study aimed to conduct a prospective cohort study and investigate the combined effects of metals and LE8 on mortality in U.S. adults. METHODS This study enrolled participants with complete information on urinary metals, LE8, mortality status, and confounders from the National Health and Nutrition Examination Survey (2005-2018). The Cox regression model, adaptive lasso penalized regression, and restricted cubic spline were used to analyze the individual effects of metals and LE8 on all-cause mortality. The additive and multiplicative interaction scales and quantile g-computation were used to evaluate the interaction and combined effects. Stratified analyses were performed to clarify whether metals and LE8 interacted with other variables to influence all-cause mortality. RESULTS A total of 8017 participants were included in this study. The concentrations of cadmium, cobalt, lead, antimony, and thorium were greater in the low CVH group than in the high CVH group [median (µg/L): 0.29 vs. 0.19, 0.36 vs. 0.35, 0.48 vs. 0.39, 0.05 vs. 0.04, and 0.07 vs. 0.06]. The interaction between cadmium and LE8 was statistically significant, with a synergy index of 1.169 (95% CI: 1.004, 1.361). The stratified analyses showed that the interaction between age and LE8 had an impact on all-cause mortality (P for interaction = 0.004). CONCLUSIONS In this representative sample of the U.S. population, we found that the combined effect of cadmium, lead, thallium, and LE8 was positively associated with all-cause mortality. Furthermore, the interaction between cadmium and LE8 influenced all-cause mortality. So people should adopt healthy behaviors and reduce heavy metal exposure to minimize the risk of adverse health outcomes.
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Affiliation(s)
- Weipeng Zhang
- The Affiliated Panyu Central Hospital, Guangzhou Medical University, Guangzhou, 511400, Guangdong, China.
| | - Weiqiang Chen
- The Second Nanning People's Hospital, Nanning, 530031, Guangxi, China
| | - Dengqiu Lu
- The Affiliated Panyu Central Hospital, Guangzhou Medical University, Guangzhou, 511400, Guangdong, China
| | - Junfeng Nie
- The Affiliated Panyu Central Hospital, Guangzhou Medical University, Guangzhou, 511400, Guangdong, China
| | - Zhumin Hu
- The Affiliated Panyu Central Hospital, Guangzhou Medical University, Guangzhou, 511400, Guangdong, China
| | - Cuiyao Xian
- The Affiliated Panyu Central Hospital, Guangzhou Medical University, Guangzhou, 511400, Guangdong, China
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Shi C, Zhi J, Zhao H, Wang W, Zhang H, Zhou G, Fu X, Ba Y. Risk of heavy metal(loid) compositions in fine particulate matter on acute cardiovascular mortality: a poisson analysis in Anyang, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:1275-1286. [PMID: 38625430 DOI: 10.1007/s00484-024-02665-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/03/2024] [Accepted: 03/28/2024] [Indexed: 04/17/2024]
Abstract
Fine particulate matter (PM2.5) is a risk factor of cardiovascular disease. Associations between PM2.5 compositions and cardiovascular disease are a point of special interest but inconsistent. This study aimed to explore the cardiovascular effects of heavy metal(loid) compositions in PM2.5. Data for mortality, air pollutants and meteorological factors in Anyang, China from 2017 to 2021 were collected. Heavy metal(loid) in PM2.5 were monitored and examined monthly. A Case-crossover design was applied to the estimated data set. The interquartile range increase in cadmium (Cd), antimony (Sb) and arsenic (As) at lag 1 was associated with increment of 8.1% (95% CI: 3.3, 13.2), 4.8% (95% CI: 0.2, 9.5) and 3.5% (95% CI: 1.1, 6.0) cardiovascular mortality. Selenium in lag 2 was inversely associated with cerebrovascular mortality (RR = 0.920 95% CI: 0.862, 0.983). Current-day exposure of aluminum was positively associated with mortality from ischemic heart disease (RR = 1.083 95% CI: 1.001, 1.172). Stratified analysis indicated sex, age and season modified the cardiovascular effects of As (P < 0.05). Our study reveals that heavy metal(loid) play key roles in adverse effects of PM2.5. Cd, Sb and As were significant risk factors of cardiovascular mortality. These findings have potential implications for accurate air pollutants control and management to improve public health benefits.
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Affiliation(s)
- Chaofan Shi
- Department of Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
- Department of Public Health, Anyang Center for Disease Control and Prevention, Anyang, Henan, 455000, PR China
| | - Jianjun Zhi
- Department of Public Health, Anyang Center for Disease Control and Prevention, Anyang, Henan, 455000, PR China
| | - Hongsheng Zhao
- Department of Public Health, Anyang Center for Disease Control and Prevention, Anyang, Henan, 455000, PR China
| | - Wan Wang
- Department of Physical and Chemical Examination, Anyang Center for Disease Control and Prevention, Anyang, Henan, 455000, PR China
| | - Hongjin Zhang
- Department of Public Health, Anyang Center for Disease Control and Prevention, Anyang, Henan, 455000, PR China
| | - Guoyu Zhou
- Department of Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
- Henan Key Laboratory of Population Defects Prevention, National Health Commission Key Laboratory of Birth Defects Prevention, Zhengzhou, Henan, 450001, PR China
| | - Xiaoli Fu
- Department of Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Yue Ba
- Department of Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China.
- Henan Key Laboratory of Population Defects Prevention, National Health Commission Key Laboratory of Birth Defects Prevention, Zhengzhou, Henan, 450001, PR China.
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Verzelloni P, Urbano T, Wise LA, Vinceti M, Filippini T. Cadmium exposure and cardiovascular disease risk: A systematic review and dose-response meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 345:123462. [PMID: 38295933 DOI: 10.1016/j.envpol.2024.123462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/30/2023] [Accepted: 01/27/2024] [Indexed: 02/05/2024]
Abstract
Exposure to toxic metals is a global public health threat. Among other adverse effects, exposure to the heavy metal cadmium has been associated with greater risk of cardiovascular disease (CVD). Nonetheless, the shape of the association between cadmium exposure and CVD risk is not clear. This systematic review summarizes data on the association between cadmium exposure and risk of CVD using a dose-response approach. We carried out a literature search in PubMed, Web of Science, and Embase from inception to December 30, 2023. Inclusion criteria were: studies on adult populations, assessment of cadmium exposure, risk of overall CVD and main CVD subgroups as endpoints, and observational study design (cohort, cross-sectional, or case-control). We retrieved 26 eligible studies published during 2005-2023, measuring cadmium exposure mainly in urine and whole blood. In a dose-response meta-analysis using the one-stage method within a random-effects model, we observed a positive association between cadmium exposure and risk of overall CVD. When using whole blood cadmium as a biomarker, the association with overall CVD risk was linear, yielding a risk ratio (RR) of 2.58 (95 % confidence interval-CI 1.78-3.74) at 1 μg/L. When using urinary cadmium as a biomarker, the association was linear until 0.5 μg/g creatinine (RR = 2.79, 95 % CI 1.26-6.16), after which risk plateaued. We found similar patterns of association of cadmium exposure with overall CVD mortality and risks of heart failure, coronary heart disease, and overall stroke, whereas for ischemic stroke there was a positive association with mortality only. Overall, our results suggest that cadmium exposure, whether measured in urine or whole blood, is associated with increased CVD risk, further highlighting the importance of reducing environmental pollution from this heavy metal.
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Affiliation(s)
- Pietro Verzelloni
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Teresa Urbano
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Marco Vinceti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Tommaso Filippini
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; School of Public Health, University of California Berkeley, Berkeley, CA, USA.
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He J, Pu Y, Du Y, Liu H, Wang X, He S, Ai S, Dang Y. An exploratory study on the association of multiple metals in serum with preeclampsia. Front Public Health 2024; 12:1336188. [PMID: 38504684 PMCID: PMC10948457 DOI: 10.3389/fpubh.2024.1336188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/22/2024] [Indexed: 03/21/2024] Open
Abstract
Background Individual metal levels are potential risk factors for the development of preeclampsia (PE). However, understanding of relationship between multiple metals and PE remains elusive. Purpose The purpose of this study was to explore whether eight metals [zinc (Zn), manganese (Mn), copper (Cu), nickel (Ni), lead (Pb), arsenic (As), cadmium (Cd), and mercury (Hg)] in serum had a certain relationship with PE. Methods A study was conducted in Dongguan, China. The concentrations of metals in maternal serum were assessed using inductively coupled plasma mass spectrometry (ICP-MS). Data on various factors were collected through a face-to-face interview and hospital electronic medical records. The unconditional logistic regression model, principal component analysis (PCA) and Bayesian Kernel Machine Regression (BKMR) were applied in our study. Results The logistic regression model revealed that the elevated levels of Cu, Pb, and Hg were associated with an increased risk of PE. According to PCA, principal component 1 (PC1) was predominated by Hg, Pb, Mn, Ni, Cu, and As, and PC1 was associated with an increased risk of PE, while PC2 was predominated by Cd and Zn. The results of BKMR indicated a significant positive cumulative effect of serum metals on PE risk, with Ni and Cu exhibiting a significant positive effect. Moreover, BKMR results also revealed the nonlinear effects of Ni and Cd. Conclusion The investigation suggests a potential positive cumulative impact of serum metals on the occurrence of PE, with a particular emphasis on Cu as a potential risk factor for the onset and exacerbation of PE. These findings offer valuable insights for guiding future studies on this concern.
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Affiliation(s)
- Jie He
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yudong Pu
- Songshan Lake Central Hospital of Dongguan City, Dongguan, China
| | - Yue Du
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Haixia Liu
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Xiaoxue Wang
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Shuzhen He
- Songshan Lake Central Hospital of Dongguan City, Dongguan, China
| | - Shiwei Ai
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yuhui Dang
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, China
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Neurotoxicity of Chronic Co-Exposure of Lead and Ionic Liquid in Common Carp: Synergistic or Antagonistic? Int J Mol Sci 2022; 23:ijms23116282. [PMID: 35682962 PMCID: PMC9181186 DOI: 10.3390/ijms23116282] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 11/17/2022] Open
Abstract
Previous studies have indicated that the harmful heavy metal lead (Pb) contamination in aquatic systems has caused intelligence development disorders and nervous system function abnormalities in juveniles due to the increased permeability of the blood-brain barrier. Ionic liquids (ILs) are considered "green" organic solvents that can replace traditional organic solvents. Studies have found the presence of ILs in soil and water due to chemical applications or unintentional leakage. Therefore, what would happen if Pb interacted with ILs in a body of water? Could ILs enable Pb to more easily cross the blood-brain barrier? Therefore, we examined the combined exposure of Pb and ILs in common carp at low concentration (18.3 mg L-1 of Pb(CH3COO)2•3 H2O and 11 mg L-1 of the IL 1-methyl-3-octylimidazolium chloride, 5% of their LC50) for 28 days in the present study. The result of a neurobehavioral assay showed that chronic exposure of lead at lower concentrations significantly altered fish movement and neurobehaviors, indicating that lead exposure caused neurotoxicity in the carp. Increases in the neurotransmitter dopamine levels and injuries in the fish brain accounted for neurobehavioral abnormalities induced by lead exposure. Moreover, we also found that lead could easily cross the blood-brain barrier and caused significant bioaccumulation in the brain. Particularly, our study indicated that the ionic liquid could not synergistically promote blood-brain barrier permeability and hence failed to increase the absorption of lead in the fish brain, suggesting that the combined exposure of lead and ILs was not a synergistic effect but antagonism to the neurotoxicity. The results of this study suggested that ILs could recede the Pb induced neurotoxicity in fish.
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Münzel T, Hahad O, Daiber A, Landrigan PJ. OUP accepted manuscript. Cardiovasc Res 2022; 119:440-449. [PMID: 35772469 PMCID: PMC10064841 DOI: 10.1093/cvr/cvac082] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 04/30/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Healthy soil is foundational to human health. Healthy soil is needed to grow crops, provides food, and sustains populations. It supports diverse ecosystems and critical ecological services such as pollination. It stores water and prevents floods. It captures carbon and slows global climate change. Soil pollution is a great and growing threat to human health. Soil may be polluted by heavy metals, organic chemicals such as pesticides, biological pathogens, and micro/nanoplastic particles. Pollution reduces soil's ability to yield food. It results in food crop contamination and disease. Soil pollutants wash into rivers causing water pollution. Deforestation causes soil erosion, liberates sequestered pollutants, and generates airborne dust. Pollution of air, water, and soil is responsible for at least 9 million deaths each year. More than 60% of pollution-related disease and death is due to cardiovascular disease. Recognizing the importance of pollution to human health, the European Commission and the EU Action Plan for 2050: A Healthy Planet for All, have determined that air, water, and soil pollution must be reduced to levels that cause no harm to human or ecosystem health. We are thus required to create a toxic-free environment, respect the concept of a safe operating space for humanity, and sustain the health of our planet for future generations. This review article summarizes current knowledge of the links between soil health and human health and discusses the more important soil pollutants and their health effects.
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Affiliation(s)
- Thomas Münzel
- Corresponding author. Tel: +49 613 117 7250; fax: +49 613 117 6615, E-mail:
| | - Omar Hahad
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Cardiology I, Geb. 605, Langenbeckstr. 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
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