Associations between heavy metal exposure and vascular age: a large cross-sectional study

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Abstract

Background

Heavy metal exposure is an emerging environmental risk factor linked to cardiovascular disease (CVD) through its effects on vascular ageing. However, the relationship between heavy metal exposure and vascular age have not been fully elucidated.

Methods

This cross-sectional study analyzed data from 3,772 participants in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2016. We measured urinary concentrations of nine heavy metals and assessed their associations with vascular age, estimated pulse wave velocity (ePWV) and heart vascular age (HVA). Additionally, sex-stratified analyses, Weighted Quantile Sum (WQS) regression and Bayesian Kernel Machine Regression were conducted to explore the effects of individual and mixed metal exposures.

Results

Exposure to metals such as cadmium (Cd) cesium (Cs), cobalt (Co), and lead (Pb) was significantly associated with increased vascular age, with odds ratios (OR) ranging from 1.05 to 3.48 in full adjusted models. Sex-stratified analyses indicated that individual metal including cobalt (Co) and cadmium (Cd) exposures had a more substantial impact on males. WQS analysis consistently showed combined heavy metals exposure had stronger associations with increased vascular age in men (OR for HVA = 3.89, 95% CI 2.91–5.28).

Conclusions

This study highlights a significant association between heavy metal exposure and increased vascular age. Stratified analyses illustrated men might be more susceptible to the combined effects of multiple heavy metal exposure. The findings underscore the importance of considering sex-specific responses and interventions measures in cardiovascular risk assessments and managements. Further research is needed to validate these findings and to develop more precise public health strategies targeting environmental risks.

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Most cited references 65

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Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing

Yoav Benjamini, Yosef Hochberg (1995)

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General cardiovascular risk profile for use in primary care: the Framingham Heart Study.

Ralph B. D’Agostino, Ramachandran S Vasan, Michael J Pencina … (2008)

Separate multivariable risk algorithms are commonly used to assess risk of specific atherosclerotic cardiovascular disease (CVD) events, ie, coronary heart disease, cerebrovascular disease, peripheral vascular disease, and heart failure. The present report presents a single multivariable risk function that predicts risk of developing all CVD and of its constituents. We used Cox proportional-hazards regression to evaluate the risk of developing a first CVD event in 8491 Framingham study participants (mean age, 49 years; 4522 women) who attended a routine examination between 30 and 74 years of age and were free of CVD. Sex-specific multivariable risk functions ("general CVD" algorithms) were derived that incorporated age, total and high-density lipoprotein cholesterol, systolic blood pressure, treatment for hypertension, smoking, and diabetes status. We assessed the performance of the general CVD algorithms for predicting individual CVD events (coronary heart disease, stroke, peripheral artery disease, or heart failure). Over 12 years of follow-up, 1174 participants (456 women) developed a first CVD event. All traditional risk factors evaluated predicted CVD risk (multivariable-adjusted P<0.0001). The general CVD algorithm demonstrated good discrimination (C statistic, 0.763 [men] and 0.793 [women]) and calibration. Simple adjustments to the general CVD risk algorithms allowed estimation of the risks of each CVD component. Two simple risk scores are presented, 1 based on all traditional risk factors and the other based on non-laboratory-based predictors. A sex-specific multivariable risk factor algorithm can be conveniently used to assess general CVD risk and risk of individual CVD events (coronary, cerebrovascular, and peripheral arterial disease and heart failure). The estimated absolute CVD event rates can be used to quantify risk and to guide preventive care.

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Hazards of heavy metal contamination.

Lars Järup (2003)

The main threats to human health from heavy metals are associated with exposure to lead, cadmium, mercury and arsenic. These metals have been extensively studied and their effects on human health regularly reviewed by international bodies such as the WHO. Heavy metals have been used by humans for thousands of years. Although several adverse health effects of heavy metals have been known for a long time, exposure to heavy metals continues, and is even increasing in some parts of the world, in particular in less developed countries, though emissions have declined in most developed countries over the last 100 years. Cadmium compounds are currently mainly used in re-chargeable nickel-cadmium batteries. Cadmium emissions have increased dramatically during the 20th century, one reason being that cadmium-containing products are rarely re-cycled, but often dumped together with household waste. Cigarette smoking is a major source of cadmium exposure. In non-smokers, food is the most important source of cadmium exposure. Recent data indicate that adverse health effects of cadmium exposure may occur at lower exposure levels than previously anticipated, primarily in the form of kidney damage but possibly also bone effects and fractures. Many individuals in Europe already exceed these exposure levels and the margin is very narrow for large groups. Therefore, measures should be taken to reduce cadmium exposure in the general population in order to minimize the risk of adverse health effects. The general population is primarily exposed to mercury via food, fish being a major source of methyl mercury exposure, and dental amalgam. The general population does not face a significant health risk from methyl mercury, although certain groups with high fish consumption may attain blood levels associated with a low risk of neurological damage to adults. Since there is a risk to the fetus in particular, pregnant women should avoid a high intake of certain fish, such as shark, swordfish and tuna; fish (such as pike, walleye and bass) taken from polluted fresh waters should especially be avoided. There has been a debate on the safety of dental amalgams and claims have been made that mercury from amalgam may cause a variety of diseases. However, there are no studies so far that have been able to show any associations between amalgam fillings and ill health. The general population is exposed to lead from air and food in roughly equal proportions. During the last century, lead emissions to ambient air have caused considerable pollution, mainly due to lead emissions from petrol. Children are particularly susceptible to lead exposure due to high gastrointestinal uptake and the permeable blood-brain barrier. Blood levels in children should be reduced below the levels so far considered acceptable, recent data indicating that there may be neurotoxic effects of lead at lower levels of exposure than previously anticipated. Although lead in petrol has dramatically decreased over the last decades, thereby reducing environmental exposure, phasing out any remaining uses of lead additives in motor fuels should be encouraged. The use of lead-based paints should be abandoned, and lead should not be used in food containers. In particular, the public should be aware of glazed food containers, which may leach lead into food. Exposure to arsenic is mainly via intake of food and drinking water, food being the most important source in most populations. Long-term exposure to arsenic in drinking-water is mainly related to increased risks of skin cancer, but also some other cancers, as well as other skin lesions such as hyperkeratosis and pigmentation changes. Occupational exposure to arsenic, primarily by inhalation, is causally associated with lung cancer. Clear exposure-response relationships and high risks have been observed.

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Author and article information

Contributors

Hongwei Tan: tanhongweikoui@163.com

Xuebo Liu:

ORCID: http://orcid.org/0009-0003-6287-0650

liuxb70@126.com

Journal

Journal ID (nlm-ta): J Transl Med

Journal ID (iso-abbrev): J Transl Med

Title: Journal of Translational Medicine

Publisher: BioMed Central (London )

ISSN (Electronic): 1479-5876

Publication date (Electronic): 3 January 2025

Publication date PMC-release: 3 January 2025

Publication date Collection: 2025

Volume: 23

Electronic Location Identifier: 4

Affiliations

[1 ]Department of Cardiology, Tongji Hospital, School of Medicine, Tongji University, ( https://ror.org/03rc6as71) No. 389 Xincun Road, Shanghai, 200065 China

[2 ]Department of Radiation Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, ( https://ror.org/03rc6as71) Shanghai, 200433 China

[3 ]Operating Room, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, ( https://ror.org/03rc6as71) Shanghai, 200072 China

[4 ]Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, ( https://ror.org/033nbnf69) Shanghai, China

Author information

Xuebo Liu http://orcid.org/0009-0003-6287-0650

Article

Publisher ID: 6021

DOI: 10.1186/s12967-024-06021-w

PMC ID: 11697934

PubMed ID: 39754096

SO-VID: a0f08a4b-1ef7-422c-b0f8-0da758b60a6c

License:

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

History

Date received : 16 August 2024

Date accepted : 22 December 2024

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;

Award ID: 82170346

Award ID: 81670403

Award ID: 81370390

Award Recipient : Xuebo Liu

Funded by: FundRef http://dx.doi.org/10.13039/501100003399, Science and Technology Commission of Shanghai Municipality;

Award ID: 18411950300

Award ID: 19XD1403300

Award ID: 19411963200

Award Recipient : Xuebo Liu

Funded by: FundRef http://dx.doi.org/10.13039/100017950, Shanghai Municipal Health Commission;

Funded by: FundRef http://dx.doi.org/10.13039/100007219, Natural Science Foundation of Shanghai Municipality;

Award ID: 20ZR1451300

Award Recipient : Hongwei Tan

Funded by: Clinical Research Project of Tongji Hospital of Tongji University

Award ID: ITJ(QN)2203

Award Recipient : Jun Qian

Custom metadata

ScienceOpen disciplines: Medicine

Keywords: heavy metal exposure,vascular ageing,vascular age,estimated pulse wave velocity

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ScienceOpen disciplines: Medicine

Keywords: heavy metal exposure, vascular ageing, vascular age, estimated pulse wave velocity

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Associations between heavy metal exposure and vascular age: a large cross-sectional study

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Abstract

Background

Methods

Results

Conclusions

Graphical Abstract

Related collections

Vascular Biology

Most cited references 65

Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing

General cardiovascular risk profile for use in primary care: the Framingham Heart Study.

Hazards of heavy metal contamination.

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Contributors

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Affiliations

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Article

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Funding

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Most referenced authors 1,281