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Wang C, Su J, Li J, Wei W, Yuan Z, Chen R, Wei W, Huang Y, Ye L, Liang H, Jiang J. Blood Lead Mediates the Relationship between Biological Aging and Hypertension: Based on the NHANES Database. Nutrients 2024; 16:2144. [PMID: 38999891 PMCID: PMC11243065 DOI: 10.3390/nu16132144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/01/2024] [Accepted: 07/01/2024] [Indexed: 07/14/2024] Open
Abstract
Hypertension remains a major global public health crisis due to various contributing factors, such as age and environmental exposures. This study delves into exploring the intricate association between biological aging, blood lead levels, and hypertension, along with examining the mediating role of blood lead levels in the relationship between biological aging and hypertension. We analyzed data from two cycles of the NHANES, encompassing 4473 individuals aged 18 years and older. Our findings indicate that biological aging potentially escalates the risk of hypertension and the incidences of systolic blood pressure (SBP) and diastolic blood pressure (DBP) abnormalities. Utilizing weighted quantile sum (WQS) and quantile g-computation (QGC) model analyses, we observed that exposure to heavy metal mixtures, particularly lead, may elevate the likelihood of hypertension, SBP, and DBP abnormalities. Further mediation analysis revealed that lead significantly mediated the relationship between biological aging and hypertension and between biological aging and SBP abnormalities, accounting for 64% (95% CI, 49% to 89%) and 64% (95% CI, 44% to 88%) of the effects, respectively. These outcomes emphasize the criticality of implementing environmental health measures.
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Affiliation(s)
- Cuixiao Wang
- Guangxi Crucial Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Jinming Su
- Guangxi Crucial Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-Constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning 530021, China
| | - Jinmiao Li
- Guangxi Crucial Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Wenfei Wei
- Guangxi Crucial Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Zongxiang Yuan
- Guangxi Crucial Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Rongfeng Chen
- Guangxi Crucial Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Wudi Wei
- Guangxi Crucial Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Youjin Huang
- Guangxi Crucial Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Li Ye
- Guangxi Crucial Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-Constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning 530021, China
| | - Hao Liang
- Guangxi Crucial Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-Constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning 530021, China
| | - Junjun Jiang
- Guangxi Crucial Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-Constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning 530021, China
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Zhao S, Fan L, Wang Y, Dong S, Han M, Qin Y, Chen J, Liu A. Combined exposure to multiple metals on hypertension in NHANES under four statistical models. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:92937-92949. [PMID: 37498425 DOI: 10.1007/s11356-023-28902-1] [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: 03/01/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023]
Abstract
Metals exposure has gained increasing attention in the hypertension prevention. However, previous studies have focused on the impacts of single or separated metals on hypertension, and the critical metals contributing to the prevalence of hypertension are still under discussion. We collected data from 5092 participants across three consecutive National Health and Nutrition Examination Survey (NHANES) circles (2011-2016). Weighted logistic regression, weighted quantile sum (WQS) regression, quantile-based g-computation (QGC), and Bayesian kernel machine regression (BKMR) analyses were conducted to evaluate the combined and individual effects of 15 urinary metals, as well as to identify the critical metals on the development of hypertension. In our study, the weighted prevalence of hypertension was 37.9%, and the average age was 47.42 years. Manganese, uranium and tin were found as the independent risk factors for hypertension, while barium, lead, and thallium were found to have protective effects against hypertension. Lead, barium, tungsten, uranium, and tin were determined as critical elements for the prediction of hypertension. No significant interaction relationship was detected between multiple metals. There might be potential positive combined effects of urinary metal mixture on hypertension. Tungsten, uranium, and tin were positively associated with hypertension while lead and barium were negatively associated with hypertension. The underlying mechanisms of urinary metal exposure on the risk of hypertension deserve further investigations.
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Affiliation(s)
- Songfeng Zhao
- Department of Neurosurgery, the Third Xiangya Hospital, Central South University, Hunan, China
| | - Liqiaona Fan
- Department of General Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Yutong Wang
- Department of Neurosurgery, the Third Xiangya Hospital, Central South University, Hunan, China
| | - Siyuan Dong
- Department of Neurosurgery, the Third Xiangya Hospital, Central South University, Hunan, China
| | - Mingyang Han
- Department of Neurosurgery, the Third Xiangya Hospital, Central South University, Hunan, China
| | - Yongkai Qin
- Department of Neurosurgery, the Third Xiangya Hospital, Central South University, Hunan, China
| | - Jigang Chen
- Department of Burn and Plastic Surgery, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Aihua Liu
- Department of Neurosurgery, the Third Xiangya Hospital, Central South University, Hunan, China.
- Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
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S R, Vaiyakkani G, S SK, Ramachandran A, Rajendran K, Krishnasamy N, Panneerselvam P, Pamarthi J, Rajaram M. Analysis of blood lead level and its clinical significance among occupational exposed painters in chennai based population: A cross sectional study. J Trace Elem Med Biol 2023; 79:127257. [PMID: 37437390 DOI: 10.1016/j.jtemb.2023.127257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 06/07/2023] [Accepted: 06/28/2023] [Indexed: 07/14/2023]
Abstract
INTRODUCTION AND AIM Lead is a ubiquitous element found in the earth crust. There is no known physiologic role of lead in human body and hence any amount of lead present in human tissue considered as a contamination. Several studies on lead toxicity show that, occupational exposure remains the main source for lead toxicity and is emerging as important public health problem. Burden and severity of occupational exposure of lead and its clinical significance are gaining more interest in the field of toxicology. Only limited studies are available and there is scarcity of epidemiology data to assess the blood lead levels of workers and the contribution of common workplace practices to lead exposure in India especially from our region. So, the current study is designed to assess the blood lead levels (BLL) and its clinical significance among high risk workers especially painters working in the construction and public private sector in Chennai based population. MATERIALS AND METHODS This cross-sectional case control study included 122 painters and 122 healthy individuals. A detailed questionnaire about demographic details, personal habits, work related safety precautions, presenting symptoms of lead toxicity were given to painter followed by detailed medical examination and blood investigations including blood lead levels were collected and statistically analyzed. The t-test were used to compare mean blood lead levels and to investigate the associations between specific job type, use of self-protection device,sex, service years and occurrence of non-specific symptoms with BLLs. RESULTS The mean BLL of the painters were less than the recommended threshold level. Among painters 13.1% were categorized under BLL > 10 μg/dL. The higher BLL among the painters were directly proportional to year of experience and poor usage of personal protective materials. The levels of Hb, HCT and eosinophil were much correlated with lead toxicity. A marginal significance were observed in some parameters especially urea and creatinine when compared with control. The Cognitive dysfunction, hypertension and renal dysfunction were also observed among the painters. CONCLUSION The BLL in painters among our group were minimal compared to biological reference value. Duration of exposure and association of patient's clinical features like cognitive dysfunction, hypertension and renal dysfunction conditions were observed and this should be carefully monitored and study on huge population of painters with longitudinal aspect is recommended to rule out the clinical correlation of lead toxicity.
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Affiliation(s)
- Ragunanthanan S
- Poison Control, Training & Research Centre, Institute of Internal Medicine, Rajiv Gandhi Government General Hospital & Madras Medical College, 1st floor, Tower II Park Town, Chennai, Tamil Nadu 600003, India
| | - Govardhini Vaiyakkani
- Poison Control, Training & Research Centre, Institute of Internal Medicine, Rajiv Gandhi Government General Hospital & Madras Medical College, 1st floor, Tower II Park Town, Chennai, Tamil Nadu 600003, India.
| | - Senthil Kumar S
- Institute of Internal Medicine, K.A.P. Viswanatham Medical College is a medical, Periyamilaguparai, Colletor's office Road, Tamil Nadu 620001, India
| | - Arunkumar Ramachandran
- Multidisciplinary Research Unit, Madras Medical College, Park Town, Chennai, Tamil Nadu 600003, India.
| | - Karthick Rajendran
- Multidisciplinary Research Unit, Madras Medical College, Park Town, Chennai, Tamil Nadu 600003, India
| | - Narayanasamy Krishnasamy
- Institute of Hepatobilary Sciences, Madras Medical College & Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu 600 003, India
| | | | - Jayakrishna Pamarthi
- Multidisciplinary Research Unit, Madras Medical College, Park Town, Chennai, Tamil Nadu 600003, India
| | - Muthukumaran Rajaram
- Multidisciplinary Research Unit, Madras Medical College, Park Town, Chennai, Tamil Nadu 600003, India
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Yimthiang S, Pouyfung P, Khamphaya T, Vesey DA, Gobe GC, Satarug S. Evidence Linking Cadmium Exposure and β 2-Microglobulin to Increased Risk of Hypertension in Diabetes Type 2. TOXICS 2023; 11:516. [PMID: 37368616 DOI: 10.3390/toxics11060516] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/31/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023]
Abstract
The most common causes of chronic kidney disease, diabetes, and hypertension are significant public health issues worldwide. Exposure to the heavy metal pollutant, cadmium (Cd), which is particularly damaging to the kidney, has been associated with both risk factors. Increased levels of urinary β2-microglobulin (β2M) have been used to signify Cd-induced kidney damage and circulating levels have been linked to blood pressure control. In this study we investigated the pressor effects of Cd and β2M in 88 diabetics and 88 non-diabetic controls, matched by age, gender and locality. The overall mean serum β2M was 5.98 mg/L, while mean blood Cd and Cd excretion normalized to creatinine clearance (Ccr) as ECd/Ccr were 0.59 µg/L and 0.0084 µg/L of filtrate (0.95 µg/g creatinine), respectively. The prevalence odds ratio for hypertension rose by 79% per every ten-fold increase in blood Cd concentration. In all subjects, systolic blood pressure (SBP) showed positive associations with age (β = 0.247), serum β2M (β = 0.230), and ECd/Ccr (β = 0.167). In subgroup analysis, SBP showed a strong positive association with ECd/Ccr (β = 0.303) only in the diabetic group. The covariate-adjusted mean SBP in the diabetics of the highest ECd/Ccr tertile was 13.8 mmHg higher, compared to the lowest tertile (p = 0.027). An increase in SBP associated with Cd exposure was insignificant in non-diabetics. Thus, for the first time, we have demonstrated an independent effect of Cd and β2M on blood pressure, thereby implicating both Cd exposure and β2M in the development of hypertension, especially in diabetics.
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Affiliation(s)
- Supabhorn Yimthiang
- Occupational Health and Safety, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Phisit Pouyfung
- Occupational Health and Safety, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Tanaporn Khamphaya
- Occupational Health and Safety, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - David A Vesey
- The Centre for Kidney Disease Research, Translational Research Institute, Brisbane 4102, Australia
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane 4102, Australia
| | - Glenda C Gobe
- The Centre for Kidney Disease Research, Translational Research Institute, Brisbane 4102, Australia
- School of Biomedical Sciences, The University of Queensland, Brisbane 4072, Australia
- NHMRC Centre of Research Excellence for CKD QLD, UQ Health Sciences, Royal Brisbane and Women's Hospital, Brisbane 4029, Australia
| | - Soisungwan Satarug
- The Centre for Kidney Disease Research, Translational Research Institute, Brisbane 4102, Australia
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Vigeh M, Sahebi L, Yokoyama K. Prenatal blood lead levels and Birth Weight: a Meta-analysis study. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2023; 21:1-10. [PMID: 37155699 PMCID: PMC10163201 DOI: 10.1007/s40201-022-00843-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 10/05/2022] [Accepted: 11/13/2022] [Indexed: 05/10/2023]
Abstract
Purpose Lead, a known toxic metal, causes several adverse reproductive effects, including low birth weight. Fortunately, the exposure level has sharply decreased during the recent decades, but a definitive safe level did not introduce for pregnant women yet. The current meta-analysis study aimed to conduct a quantitative estimation of maternal and umbilical cord blood lead effects on birth weight. Methods Two researchers have independently searched the scientific literature for retrieving related studies using the PRISMA criteria for data extraction. Twenty-one full-text articles were selected from primary 5006 titles, limited by the English language and published between 1991 and 2020 on humans. Results The pooled mean of maternal and umbilical cord blood lead levels were 6.85 µg/dL (95% CI: 3.36-10.34) and 5.41 µg/dL (95%CI: 3.43-7.40), respectively. The correlation coefficient analysis showed a significant inverse association between the mean maternal blood lead level and birth weight, which was confirmed by Fisher Z-Transformation analysis (-0.374, 95% CI: -0.382, -0.365, p < 0.01). In addition, a significantly lower birth weight (∆: 229 gr, p < 0.05) was found in the relatively high level of maternal blood lead than in low-level exposure (> 5 µg/dL vs. ≤ 5 µg/dL, respectively). Conclusion In short, the present study findings suggest an increasing maternal blood lead levels could be a potential risk factor for reducing birth weight. Thus, pregnant women should avoid lead exposure, as much as possible. Supplementary information The online version contains supplementary material available at 10.1007/s40201-022-00843-w.
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Affiliation(s)
- Mohsen Vigeh
- Maternal, Fetal and Neonatal Research Center, Family Health Research Institute, Immam Knomeini Hospital , Tehran University of Medical Sciences, Tehran 142933141, Iran
- Department of Epidemiology and Environmental Health, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunyaku-ko, 113-8421 Tokyo, Japan
| | - Leyla Sahebi
- Department of Epidemiology and Environmental Health, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunyaku-ko, 113-8421 Tokyo, Japan
| | - Kazuhito Yokoyama
- Department of Epidemiology and Environmental Health, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunyaku-ko, 113-8421 Tokyo, Japan
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Satarug S, Vesey DA, Gobe GC, Phelps KR. Estimation of health risks associated with dietary cadmium exposure. Arch Toxicol 2023; 97:329-358. [PMID: 36592197 DOI: 10.1007/s00204-022-03432-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 12/13/2022] [Indexed: 01/03/2023]
Abstract
In much of the world, currently employed upper limits of tolerable intake and acceptable excretion of cadmium (Cd) (ECd/Ecr) are 0.83 µg/kg body weight/day and 5.24 µg/g creatinine, respectively. These figures were derived from a risk assessment model that interpreted β2-microglobulin (β2MG) excretion > 300 μg/g creatinine as a "critical" endpoint. However, current evidence suggests that Cd accumulation reduces glomerular filtration rate at values of ECd/Ecr much lower than 5.24 µg/g creatinine. Low ECd/Ecr has also been associated with increased risks of kidney disease, type 2 diabetes, osteoporosis, cancer, and other disorders. These associations have cast considerable doubt on conventional guidelines. The goals of this paper are to evaluate whether these guidelines are low enough to minimize associated health risks reliably, and indeed whether permissible intake of a cumulative toxin like Cd is a valid concept. We highlight sources and levels of Cd in the human diet and review absorption, distribution, kidney accumulation, and excretion of the metal. We present evidence for the following propositions: excreted Cd emanates from injured tubular epithelial cells of the kidney; Cd excretion is a manifestation of current tissue injury; reduction of present and future exposure to environmental Cd cannot mitigate injury in progress; and Cd excretion is optimally expressed as a function of creatinine clearance rather than creatinine excretion. We comprehensively review the adverse health effects of Cd and urine and blood Cd levels at which adverse effects have been observed. The cumulative nature of Cd toxicity and the susceptibility of multiple organs to toxicity at low body burdens raise serious doubt that guidelines concerning permissible intake of Cd can be meaningful.
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Affiliation(s)
- Soisungwan Satarug
- Kidney Disease Research Collaborative, Level 5, Translational Research Institute, Brisbane, QLD, Australia.
| | - David A Vesey
- Kidney Disease Research Collaborative, Level 5, Translational Research Institute, Brisbane, QLD, Australia
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Glenda C Gobe
- Kidney Disease Research Collaborative, Level 5, Translational Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia
- NHMRC Centre of Research Excellence for CKD QLD, UQ Health Sciences, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Kenneth R Phelps
- Stratton Veterans Affairs Medical Center and Albany Medical College, Albany, NY, USA
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Abstract
Epidemiologic studies often quantify exposure using biomarkers, which commonly have statistically skewed distributions. Although normality assumption is not required if the biomarker is used as an independent variable in linear regression, it has become common practice to log-transform the biomarker concentrations. This transformation can be motivated by concerns for nonlinear dose-response relationship or outliers; however, such transformation may not always reduce bias. In this study, we evaluated the validity of motivations underlying the decision to log-transform an independent variable using simulations, considering eight scenarios that can give rise to skewed X and normal Y. Our simulation study demonstrates that (1) if the skewness of exposure did not arise from a biasing factor (e.g., measurement error), the analytic approach with the best overall model fit best reflected the underlying outcome generating methods and was least biased, regardless of the skewness of X and (2) all estimates were biased if the skewness of exposure was a consequence of a biasing factor. We additionally illustrate a process to determine whether the transformation of an independent variable is needed using NHANES. Our study and suggestion to divorce the shape of the exposure distribution from the decision to log-transform it may aid researchers in planning for analysis using biomarkers or other skewed independent variables.
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Affiliation(s)
- Giehae Choi
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins, Baltimore, Maryland
| | - Jessie P. Buckley
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins, Baltimore, Maryland
| | - Jordan Kuiper
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins, Baltimore, Maryland
| | - Alexander P. Keil
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
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Blood Lead Levels and Risk of Deaths from Cardiovascular Disease. Am J Cardiol 2022; 173:132-138. [PMID: 35351283 DOI: 10.1016/j.amjcard.2022.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/25/2022] [Accepted: 03/01/2022] [Indexed: 11/22/2022]
Abstract
Environmental exposure could be an important modifiable risk factor for cardiovascular disease (CVD). In this study, we investigated the relation between lead exposure, measured as blood lead levels (BLLs) and CVD mortality in a national cohort. A total of 15,036 adults aged ≥19 who participated in the National Health and Nutrition Examination Survey (1988 to 1994) as the baseline examination were followed up through December 31, 2010. Adjusted hazard ratios (HRs) derived from Cox proportional hazard regressions were used to estimate the risk of dying from CVD in association with BLLs. Cardiovascular mortality was 3.76, 8.11, and 14.77 per 1,000 person-years for patients in low, moderate, and high BLLs, respectively. After adjusting for potential confounders, patients in the high lead level had a significantly increased risk of death from all CVD (HR 1.35, 95% confidence interval 1.03 to 1.77), compared with those with low level. Participants in both moderate and high lead levels showed a significantly increased risk of death from heart disease, with an HR of 1.37 (1.04 to 1.81) and 1.60 (1.21 to 2.13), respectively. A significant linear association with all CVD and heart disease deaths was also seen with an HR of 1.08 (1.00 to 1.16) and 1.09 (1.02 to 1.16), respectively, per 1-unit increase in BLLs. In conclusion, the study demonstrates that increasing BLLs were associated with an increased risk of cardiovascular deaths, especially from heart disease. This further supports the possible cardiovascular effects that lead poses on patients at low levels of exposure and the importance of further reducing lead exposure in the general population.
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Huang Z. Association Between Blood Lead Level With High Blood Pressure in US (NHANES 1999–2018). Front Public Health 2022; 10:836357. [PMID: 35548077 PMCID: PMC9081331 DOI: 10.3389/fpubh.2022.836357] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background Lead is a toxic metal for human health, but the effect on blood pressure (BP) is still controversial. The object of this study was to demonstrate the association between blood lead levels with BP and hypertension (HTN). Methods We used the database from the National Health and Nutrition Examination Survey (NHANES, 1999–2018) to perform a cross-sectional study. We performed multivariate regressions to examine the association between blood lead level with HTN and BP, and then a subgroup analysis was performed. Results A total of 32,289 participants were included in this study, but no significant difference was found between blood lead levels and HTN. However, the association between blood lead levels with systolic and diastolic pressure became positive. In the subgroup analysis stratified by race, the association between non-Hispanic white and black people still existed. Conclusion The association between blood lead levels with HTN was not significant, but it was positively associated with BP. Besides, the association between non-Hispanic white and black people was also significant.
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Qu Y, Lv Y, Ji S, Ding L, Zhao F, Zhu Y, Zhang W, Hu X, Lu Y, Li Y, Zhang X, Zhang M, Yang Y, Li C, Zhang M, Li Z, Chen C, Zheng L, Gu H, Zhu H, Sun Q, Cai J, Song S, Ying B, Lin S, Cao Z, Liang D, Ji JS, Ryan PB, Barr DB, Shi X. Effect of exposures to mixtures of lead and various metals on hypertension, pre-hypertension, and blood pressure: A cross-sectional study from the China National Human Biomonitoring. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 299:118864. [PMID: 35063540 DOI: 10.1016/j.envpol.2022.118864] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 01/14/2022] [Accepted: 01/15/2022] [Indexed: 06/14/2023]
Abstract
We aimed to explore the effects of mixtures of lead and various metals on blood pressure (BP) and the odds of pre-hypertension (systolic blood pressure (SBP) 120-139 mmHg, and/or diastolic blood pressure (DBP) 80-89 mmHg) and hypertension (SBP/DBP ≥140/90 mmHg) among Chinese adults in a cross-sectional study. This study included 11,037 adults aged 18 years or older from the 2017-2018 China National Human Biomonitoring. Average BP and 13 metals (lead, antimony, arsenic, cadmium, mercury, thallium, chromium, cobalt, molybdenum, manganese, nickel, selenium, and tin) in blood and urine were measured and lifestyle and demographic data were collected. Weighted multiple linear regressions were used to estimate associations of metals with BP in both single and multiple metal models. Weighted quantile sum (WQS) regression was performed to assess the relationship between metal mixture levels and BP. In the single metal model, after adjusting for potential confounding factors, the blood lead levels in the highest quartile were associated with the greater odds of both pre-hypertension (odds ratio (OR): 1.56, 95% CI: 1.22-1.99) and hypertension (OR:1.75, 95% CI: 1.28-2.40) when compared with the lowest quartile. We also found that blood arsenic levels were associated with increased odds of pre-hypertension (OR:1.31, 95% CI:1.00-1.74), while urinary molybdenum levels were associated with lower odds of hypertension (OR:0.68, 95% CI:0.50-0.93). No significant associations were found for the other 10 metals. WQS regression analysis showed that metal mixture levels in blood were significantly associated with higher SBP (β = 1.56, P < 0.05) and DBP (β = 1.56, P < 0.05), with the largest contributor being lead (49.9% and 66.8%, respectively). The finding suggests that exposure to mixtures of metals as measured in blood were positively associated with BP, and that lead exposure may play a critical role in hypertension development.
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Affiliation(s)
- Yingli Qu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Yuebin Lv
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Saisai Ji
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Liang Ding
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Feng Zhao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Ying Zhu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Wenli Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Xiaojian Hu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Yifu Lu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Yawei Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Xu Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Mingyuan Zhang
- School of Public Health, Jilin University, 2699 Qianjin Street, Changchun, Jilin, 130012, China
| | - Yanwei Yang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Chengcheng Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Miao Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Zheng Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Chen Chen
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Lei Zheng
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Heng Gu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Huijuan Zhu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Qi Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Jiayi Cai
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Shixun Song
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Bo Ying
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Shaobin Lin
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Zhaojin Cao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Donghai Liang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 201 Dowman Drive, Atlanta, GA, 30322, United States
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, 30 Shuangqing Street, Haidian, Beijing, 100084, China; Environmental Research Center, Duke Kunshan University, 8 Duke Avenue, Kunshan, Jiangsu, 215316, China; Nicholas School of the Environment, Duke University, 2080 Duke University Road, Durham, NC, 27708, United States
| | - P Barry Ryan
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 201 Dowman Drive, Atlanta, GA, 30322, United States
| | - Dana Boyd Barr
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 201 Dowman Drive, Atlanta, GA, 30322, United States
| | - Xiaoming Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China.
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Wei MH, Cui Y, Zhou HL, Song WJ, Di DS, Zhang RY, Huang Q, Liu JA, Wang Q. Associations of multiple metals with bone mineral density: A population-based study in US adults. CHEMOSPHERE 2021; 282:131150. [PMID: 34470175 DOI: 10.1016/j.chemosphere.2021.131150] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/06/2021] [Accepted: 06/08/2021] [Indexed: 06/13/2023]
Abstract
Epidemiologic studies focus on combined effects of multiple metals on bone mineral density (BMD) are scarce. Therefore, this study was conducted to examine associations of multiple metals exposure with BMD. Data of adults aged ≥20 years (n = 2545) from the US National Health and Nutrition Examination Survey (NHANES, 2011-2016) were collected and analyzed. Concentrations of metals were measured in blood (cadmium [Cd], lead [Pb], mercury [Hg], and manganese [Mn]) and serum (copper [Cu], selenium [Se], and zinc [Zn]) using inductively coupled plasma mass spectrometry and inductively coupled plasma dynamic reaction cell mass spectrometry, respectively. The weighted quantile sum (WQS) and Bayesian kernel machine regression (BKMR) models were performed to determine the joint effects of multiple metals exposure on lumbar and total BMD. The linear regression analyses showed Pb was negatively associated with BMDs. The WQS regression analyses revealed that the WQS index was inversely related to lumbar (β = -0.022, 95% CI: -0.036, -0.008) and total BMD (β = -0.015, 95% CI: -0.024, -0.006), and Se, Mn, and Pb were the main contributors for the combined effects. Additionally, nonlinear dose-response relationships between Pb, Mn, and Se and BMD, as well as a synergistic interaction of Pb and Mn, were found in the BKMR analyses. Our findings suggested co-exposure to Cd, Pb, Hg, Mn, Cu, Se, and Zn (above their 50th percentiles) was associated with reduced BMD, and Pb, Mn, and Se were the main contributors driving the overall effects.
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Affiliation(s)
- Mu-Hong Wei
- MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yuan Cui
- MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hao-Long Zhou
- MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wen-Jing Song
- MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Dong-Sheng Di
- MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ru-Yi Zhang
- MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qin Huang
- Department of Rehabilitation Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jun-An Liu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Qi Wang
- MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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12
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Li X, Li L, Yang L, Yang J, Lu H. No association between serum uric acid and lumbar spine bone mineral density in US adult males: a cross sectional study. Sci Rep 2021; 11:15588. [PMID: 34341438 PMCID: PMC8329127 DOI: 10.1038/s41598-021-95207-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 07/20/2021] [Indexed: 12/17/2022] Open
Abstract
Available evidence linking serum uric acid (SUA) and bone mineral density (BMD) remains controversial, and data on this association are limited among adult men in the general population. Thus, the aim of this study was to evaluate the association of SUA with lumbar spine BMD in US adult males. A cross-sectional study was conducted based on the National Health and Nutrition Examination Survey (NHANES, 1999–2006) database. Multivariate linear regression analyses were employed to assess the association of SUA with lumbar spine BMD, considering complex survey design and sampling weights. Through rigorous eligibility criteria, a total of 6704 individuals were yielded for final data analysis (average age, 40.5 years; 70.6% white). After fully adjusting potential confounders, no associations were detected between SUA and lumbar spine BMD [β (95% confidence interval, CI), − 0.003 (− 0.007, 0.002)]. Additionally, similar results were observed in all stratification analyses, and no interactions were found based on all priori specifications. In brief, our findings did not provide an inspiring clue for the hypothesis that SUA may be beneficial to lumbar spine BMD. Future more prospective studies are needed to further explore the causal relationship of SUA with lumbar spine BMD.
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Affiliation(s)
- Xiaoli Li
- Department of Rheumatology, Xingtai People's Hospital, Xingtai, 054001, Hebei, China. .,Department of Internal Medicine, Hebei Medical University, Shijiazhuang, 050017, Hebei, China.
| | - Lianju Li
- Department of Rheumatology, Xingtai People's Hospital, Xingtai, 054001, Hebei, China
| | - Lixian Yang
- Department of Breast Surgery, Xingtai People's Hospital, Xingtai, 054001, Hebei, China
| | - Jiaxun Yang
- Department of Information Center, Xingtai People's Hospital, Xingtai, 054001, Hebei, China
| | - Hua Lu
- Department of Nephrology, Xingtai People's Hospital, Xingtai, 054001, Hebei, China
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13
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Wang T, Zhou YP, Sun Y, Zheng YX. Trends in Blood Lead Levels in the U.S. From 1999 to 2016. Am J Prev Med 2021; 60:e179-e187. [PMID: 33485723 DOI: 10.1016/j.amepre.2020.10.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 09/27/2020] [Accepted: 10/30/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Trends in blood lead levels in the same birth cohort (generation) are necessary to identify the lead load in the population. This analysis uses a nationally representative sample to investigate the trends in blood lead levels from 1999 to 2016 by birth cohort and to revisit the association between blood lead levels and age. METHODS Data from the 1996 to 2016 National Health and Nutrition Examination Surveys were used to describe the distribution of blood lead levels. Trends in blood lead levels were analyzed using joinpoint regression models. Association of blood lead levels with age was conducted with both cross-sectional and birth cohort analysis. Analyses were conducted in 2020. RESULTS In total, 68,877 participants were included (weighted mean age=38.4 years, 50.6% female). From 1999 to 2016, the geometric mean of blood lead levels decreased from 1.68 µg/dL (95% CI=1.63, 1.74) to 0.82 µg/dL (95% CI=0.77, 0.87). The annual percentage change estimated by the joinpoint model was -4.26% (p<0.05). The associations between blood lead levels and age were "U"-shaped by cross-sectional analysis, with higher risks for the lowest and highest ages. However, by birth cohort analysis the blood lead levels declined monotonically with age. The joinpoint analysis indicated the inflection point of age 13-17 years and statistically significant differences in decline slopes before and after this age. CONCLUSIONS In this nationally representative study of the U.S. population, estimates of blood lead levels showed an overall decrease from 1999 to 2016. Blood lead levels are highest in childhood.
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Affiliation(s)
- Tao Wang
- School of Public Health, Qingdao University, Qingdao, China
| | - Yun Ping Zhou
- School of Nursing, Qingdao University, Qingdao, China
| | - Yun Sun
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Yu Xin Zheng
- School of Public Health, Qingdao University, Qingdao, China.
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14
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Everson TM, Niedzwiecki MM, Toth D, Tellez-Plaza M, Liu H, Barr DB, Gribble MO. Metal biomarker mixtures and blood pressure in the United States: cross-sectional findings from the 1999-2006 National Health and Nutrition Examination Survey (NHANES). Environ Health 2021; 20:15. [PMID: 33583418 PMCID: PMC7883578 DOI: 10.1186/s12940-021-00695-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 01/18/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND The objective of this study was to identify conditional relationships between multiple metal biomarkers that predict systolic and diastolic blood pressure in the non-institutionalized United States adult population below the age of 60. METHODS We used inorganic exposure biomarker data and blood pressure data from three cycles (1999-2004) of the National Health and Nutrition Examination Survey (NHANES) to construct regression trees for blood pressure among adults ages 20-60 (adjusted for age, sex, body mass index, race, and smoking status) to identify predictors of systolic (SBP) and diastolic blood pressure (DBP). We also considered relationships among non-Hispanic black, Mexican-American, and white adults separately. RESULTS The following metal exposure biomarkers were conditionally predictive of SBP and/or DBP in the full sample: antimony (Sb), barium (Ba), cadmium (Cd), cesium (Cs), lead (Pb), tungsten (W) and molybdenum (Mo). The highest average SBP (> 120 mmHg) was observed among those with low Sb (≤ 0.21 μg/dL) high Cd (> 0.22 μg/g creatinine) and high Pb (> 2.55 μg/dL) biomarkers. Those with the highest average DBP had high urinary W levels (> 0.10 μg/g creatinine) in combination with either urinary Sb > 0.17 μg/g creatinine or those with urinary Sb ≤ 0.17 μg/g creatinine, but with high blood Pb levels (> 1.35 μg/dL). Predictors differed by ethnicity, with Cd as the main predictor of SBP among non-Hispanic black adults, and Pb not selected by the algorithm as a predictor of SBP among non-Hispanic white adults. CONCLUSIONS Combinations of metal biomarkers have different apparent relationships with blood pressure. Additional research in toxicological experimental models and in epidemiological studies is warranted to evaluate the suggested possible toxicological interactions between Sb, Cd, and Pb; and between W, Sb, and Pb; for cardiovascular (e.g., blood pressure) health. We also think future epidemiological research on inorganic exposure sets in relation to health outcomes like blood pressure might benefit from stratification by race and ethnicity.
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Affiliation(s)
- Todd M. Everson
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Mailstop 1518-002-2BB, Atlanta, GA 30322 USA
| | - Megan M. Niedzwiecki
- Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Daniell Toth
- U.S. Bureau of Labor Statistics, Office of Survey Methods Research, D. C, Washington, USA
| | | | - Haoran Liu
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Dana B. Barr
- Laboratory for Exposure Assessment and Development for Environmental Research, Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322 USA
| | - Matthew O. Gribble
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Mailstop 1518-002-2BB, Atlanta, GA 30322 USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Mailstop 1518-002-2BB, Atlanta, GA 30322 USA
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15
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Tsoi MF, Lo CWH, Cheung TT, Cheung BMY. Blood lead level and risk of hypertension in the United States National Health and Nutrition Examination Survey 1999-2016. Sci Rep 2021; 11:3010. [PMID: 33542319 PMCID: PMC7862639 DOI: 10.1038/s41598-021-82435-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/20/2021] [Indexed: 11/26/2022] Open
Abstract
Lead is a heavy metal without a biological role. High level of lead exposure is known to be associated with hypertension, but the risk at low levels of exposure is uncertain. In this study, data from US NHANES 1999–2016 were analyzed. Adults with blood lead and blood pressure measurements, or self-reported hypertension diagnosis, were included. If not already diagnosed, hypertension was defined according to the AHA/ACC 2017 hypertension guideline. Results were analyzed using R statistics version 3.5.1 with sample weight adjustment. Logistic regression was used to study the association between blood lead level and hypertension. Odds ratio (OR) and 95% confidence interval (95% CI) were estimated. Altogether, 39,477 participants were included. Every doubling in blood lead level was associated with hypertension (OR [95%CI] 1.45 [1.40–1.50]), which remained significant after adjusting for demographics. Using quartile 1 as reference, higher blood lead levels were associated with increased adjusted odds of hypertension (Quartile 4 vs. Quartile 1: 1.22 [1.09–1.36]; Quartile 3 vs. Quartile 1: 1.15 [1.04–1.28]; Quartile 2 vs. Quartile 1: 1.14 [1.05–1.25]). In conclusion, blood lead level is associated with hypertension in the general population with blood lead levels below 5 µg/dL. Our findings suggest that reducing present levels of environmental lead exposure may bring cardiovascular benefits by reducing blood pressure.
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Affiliation(s)
- Man Fung Tsoi
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, China
| | - Chris Wai Hang Lo
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, China
| | - Tommy Tsang Cheung
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, China.,Institute of Cardiovascular Science and Medicine, The University of Hong Kong, Hong Kong, China.,Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - Bernard Man Yung Cheung
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, China. .,Partner State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong, China. .,Institute of Cardiovascular Science and Medicine, The University of Hong Kong, Hong Kong, China.
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16
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Park J, Kim Y. Associations of Blood Heavy Metals with Uric Acid in the Korean General Population: Analysis of Data from the 2016-2017 Korean National Health and Nutrition Examination Survey. Biol Trace Elem Res 2021; 199:102-112. [PMID: 32342340 DOI: 10.1007/s12011-020-02152-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 04/07/2020] [Indexed: 12/24/2022]
Abstract
We hypothesized that blood heavy metal levels such as lead, cadmium, and mercury were associated with uric acid level and hyperuricemia, and that this association remains significant after adjustment for other metals. We tested this hypothesis using the Korean National Health and Nutrition Examination Survey data. Beta coefficients and 95% confidence intervals (95% CIs) were calculated using multiple linear regression, and odds ratios (ORs) and 95% CIs were calculated using logistic regression in the cross-sectional study design. Relative to women, men had a higher geometric mean (GM) of lead (1.95 vs. 1.50 μg/dL) and mercury (3.94 vs. 2.77 μg/L), a lower GM of cadmium (0.80 vs. 1.04 μg/L), and a higher arithmetic mean (AM) of uric acid (5.84 vs. 4.40 mg/dL). Women had significant positive associations of log uric acid level with doubling of lead and mercury, and negative association with cadmium. Logistic regression analysis indicated the inverse association of serum hyperuricemia with doubling of blood metals was only significant for cadmium in women (OR = 0.641, 95% CI = 0.463 to 0.886) and the associations of serum hyperuricemia in the highest versus lowest quartiles of heavy metals were only significant for cadmium in women (OR = 0.495, 95% CI = 0.246 to 0.998). For both genders, age and estimated glomerular filtration rate (e-GFR) had negative associations with uric acid, but hypertension and triglycerides had positive associations with uric acid. In conclusion, blood lead and mercury levels were positively associated with uric acid level, but blood cadmium level was inversely associated with uric acid level and hyperuricemia in women.
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Affiliation(s)
- Jungsun Park
- Department of Occupational Health, Catholic University of Daegu, Gyeongsan, South Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, # 290-3 Cheonha-dong, Dong-gu, Ulsan, 44033, South Korea.
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17
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Upadhyay K, Viramgami A, Pagdhune A, Balachandar R, Sarkar K. Hematological and cardiovascular effects of chronic low level lead exposure: A study on e-waste recyclers. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2020.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
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18
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Teye SO, Yanosky JD, Cuffee Y, Weng X, Luquis R, Farace E, Wang L. Association between blood lead levels and blood pressure in American adults: results from NHANES 1999-2016. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:45836-45843. [PMID: 32803607 DOI: 10.1007/s11356-020-10381-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 08/03/2020] [Indexed: 06/11/2023]
Abstract
The aim of this study was to investigate the association between blood lead level (BLL) and hypertension in adults when lead exposure for the general population is low. The study used data from the US National Health and Nutrition Examination Survey (NHANES) 1999-2016. Participants aged 20 to 79 years were included in our study. Weighted multiple linear regression and logistic regression were conducted to test the association between BLL and systolic/diastolic blood pressure and hypertension status, respectively, while controlling for age, gender, race/ethnicity, body mass index, income level, and education. A total of 30,467 participants were included in this study. There was no association between BLL and hypertension status for the overall sample. Among those who were not taking antihypertensive medication, after adjusting for covariates, systolic blood pressure was positively correlated with BLL in non-Hispanic Whites (P = 0.004) and non-Hispanic Blacks (P = 0.0005), but not Hispanics (P = 0.07) nor Others (P = 0.37). The relationship between diastolic blood pressure and lead levels was also significant in non-Hispanic Whites and non-Hispanic Blacks. This study showed that higher BLL was associated with higher systolic and diastolic blood pressure in some population groups, but not associated with hypertension status.
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Affiliation(s)
- Simisola O Teye
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
| | - Jeff D Yanosky
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Yendelela Cuffee
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Xingran Weng
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Raffy Luquis
- School of Behavioral Sciences and Education, Penn State Harrisburg, Middletown, PA, USA
| | - Elana Farace
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
- Department of Neurosurgery, Penn State College of Medicine, Hershey, PA, USA
| | - Li Wang
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
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19
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Brown L, Lynch M, Belova A, Klein R, Chiger A. Developing a Health Impact Model for Adult Lead Exposure and Cardiovascular Disease Mortality. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:97005. [PMID: 32965128 PMCID: PMC7510336 DOI: 10.1289/ehp6552] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Lead (Pb) is a highly toxic pollutant. Evidence suggests it is associated with cardiovascular disease (CVD)-related mortality. OBJECTIVES We present a rigorous approach for identifying concentration-response functions that relate adult Pb exposures to CVD mortality to inform a health impact model (HIM). We then use the model in a proof-of-concept example. METHODS Building on previously conducted government literature reviews and a de novo supplemental literature review, we compiled and evaluated the available data on Pb and CVD mortality in humans. We applied a set of predefined selection criteria to identify studies that would be most useful in understanding the impact of Pb exposure on CVD mortality risk in adults. Once we identified the studies, we derived a HIM and used each study's concentration-response function in a proof-of-concept example. RESULTS Our literature search identified 15 studies for full-text review. Of those 15 studies, 4 fit our criteria for use in the HIM. Using population and CVD mortality rates for 40- to 80-y-olds in 2014, we estimated that 34,000-99,000 deaths have been avoided due to the lowering of blood Pb levels from 1999 to 2014. Based on these values we estimated that approximately 16%-46% of the decreased CVD-related death rate from 1999 to 2014 may be attributable to decreased blood Pb levels. CONCLUSION Our results demonstrate that decreases in Pb exposure can result in large benefits for the adult population. We have provided a HIM that can be used in a variety of applications from burden-of-disease estimates to regulatory impact assessments and have demonstrated its sensitivity to the choice of concentration-response function. https://doi.org/10.1289/EHP6552.
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Affiliation(s)
- Lauren Brown
- Division of Health and Environment, Abt Associates Inc., Rockville, Maryland, USA
| | - Meghan Lynch
- Division of Health and Environment, Abt Associates Inc., Rockville, Maryland, USA
| | - Anna Belova
- Abt Associates Inc., Rockville, Maryland, USA
| | - Ryan Klein
- Division of Health and Environment, Abt Associates Inc., Rockville, Maryland, USA
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20
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Yao B, Lu X, Xu L, Wang Y, Qu H, Zhou H. Relationship between low-level lead, cadmium and mercury exposures and blood pressure in children and adolescents aged 8-17 years: An exposure-response analysis of NHANES 2007-2016. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 726:138446. [PMID: 32320874 DOI: 10.1016/j.scitotenv.2020.138446] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 06/11/2023]
Abstract
This study investigated whether low-level blood and urinary lead, cadmium and mercury exposures were associated with blood pressure (BP) in children and adolescents. Data from National Health and Nutrition Examination Survey (NHANES) between 2007 and 2016 for children and adolescents aged 8-17 years (n = 7076) were analyzed. Outcome variables were systolic BP, diastolic BP and high BP status. High BP was defined as: self-reported antihypertensive medication usage or a diagnosis of hypertension; classified as having elevated BP/hypertension according to 2017 AAP guidelines. Multivariable linear and logistic regressions models were performed and stratified by race/ethnicity and gender. Blood lead was negatively associated with diastolic BP among blacks, and positively associated with diastolic BP among whites. For a two-fold increase of blood lead concentration, the change in diastolic BP was -1.59 mm Hg (95% CI: -3.04 to -0.16 mm Hg) among blacks and 1.38 mm Hg (95% CI: 0.40 to 2.36 mm Hg) among whites. No significant associations between either systolic BP or diastolic BP with urinary lead were observed. The inverse associations between blood lead and high BP were found in females, Mexican Americans and other Hispanics. No associations between blood cadmium and BP were observed, except in other Hispanics. Urinary cadmium levels were inversely correlated with systolic BP, diastolic BP and high BP in all participants and in men. When compared to the lowest quartile of urinary cadmium levels, participants with a urinary cadmium level ≥ 0.12 μg/L had 0.48 (95% CI: 0.29-0.78) times and 0.53 (95% CI: 0.30-0.94) times reduced odds of having high BP in all participants and in men, respectively. No associations between either blood mercury or urinary mercury with systolic BP were observed. Significant inverse associations were found between blood total mercury and methyl mercury with diastolic BP in all participants and in men. Future prospective studies are warranted to confirm these findings.
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Affiliation(s)
- Baodong Yao
- Department of Cardiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; Institute of Cardiovascular Disease Research, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, China
| | - Xiaojing Lu
- Department of Performance Management, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Lai Xu
- Department of Performance Management, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yue Wang
- Department of Cardiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; Institute of Cardiovascular Disease Research, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, China
| | - Huiyan Qu
- Department of Cardiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; Institute of Cardiovascular Disease Research, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, China.
| | - Hua Zhou
- Department of Cardiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; Institute of Cardiovascular Disease Research, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, China.
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21
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Miao H, Liu Y, Tsai TC, Schwartz J, Ji JS. Association Between Blood Lead Level and Uncontrolled Hypertension in the US Population (NHANES 1999-2016). J Am Heart Assoc 2020; 9:e015533. [PMID: 32573312 PMCID: PMC7670543 DOI: 10.1161/jaha.119.015533] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background This study aims to explore whether higher blood lead levels (BLL) may be associated with failure to control blood pressure and subsequent uncontrolled hypertension. Methods and Results We used serial cross‐sectional waves of the US National Health and Nutrition Examination Survey (NHANES) from 1999 to 2016. 30 762 subjects aged 20 years and above were included. Uncontrolled hypertension was defined as systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥80 mm Hg. We estimated odds ratios (ORs) of quartiles of BLL for any hypertension and uncontrolled hypertension by sex using logistic regression, adjusted for demographics, smoking status, serum cotinine, alcohol intake, body mass index, and menopause status in women. The weighted prevalence of hypertension was 46.7%, of which 80.1% were uncontrolled. Men, younger ages, ethnic minorities, people with lower income, never and current smokers, and people with higher BLL were less likely to have their hypertension controlled. In men, compared with the lowest quartile of BLL (<0.94 μg/dL), the highest 2 quartiles (0.94–1.50 μg/dL, 1.50–2.30 μg/dL) were associated with hypertension (Q2: OR, 1.12; 95% CI, 0.96–1.30; Q3: OR, 1.16; 95% CI, 1.01–1.34; Q4: OR, 1.25; 95% CI, 1.08–1.45), but not in women. In hypertensive men, higher BLL was related to uncontrolled hypertension compared with the lowest quartile (Q2: OR, 1.34; 95% CI, 0.98–1.85; Q3: OR, 1.70; 95% CI, 1.26–2.30; Q4: OR, 1.96; 95% CI, 1.45–2.65). In women, the relationship was similar (Q2: OR, 1.26; 95% CI, 0.95–1.67; Q3: OR, 1.48; 95% CI, 1.10–2.00; Q4: 1.70; 95% CI, 1.26–2.30). Conclusions BLL is associated with higher prevalence of hypertension and uncontrolled hypertension, with more pronounced association in men.
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Affiliation(s)
- Hui Miao
- Environmental Research Center Duke Kunshan University Kunshan China
| | - Yan Liu
- Department of Medicine University of Texas Dell Medical School Austin TX
| | - Thomas C Tsai
- Department of Surgery Brigham and Women's Hospital Boston MA
| | - Joel Schwartz
- Harvard T.H. Chan School of Public Health Harvard University Boston MA
| | - John S Ji
- Environmental Research Center Duke Kunshan University Kunshan China.,Nicholas School of the Environment Duke University Durham NC
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22
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A Comparison of the Nephrotoxicity of Low Doses of Cadmium and Lead. TOXICS 2020; 8:toxics8010018. [PMID: 32131418 PMCID: PMC7151741 DOI: 10.3390/toxics8010018] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/06/2020] [Accepted: 02/25/2020] [Indexed: 11/29/2022]
Abstract
Environmental exposure to moderate-to-high levels of cadmium (Cd) and lead (Pb) is associated with nephrotoxicity. In comparison, the health impacts of chronic low-level exposure to Cd and Pb remain controversial. The aim of this study was to therefore evaluate kidney dysfunction associated with chronic low-level exposure to Cd and Pb in a population of residents in Bangkok, Thailand. The mean age and the estimated glomerular filtration rate (eGFR) for 392 participants (195 men and 197 women) were 34.9 years and 104 mL/min/1.73 m2, respectively, while the geometric mean concentrations of urinary Cd and Pb were 0.25 μg/L (0.45 μg/g of creatinine) and 0.89 μg/L (1.52 μg/g of creatinine), respectively. In a multivariable regression analysis, the eGFR varied inversely with blood urea nitrogen in both men (β = −0.125, p = 0.044) and women (β = −0.170, p = 0.008), while inverse associations of the eGFR with urinary Cd (β = −0.132, p = 0.043) and urinary Pb (β = −0.130, p = 0.044) were seen only in women. An increased urinary level of Cd to the median level of 0.38 μg/L (0.44 μg/g of creatinine) was associated with a decrease in the eGFR by 4.94 mL/min/1.73 m2 (p = 0.011). The prevalence odds of a reduced eGFR rose 2.5-, 2.9- and 2.3-fold in the urinary Cd quartile 3 (p = 0.013), the urinary Cd quartile 4 (p = 0.008), and the urinary Pb quartile 4 (p = 0.039), respectively. This study suggests that chronic exposure to low-level Cd is associated with a decline in kidney function and that women may be more susceptible than men to nephrotoxicity due to an elevated intake of Cd and Pb.
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23
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Dolan LC, Flannery BM, Hoffman-Pennesi D, Gavelek A, Jones OE, Kanwal R, Wolpert B, Gensheimer K, Dennis S, Fitzpatrick S. A review of the evidence to support interim reference level for dietary lead exposure in adults. Regul Toxicol Pharmacol 2020; 111:104579. [PMID: 31945454 DOI: 10.1016/j.yrtph.2020.104579] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 12/13/2022]
Abstract
FDA developed the interim reference level (IRL) for lead of 3 μg/day in children and 12.5 μg/day in women of childbearing age (WOCBA) to better protect the fetus from lead toxicity. These IRLs correspond to a blood lead level (BLL) of 0.5 μg/dL in both populations. The current investigation was performed to determine if the IRL for WOCBA should apply to the general population of adults. A literature review of epidemiological studies was conducted to determine whether a BLL of 0.5 μg/dL is associated with adverse effects in adults. Some studies reported adverse effects over a wide range of BLLs that included 0.5 μg/dL adding uncertainty to conclusions about effects at 0.5 μg/dL; however, no studies clearly identified this BLL as an adverse effect level. Results also showed that the previously developed PTTDI for adults of 75 μg/day lead may not be health protective, supporting use of a lower reference value for lead toxicity in this population group. Use of the 12.5 μg/day IRL as a benchmark for dietary lead intake is one way FDA will ensure that dietary lead intake in adults is reduced.
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Affiliation(s)
- Laurie C Dolan
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Brenna M Flannery
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA.
| | - Dana Hoffman-Pennesi
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Alexandra Gavelek
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Olivia E Jones
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Richard Kanwal
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Beverly Wolpert
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Kathleen Gensheimer
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Sherri Dennis
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Suzanne Fitzpatrick
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
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24
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Yu CG, Wei FF, Zhang ZY, Thijs L, Yang WY, Mujaj B, Feng YM, Boggia J, Roels HA, Struijker-Boudier HAJ, Nawrot TS, Verhamme P, Staessen JA. Central hemodynamics in relation to low-level environmental lead exposure. Blood Press 2019; 29:157-167. [PMID: 31833420 DOI: 10.1080/08037051.2019.1658518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Purpose: Arterial stiffness predicts cardiovascular complications. The association between arterial stiffness and blood lead (BL) remains poorly documented. We aimed to assess the association of central hemodynamic measurements, including pulse wave velocity (aPWV), with blood lead in a Flemish population.Materials and Methods: In this Flemish population study (mean age, 37.0 years; 48.3% women), 267 participants had their whole BL and 24-h urinary cadmium (UCd) measured by electrothermal atomic absorption spectrometry in 1985-2005. After 9.4 years (median), they underwent applanation tonometry to estimate central pulse pressure (cPP), the augmentation index (AI), pressure amplification (PA), and aPWV. The amplitudes of the forward (Pf) and backward (Pb) pulse waves and reflection index (RI) were derived by a pressure-based wave separation algorithm.Results: BL averaged 2.93 μg/dL (interquartile range, 1.80-4.70) and UCd 4.79 µg (2.91-7.85). Mean values were 45.0 ± 15.2 mm Hg for cPP, 24.4 ± 12.4% for AI, 1.34 ± 0.21 for PA, 7.65 ± 1.74 m/s for aPWV, 32.7 ± 9.9 mm Hg for Pf, 21.8 ± 8.4 mm Hg for Pb, and 66.9 ± 18.4% for RI. The multivariable-adjusted association sizes for a 2-fold higher BL were: +3.03% (95% confidence interval, 1.56, 4.50) for AI; -0.06 (-0.08, -0.04) for PA; 1.02 mm Hg (0.02, 2.02) for Pb; and 3.98% (1.71, 6.24) for RI (p ≤ .045). In 206 participants never on antihypertensive drug treatment, association sizes were +2.59 mm Hg (0.39, 4.79) for cPP and +0.26 m/s (0.03, 0.50) for aPWV. Analyses adjusted for co-exposure to cadmium were consistent.Conclusion: In conclusion, low-level environmental lead exposure possibly contributes to arterial stiffening and wave reflection from peripheral sites.
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Affiliation(s)
- Cai-Guo Yu
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.,Department of Endocrinology, Beijing Luhe Hospital and, Key Laboratory of Diabetes Prevention and Research, Capital Medical University, Beijing, China
| | - Fang-Fei Wei
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Wen-Yi Yang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.,Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Blerim Mujaj
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Ying-Mei Feng
- Department of Endocrinology, Beijing Luhe Hospital and, Key Laboratory of Diabetes Prevention and Research, Capital Medical University, Beijing, China
| | - José Boggia
- Unidad de Hipertensión Arterial, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - Harry A Roels
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | | | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Peter Verhamme
- Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Jan A Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
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25
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Zheutlin AR, Hu H, Weisskopf MG, Sparrow D, Vokonas PS, Park SK. Low-Level Cumulative Lead and Resistant Hypertension: A Prospective Study of Men Participating in the Veterans Affairs Normative Aging Study. J Am Heart Assoc 2019; 7:e010014. [PMID: 30608198 PMCID: PMC6404221 DOI: 10.1161/jaha.118.010014] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background Bone lead offers a better method over blood lead measurement to discern long‐term lead exposure and accumulation. We examined the risk of resistant hypertension based on bone lead levels in a prospective cohort study of NAS (Normative Aging Study). Methods and Results Participants had clinic data on hypertension (systolic blood pressure, diastolic blood pressure, and antihypertension medication), lead (blood, bone‐patella, bone‐tibia), and demographic and confounding variables. Cases of resistant hypertension were identified by meeting criteria for: (1) inadequate systolic blood pressure (>140 mm Hg) or diastolic blood pressure (>90 mm Hg) while taking 3 medications or (2) requiring >4 medications for blood pressure control. A modified Poisson regression was used for model analysis. Of the 475 participants, 97 cases of resistant hypertension (20.4%) were identified. Among the cases of resistant hypertension, the median tibia and patella lead levels were 20 μg/g and 25 μg/g, respectively, while median tibia and patella lead levels were 20 μg/g and 27.5 μg/g, respectively, in participants without resistant hypertension. Tibia lead demonstrated a significant association with resistant hypertension (relative risk, 1.19; 95% confidence interval, 1.01–1.41 [P=0.04]) per interquartile range increase in tibia lead (13–28.5 μg/g). Patella lead was not associated with resistant hypertension (relative risk, 1.10; 95% confidence interval, 0.92–1.31 [P=0.31]) per interquartile range increase in patella lead (18–40 μg/g). Blood lead levels were not significantly associated with resistant hypertension (relative risk, 1.11; 95% confidence interval, 0.88–1.40 [P=0.38]). Conclusions Tibia lead represents a novel risk factor for resistant hypertension. Our study demonstrates an increased association between tibia lead and resistant hypertension status, with an increased risk of 19% per 1 interquartile range increase in tibia lead.
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Affiliation(s)
- Alexander R Zheutlin
- 1 Department of Epidemiology University of Michigan Ann Arbor MI.,2 University of Michigan Medical School Ann Arbor MI
| | - Howard Hu
- 3 School of Public Health, University of Washington Seattle WA
| | - Marc G Weisskopf
- 4 Department of Epidemiology, Harvard T.H. Chan School of Public Health Boston MA
| | - David Sparrow
- 5 VA Normative Aging Study Veterans Affairs Boston Health Care System Boston MA.,6 Department of Medicine Boston University School of Medicine Boston MA
| | - Pantel S Vokonas
- 5 VA Normative Aging Study Veterans Affairs Boston Health Care System Boston MA.,6 Department of Medicine Boston University School of Medicine Boston MA
| | - Sung Kyun Park
- 1 Department of Epidemiology University of Michigan Ann Arbor MI
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26
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Hu G, Jia G, Tang S, Zheng P, Hu L. Association of low-level blood lead with serum uric acid in U.S. adolescents: a cross-sectional study. Environ Health 2019; 18:86. [PMID: 31619249 PMCID: PMC6794798 DOI: 10.1186/s12940-019-0524-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 09/22/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Uncertainty remains regarding the association between blood lead levels (BLL) and serum uric acid (SUA) with relatively low BLL exposure because of limited data in the adolescent population. We examined the association between BLL and SUA in U.S. adolescents. METHODS In this cross-sectional study, 8303 adolescents aged 12-19 years from NHANES 1999-2006 were analyzed. BLL was Ln-transformed for analysis for the skewed distribution. Elevated SUA was defined as ≥5.5 mg/dL. Multivariate linear and multiple logistic regression analyses were performed to evaluate the association of BLL with SUA and elevated SUA. Moreover, a generalized additive model (GAM) and a fitted smoothing curve (penalized spline method) were conducted. RESULTS The overall mean BLL was 1.3 μg/dL. Multivariate linear regression analyses showed that LnBLL was independently and positively correlated with SUA level (β = 0.13, 95%CI: 0.09-0.17). Multiple logistic analyses showed that LnBLL was associated with a 24% increased prevalence of elevated SUA (OR = 1.24; 95% CI, 1.11-1.38). Analyses using restricted cubic spline confirmed that the associations of LnBLL with SUA and elevated SUA were linear. Subgroup analyses showed that stronger associations between LnBLL and SUA were detected in adolescents with lower levels of education and estimated glomerular filtration rate (eGFR) (all P for interaction < 0.05). CONCLUSIONS BLL was independently and positively correlated with SUA level and elevated SUA among U.S. adolescents, particularly with lower levels of education and eGFR. The data suggest that there is no "safe" threshold level of exposure to lead.
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Affiliation(s)
- Guiping Hu
- School of Medicine, Beihang University, Beijing, 100191 China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing, 100191 China
- Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, 100083 China
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191 China
| | - Guang Jia
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191 China
| | - Shichuan Tang
- Key Laboratory of Occupational Safety and Health, Beijing Municipal Institute of Labor Protection, Beijing, 100054 China
| | - Pai Zheng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191 China
| | - Lihua Hu
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006 Jiangxi China
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27
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Yu CG, Wei FF, Yang WY, Zhang ZY, Mujaj B, Thijs L, Feng YM, Boggia J, Nawrot TS, Struijker-Boudier HAJ, Staessen JA. Central hemodynamics in relation to blood lead in young men prior to chronic occupational exposure. Blood Press 2019; 28:279-290. [DOI: 10.1080/08037051.2019.1610654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Cai-Guo Yu
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- Department of Endocrinology, Beijing Luhe Hospital and Key Laboratory of Diabetes Prevention and Research, Capital Medical University, Beijing, China
| | - Fang-Fei Wei
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Wen-Yi Yang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Blerim Mujaj
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Ying-Mei Feng
- Department of Endocrinology, Beijing Luhe Hospital and Key Laboratory of Diabetes Prevention and Research, Capital Medical University, Beijing, China
| | - José Boggia
- Unidad de Hipertensión Arterial, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - Tim S. Nawrot
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | | | - Jan A. Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
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28
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Madrigal JM, Ricardo AC, Persky V, Turyk M. Associations between blood cadmium concentration and kidney function in the U.S. population: Impact of sex, diabetes and hypertension. ENVIRONMENTAL RESEARCH 2019; 169:180-188. [PMID: 30466011 PMCID: PMC6347526 DOI: 10.1016/j.envres.2018.11.009] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/09/2018] [Accepted: 11/05/2018] [Indexed: 05/03/2023]
Abstract
BACKGROUND Exposure to cadmium has been associated with nephropathy and implicated in the development of diabetes and hypertension. The role of environmental metal exposure may be an underexplored risk factor for decreased kidney function among people with diabetes and/or hypertension. The objective of this study was to examine the association of blood concentration of cadmium with kidney function parameters and evaluate sex, diabetes, and hypertension as effect modifiers of the association. METHODS This study used data from 12,577 adult participants in the National Health and Nutrition Examination Survey (NHANES) 2007-2012 cycles. We used multivariable linear and logistic regression models to conduct a cross-sectional analysis of the association between cadmium exposure quartiles and estimated glomerular filtration rate (eGFR), urine albumin to creatinine ratio (UACR), low eGFR (defined as eGFR <60 mL/minute/1.73 m2), and albuminuria (defined as UACR ≥ 30 mg/g). Models were adjusted for confounders and interaction terms were evaluated for cadmium concentration and sex, diabetes, and hypertension. Final models were stratified by sex and indices of existing diabetes and hypertension status. RESULTS The mean eGFR was 94.3 mL/minute/1.73 m2 (SD 21.5) and the geometric mean of UACR was 7.9 mg/g (95% CI 7.6-8.2 mg/g). Blood cadmium concentration was inversely associated with eGFR and positively associated with UACR. We found significant effect modification of the association of eGFR with cadmium, predominantly for sex and hypertension. The strength of the association between cadmium quartiles and eGFR was more pronounced among females compared to males. Among females with hypertension and diabetes, eGFR was lower on average by 4.9 mL/minute/1.73 m2 (95% CI -10.1 to 0.29) in the highest versus lowest cadmium quartile, and in females with hypertension alone, eGFR was lower on average by 5.8 mL/minute/1.73 m2 (95% CI -8.2 to -3.3) in the highest versus lowest cadmium quartile. Among those in the highest exposure quartile, higher mean UACR was observed among participants with hypertension compared to those without. CONCLUSIONS Our results confirm that cadmium exposure is associated with decreased glomerular filtration and increased urine protein excretion, and provide evidence that the magnitude of these associations differ by sex and may vary based on preexisting diabetes and hypertension. Future prospective sex-specific investigations are necessary to address concerns of reverse causality and efforts should be made to reduce smoking and environmental contamination from cadmium to protect human health.
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Affiliation(s)
- Jessica M Madrigal
- Division of Epidemiology & Biostatistics, University of Illinois at Chicago, 1603 West Taylor Street, Chicago, IL 60612, United States.
| | - Ana C Ricardo
- Division of Nephrology, University of Illinois at Chicago, 808 South Wood Street, Chicago, IL 60612, United States
| | - Victoria Persky
- Division of Epidemiology & Biostatistics, University of Illinois at Chicago, 1603 West Taylor Street, Chicago, IL 60612, United States
| | - Mary Turyk
- Division of Epidemiology & Biostatistics, University of Illinois at Chicago, 1603 West Taylor Street, Chicago, IL 60612, United States
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29
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Wang Q, Wei S. Cadmium affects blood pressure and negatively interacts with obesity: Findings from NHANES 1999-2014. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 643:270-276. [PMID: 29936168 DOI: 10.1016/j.scitotenv.2018.06.105] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 05/05/2018] [Accepted: 06/09/2018] [Indexed: 06/08/2023]
Abstract
Inconsistencies are noted regarding the association between cadmium exposure and blood pressure/hypertension and the interaction between cadmium and body mass index (BMI). This study aims to clarify these inconsistencies in a large sample (n = 32,791) of adults age ≥20 years from eight cycles of the US National Health Examination and Nutrition Survey (NHANES, 1999-2014). The cadmium levels in blood (BCd) and urine (UCd) were used as exposure biomarker. Multiple-linear/logistic regression models were built and stratified by sex, ethnicity and BMI category. The interaction between BCd and BMI was assessed on additive and multiplicative scales. A twofold increase in BCd was associated with 0.54 mm Hg (95% CI: 0.49, 0.58) and 0.05 mm Hg (95% CI: 0.04, 0.06) increases in the systolic blood pressure (SBP) and diastolic blood pressure (DBP), respectively, in black women. The SBP and DBP increased by 0.92 mm Hg (95% CI: 0.73, 1.11) and 0.85 mm Hg (95% CI: 0.65, 1.05), respectively, in Mexican-Am women. Significant associations were found between BCd and hypertension in them (systolic risk per twofold BCd, OR = 1.31; 95% CI: 1.07, 1.61; and diastolic risk per twofold BCd, OR = 1.55; 95% CI: 1.17, 2.05). UCd was significantly associated with hypertension in all individuals (OR = 1.14 per twofold; 95% CI: 1.07, 1.21). The associations between cadmium exposure and blood pressure/hypertension showed some discrepancies across BMI categories. A negative interaction was observed between BCd and obesity with regard to their effects on systolic hypertension (RERI = -0.30; 95% CI: -0.56, -0.03; ratio of ORs = 0.55; 95% CI: 0.35, 0.89). Our findings provided evidence for the effect of cadmium on blood pressure and the prevalence of hypertension in American adults. The associations showed discrepancies by sex and ethnicity. The negative interaction between cadmium exposure and obesity influenced systolic hypertension risk.
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Affiliation(s)
- Qi Wang
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubation), Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Sheng Wei
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubation), Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
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30
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Satarug S, Boonprasert K, Gobe GC, Ruenweerayut R, Johnson DW, Na-Bangchang K, Vesey DA. Chronic exposure to cadmium is associated with a marked reduction in glomerular filtration rate. Clin Kidney J 2018; 12:468-475. [PMID: 31384436 PMCID: PMC6671389 DOI: 10.1093/ckj/sfy113] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Indexed: 01/09/2023] Open
Abstract
Background Urinary 20-hydroxyeicosatetraenoic acid (20-HETE) has been associated with hypertension in women with elevated urinary cadmium (Cd) excretion rates. The present study investigates the urinary Cd and 20-HETE levels in relation to the estimated glomerular filtration rate (eGFR) and albumin excretion in men and women. Methods A population-based, cross-sectional study, which included 225 women and 84 men aged 33–55 years, was conducted in a rural area known to be polluted with Cd. Results In all subjects, lower eGFR values were associated with higher urinary Cd excretion (P = 0.030), and tubulopathy markers N-acetyl-β-d-glucosaminidase (P < 0.001) and β2-microglobulin (β2-MG) (P < 0.001). On average, the hypertensive subjects with the highest quartile of urinary Cd had eGFR values of 12 and 17 mL/min/1.73 m2 lower than that in the hypertensive (P = 0.009) and normotensive subjects (P < 0.001) with the lowest quartile of urinary Cd, respectively. In men, urinary albumin was inversely associated with 20-HETE (β = −0.384, P < 0.001), while showing a moderately positive association with systolic blood pressure (SBP) (β = 0.302, P = 0.037). In women, urinary albumin was not associated with 20-HETE (P = 0.776), but was associated with tubulopathy, reflected by elevated urinary excretion of β2-MG (β = 0.231, P = 0.002). Conclusions Tubulopathy is a determinant of albumin excretion in women, while 20-HETE and SBP are determinants of urinary albumin excretion in men. Associations of chronic exposure to Cd with marked eGFR decline and renal tubular injury seen in both Cd-exposed men and women add to mounting research data that links Cd to the risk of developing chronic kidney disease.
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Affiliation(s)
- Soisungwan Satarug
- Centre for Kidney Disease Research, Faculty of Medicine, Translational Research Institute, University of Queensland, Brisbane, Australia
| | - Kanyarat Boonprasert
- Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand
| | - Glenda C Gobe
- Centre for Kidney Disease Research, Faculty of Medicine, Translational Research Institute, University of Queensland, Brisbane, Australia
| | | | - David W Johnson
- Centre for Kidney Disease Research, Faculty of Medicine, Translational Research Institute, University of Queensland, Brisbane, Australia.,Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
| | - Kesara Na-Bangchang
- Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand
| | - David A Vesey
- Centre for Kidney Disease Research, Faculty of Medicine, Translational Research Institute, University of Queensland, Brisbane, Australia.,Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
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Satarug S. Dietary Cadmium Intake and Its Effects on Kidneys. TOXICS 2018; 6:E15. [PMID: 29534455 PMCID: PMC5874788 DOI: 10.3390/toxics6010015] [Citation(s) in RCA: 172] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 03/08/2018] [Accepted: 03/09/2018] [Indexed: 12/11/2022]
Abstract
Cadmium (Cd) is a food-chain contaminant that has high rates of soil-to-plant transference. This phenomenon makes dietary Cd intake unavoidable. Although long-term Cd intake impacts many organ systems, the kidney has long been considered to be a critical target of its toxicity. This review addresses how measurements of Cd intake levels and its effects on kidneys have traditionally been made. These measurements underpin the derivation of our current toxicity threshold limit and tolerable intake levels for Cd. The metal transporters that mediate absorption of Cd in the gastrointestinal tract are summarized together with glomerular filtration of Cd and its sequestration by the kidneys. The contribution of age differences, gender, and smoking status to Cd accumulation in lungs, liver, and kidneys are highlighted. The basis for use of urinary Cd excretion to reflect body burden is discussed together with the use of urinary N-acetyl-β-d-glucosaminidase (NAG) and β2-microglobulin (β2-MG) levels to quantify its toxicity. The associations of Cd with the development of chronic kidney disease and hypertension, reduced weight gain, and zinc reabsorption are highlighted. In addition, the review addresses how urinary Cd threshold levels have been derived from human population data and their utility as a warning sign of impending kidney malfunction.
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Affiliation(s)
- Soisungwan Satarug
- Centre for Kidney Disease Research and Translational Research Institute, The University of Queensland Diamantina Institute and Centre for Health Services Research, Woolloongabba, Brisbane 4102, Australia.
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Boonprasert K, Vesey DA, Gobe GC, Ruenweerayut R, Johnson DW, Na-Bangchang K, Satarug S. Is renal tubular cadmium toxicity clinically relevant? Clin Kidney J 2018; 11:681-687. [PMID: 30288264 PMCID: PMC6165745 DOI: 10.1093/ckj/sfx153] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 11/27/2017] [Indexed: 11/14/2022] Open
Abstract
Background Exposure to cadmium (Cd) has been associated with the development of hypertension, especially in women, but the mechanism of such an association is not understood. We hypothesize that Cd exposure alters renal production of 20-hydroxyeicosatetraenoic acid (20-HETE), which plays an indispensable role in renal salt balance and blood pressure control. Methods We examined long-term Cd exposure in relation to urinary 20-HETE excretion levels, tubular dysfunction and blood pressure measures, using data from a population-based, cross-sectional study that included 115 normotensive and 110 hypertensive women, 33-55 years of age, who lived in Cd contamination areas in Thailand. Results The mean [standard deviation (SD)] blood Cd level of the study subjects was 3.57 (3.3) µg/L, while the mean (SD) urinary Cd and urinary 20-HETE levels were 0.58 (0.47) µg/g creatinine and 1651 (4793) pg/mL, respectively. Elevated 20-HETE levels were associated with a 90% increase in prevalence odds of hypertension (P = 0.029), four times greater odds of having higher urinary Cd levels (P = 0.030) and a 53% increase in odds of having higher levels of tubular dysfunction (P = 0.049), evident from an increase in urinary excretion of β2-microglobulin. In normotensive subjects, an increase in urinary 20-HETE levels from tertile 1 to tertile 3 was associated with a systolic blood pressure increase of 6 mmHg (95% confidence interval 0.3-12, P = 0.040). Conclusions This is the first report that links urinary 20-HETE levels to blood pressure increases in Cd-exposed women, thereby providing a plausible mechanism for associated development of hypertension.
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Affiliation(s)
- Kanyarat Boonprasert
- Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand
| | - David A Vesey
- Centre for Kidney Disease Research, UQ Diamantina Institute and Centre for Health Services Research, Translational Research Institute, University of Queensland, Brisbane, Australia.,Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
| | - Glenda C Gobe
- Centre for Kidney Disease Research, UQ Diamantina Institute and Centre for Health Services Research, Translational Research Institute, University of Queensland, Brisbane, Australia
| | | | - David W Johnson
- Centre for Kidney Disease Research, UQ Diamantina Institute and Centre for Health Services Research, Translational Research Institute, University of Queensland, Brisbane, Australia.,Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
| | - Kesara Na-Bangchang
- Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand
| | - Soisungwan Satarug
- Centre for Kidney Disease Research, UQ Diamantina Institute and Centre for Health Services Research, Translational Research Institute, University of Queensland, Brisbane, Australia
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Ngueta G, Verner MA, Fiocco AJ, Lupien S, Plusquellec P. Blood lead levels and hypothalamic-pituitary-adrenal function in middle-aged individuals. ENVIRONMENTAL RESEARCH 2018; 160:554-561. [PMID: 29102031 DOI: 10.1016/j.envres.2017.10.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 09/10/2017] [Accepted: 10/19/2017] [Indexed: 06/07/2023]
Abstract
Experimental and epidemiological studies suggested that exposure to lead (Pb) may influence the hypothalamic-pituitary-adrenal (HPA) axis. However, previous studies have yielded mixed results. We evaluated changes in basal salivary cortisol levels and acute cortisol responsivity to psychological stress in relation with blood Pb levels (BPb), in Caucasian individuals 50-67 years of age. Data were collected through the Study of Genetics, Stress and Cognitive Development (2004-2006). Diurnal basal and stress-reactive salivary cortisol levels were collected and BPb levels were determined using inductively coupled plasma mass spectroscopy. A total of 65 participants were included in the current study. General linear mixed models were used to assess the association between BPb level and change in cortisol secretion over time, for diurnal basal pattern and stress-reactive pattern, respectively. The geometric mean BPb was 2.70μg/dL (± 1.44) and two exposure groups were created based on the median value of 2.48µg/dL. No difference in geometric mean of salivary cortisol (µg/dL) at awakening was observed between High and Low BPb groups (0.23 (± 0.11) vs 0.20 (± 0.11), p = 0.36). The overall pattern of change in both diurnal basal (from the awakening to bedtime) and reactive salivary cortisol (during the stress induction protocol) did not differ between groups. In these middle-aged and older adults, we concluded that Pb exposure, within the range observed in the current study, was associated with neither diurnal nor stress-reactive cortisol secretion. Further investigation with larger datasets are needed to confirm our observations.
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Affiliation(s)
- Gérard Ngueta
- Department of Occupational and Environmental Health, Université de Montréal, Montreal, Canada; Université de Montréal Public Health Research Institute, Montreal, Canada.
| | - Marc-André Verner
- Department of Occupational and Environmental Health, Université de Montréal, Montreal, Canada; Université de Montréal Public Health Research Institute, Montreal, Canada
| | | | - Sonia Lupien
- Center for Studies on Human Stress, Montreal Mental Health University Institute, Montreal, Canada; Department of Psychiatry, Université de Montréal, Montreal, Canada
| | - Pierrich Plusquellec
- Center for Studies on Human Stress, Montreal Mental Health University Institute, Montreal, Canada; School of Psychoeducation, Université de Montréal, Montreal, Canada.
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Satarug S, Vesey DA, Gobe GC. Current health risk assessment practice for dietary cadmium: Data from different countries. Food Chem Toxicol 2017; 106:430-445. [PMID: 28602857 DOI: 10.1016/j.fct.2017.06.013] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 06/05/2017] [Accepted: 06/06/2017] [Indexed: 02/01/2023]
Abstract
Cadmium (Cd) is an environmental toxicant with high rates of soil-to-plant transference. This makes exposure to Cd through the food-chain contamination a public health concern. Cd accumulates in kidneys, and the most frequently reported adverse effect of long-term Cd intake is injury to kidneys. The FAO/WHO Joint Expert Committee on Food Additives established a tolerable dietary intake level and a threshold to safeguard population health. The FAO/WHO tolerable intake was set at 25 μg per kg body weight per month (58 μg per day for a 70-kg person) with urinary Cd threshold at 5.24 μg/g creatinine. Worldwide population data indicate that urinary Cd excretion reflects cumulative Cd exposure or body burden more accurately than estimated Cd intake, derived from total diet study (TDS). For the adult population, TDS estimated Cd intake of 8-25 μg/day, while urinary Cd levels suggest higher intake levels (>30 μg/day). These Cd intake estimates are below the FAO/WHO intake guideline, but they exceed the levels that are associated with distinct pathologies in many organ systems. A wide diversity of Cd toxicity targets and Cd toxicity levels argue for a more restrictive dietary Cd intake guideline and the measures that minimize Cd levels in foodstuffs.
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Affiliation(s)
- Soisungwan Satarug
- UQ Diamantina Institute and Centre for Health Services Research, Translational Research Institute, The University of Queensland, Woolloongabba, Brisbane, Australia.
| | - David A Vesey
- UQ Diamantina Institute and Centre for Health Services Research, Translational Research Institute, The University of Queensland, Woolloongabba, Brisbane, Australia; Department of Renal Medicine, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane, Australia
| | - Glenda C Gobe
- UQ Diamantina Institute and Centre for Health Services Research, Translational Research Institute, The University of Queensland, Woolloongabba, Brisbane, Australia
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Shi Z, Zhen S, Orsini N, Zhou Y, Zhou Y, Liu J, Taylor AW. Association between dietary lead intake and 10-year mortality among Chinese adults. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2017; 24:12273-12280. [PMID: 28357790 DOI: 10.1007/s11356-017-8871-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 03/20/2017] [Indexed: 06/06/2023]
Abstract
Blood lead level is associated with increased risk of mortality, but dietary lead exposure and mortality, particularly with cancer, has not been studied in the general population. The objective of the study was to assess the association between lead intake and 10-year mortality among 2832 Chinese adults. Food intake was measured by 3-day weighed food record in 2002. We documented 184 deaths (63 cancer deaths and 70 cardiovascular disease (CVD) deaths) during 27,742 person-years of follow-up. Dietary lead intake was positively associated with cancer and all-cause mortality. Across quartiles of lead intake, hazard ratios (HRs) for cancer mortality were 1.00, 0.80 (0.33-1.92), 1.52 (0.65-3.56), and 3.00 (1.06-8.44) (p for trend 0.028). HRs for all-cause mortality were 1.00, 1.28 (0.83-1.98), 1.24 (0.78-1.97), and 2.24 (1.28-3.94) (p for trend 0.011). Each 30 μg/day increase of lead intake was associated with 25% (95% CI 3-52%) increase of all-cause mortality. There was an interaction between lead intake and hypertension in relation to CVD mortality (p for interaction 0.003): HRs conferred by every 30 μg/day of lead intake were 1.57 (0.98-2.52) and 1.06 (0.81-1.39) among those with or without hypertension. Dietary lead intake was positively related to cancer and all-cause mortality.
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Affiliation(s)
- Zumin Shi
- Department of Nutrition and Foodborne Disease Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China.
- Discipline of Medicine, University of Adelaide, L7 SAHMRI, North Terrace, Adelaide, 5000, Australia.
- Discipline of Medicine, University of Adelaide, 122 Frome Street, Adelaide, 5005, Australia.
| | - Shiqi Zhen
- Department of Nutrition and Foodborne Disease Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China
| | - Nicola Orsini
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Yonglin Zhou
- Department of Nutrition and Foodborne Disease Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China
| | - Yijing Zhou
- Department of Nutrition and Foodborne Disease Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China
| | - Jianghong Liu
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Anne W Taylor
- Discipline of Medicine, University of Adelaide, L7 SAHMRI, North Terrace, Adelaide, 5000, Australia
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Garner RE, Levallois P. Associations between cadmium levels in blood and urine, blood pressure and hypertension among Canadian adults. ENVIRONMENTAL RESEARCH 2017; 155:64-72. [PMID: 28189876 DOI: 10.1016/j.envres.2017.01.040] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 01/05/2017] [Accepted: 01/31/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Cadmium has been inconsistently related to blood pressure and hypertension. The present study seeks to clarify the relationship between cadmium levels found in blood and urine, blood pressure and hypertension in a large sample of adults. METHODS The study sample included participants ages 20 through 79 from multiple cycles of the Canadian Health Measures Survey (2007 through 2013) with measured blood cadmium (n=10,099) and urinary cadmium (n=6988). Linear regression models examined the association between natural logarithm transformed cadmium levels and blood pressure (separate models for systolic and diastolic blood pressure) after controlling for known covariates. Logistic regression models were used to examine the association between cadmium and hypertension. Models were run separately by sex, smoking status, and body mass index category. RESULTS Men had higher mean systolic (114.8 vs. 110.8mmHg, p<0.01) and diastolic (74.0 vs. 69.6mmHg, p<0.01) blood pressure compared to women. Although, geometric mean blood (0.46 vs. 0.38µg/L, p<0.01) and creatinine-adjusted standardized urinary cadmium levels (0.48 vs. 0.38µg/L, p<0.01) were higher among those with hypertension, these differences were no longer significant after adjustment for age, sex and smoking status. In overall regression models, increases in blood cadmium were associated with increased systolic (0.70mmHg, 95% confidence interval [CI]=0.25-1.16, p<0.01) and diastolic blood pressure (0.74mmHg, 95% CI=0.30-1.19, p<0.01). The associations between urinary cadmium, blood pressure and hypertension were not significant in overall models. Model stratification revealed significant and negative associations between urinary cadmium and hypertension among current smokers (OR=0.61, 95% CI=0.44-0.85, p<0.01), particularly female current smokers (OR=0.52, 95% CI=0.32-0.85, p=0.01). CONCLUSION This study provides evidence of a significant association between cadmium levels, blood pressure and hypertension. However, the significance and direction of this association differs by sex, smoking status, and body mass index category.
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Affiliation(s)
- Rochelle E Garner
- Health Analysis Division, Statistics Canada, Ottawa, Ontario, Canada.
| | - Patrick Levallois
- Direction de la santé environnementale et de la toxicologie, Institut National de Santé Publique du Québec, Québec City, Québec, Canada; Axe santé des populations et pratiques optimales en santé, Centre de Recherche du CHU de Québec-Université Laval, Québec City, Québec, Canada
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Luo Y, McCullough LE, Tzeng JY, Darrah T, Vengosh A, Maguire RL, Maity A, Samuel-Hodge C, Murphy SK, Mendez MA, Hoyo C. Maternal blood cadmium, lead and arsenic levels, nutrient combinations, and offspring birthweight. BMC Public Health 2017; 17:354. [PMID: 28438148 PMCID: PMC5402649 DOI: 10.1186/s12889-017-4225-8] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 04/05/2017] [Indexed: 12/24/2022] Open
Abstract
Background Cadmium (Cd), lead (Pb) and arsenic (As) are common environmental contaminants that have been associated with lower birthweight. Although some essential metals may mitigate exposure, data are inconsistent. This study sought to evaluate the relationship between toxic metals, nutrient combinations and birthweight among 275 mother-child pairs. Methods Non-essential metals, Cd, Pb, As, and essential metals, iron (Fe), zinc (Zn), selenium (Se), copper (Cu), calcium (Ca), magnesium (Mg), and manganese (Mn) were measured in maternal whole blood obtained during the first trimester using inductively coupled plasma mass spectrometry. Folate concentrations were measured by microbial assay. Birthweight was obtained from medical records. We used quantile regression to evaluate the association between toxic metals and nutrients due to their underlying wedge-shaped relationship. Ordinary linear regression was used to evaluate associations between birth weight and toxic metals. Results After multivariate adjustment, the negative association between Pb or Cd and a combination of Fe, Se, Ca and folate was robust, persistent and dose-dependent (p < 0.05). However, a combination of Zn, Cu, Mn and Mg was positively associated with Pb and Cd levels. While prenatal blood Cd and Pb were also associated with lower birthweight. Fe, Se, Ca and folate did not modify these associations. Conclusion Small sample size and cross-sectional design notwithstanding, the robust and persistent negative associations between some, but not all, nutrient combinations with these ubiquitous environmental contaminants suggest that only some recommended nutrient combinations may mitigate toxic metal exposure in chronically exposed populations. Larger longitudinal studies are required to confirm these findings. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4225-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yiwen Luo
- Bioinformatics Research Center, North Carolina State University, Raleigh, NC, USA.,Department of Statistics, North Carolina State University, Raleigh, NC, USA
| | | | - Jung-Ying Tzeng
- Bioinformatics Research Center, North Carolina State University, Raleigh, NC, USA. .,Department of Statistics, North Carolina State University, Raleigh, NC, USA. .,Department of Statistics, National Cheng-Kung University, Tainan, Taiwan.
| | - Thomas Darrah
- School of Earth Sciences, The Ohio State University, Columbus, OH, USA
| | - Avner Vengosh
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | - Rachel L Maguire
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27533, USA
| | - Arnab Maity
- Department of Statistics, North Carolina State University, Raleigh, NC, USA
| | | | | | | | - Cathrine Hoyo
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27533, USA.
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Almeida Lopes ACBD, Silbergeld EK, Navas-Acien A, Zamoiski R, Martins Jr. ADC, Camargo AEI, Urbano MR, Mesas AE, Paoliello MMB. Association between blood lead and blood pressure: a population-based study in Brazilian adults. Environ Health 2017; 16:27. [PMID: 28292314 PMCID: PMC5351182 DOI: 10.1186/s12940-017-0233-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Accepted: 03/03/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Environmental lead exposure among adults may increase blood pressure and elevate the risk of hypertension. The availability of data on blood lead levels (BLL) in adult Brazilian population is scarce and population-based studies are important for screening the population exposure and also to evaluate associations with adverse health effects. The goal of this study was to examine the association of BLL with blood pressure and hypertension in a population-based study in a city in Southern Brazil. METHODS A total of 948 adults, aged 40 years or older, were randomly selected. Information on socioeconomic, dietary, lifestyle and occupational background was obtained by orally administered household interviews. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured according to the guidelines VI Brazilian Guidelines on Hypertension. BLL were measured by inductively coupled plasma mass spectrometry technique. Multiple linear and logistic regression models were performed to evaluate associations of BLL with SBP and DBP, and with the chance of hypertension and of elevated SBP and DBP. RESULTS The geometric mean of BLL was 1.97 μg/dL (95%CI:1.90-2.04 μg/dL). After multivariable adjustment, participants in the quartile 4 of blood lead presented 0.06 mm/Hg (95%CI, 0.04-0.09) average difference in DBP comparing with those in quartile 1. Participants in the 90th percentile of blood lead distribution had 0.07 mmHg (95% CI, 0.03 to 0.11) higher DBP compared with those participants in the 10th percentile of blood lead. The adjusted OR for hypertension was 2.54 (95% CI, 1.17-5.53), comparing the highest to the lowest blood lead quartiles. Compared with participants in the 10th percentile of blood lead, participants in the 90th percentile presented higher OR for hypertension (OR: 2.77; 95% CI, 1.41 to 5.46). CONCLUSION At low concentrations, BLL were positively associated with DBP and with the odds for hypertension in adults aged 40 or older. It is important to enforce lead exposure monitoring and the enactment of regulatory laws to prevent lead contamination in urban settings.
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Affiliation(s)
| | - Ellen Kovner Silbergeld
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Rachel Zamoiski
- Radiation Epidemiology Branch of the Division of Cancer Epidemiology and Genetics National Cancer Institute, National Institutes of Health, Washington D.C., USA
| | - Airton da Cunha Martins Jr.
- Graduate Program in Toxicology, Faculty of Pharmaceutical Sciences of University of São Paulo – USP, Ribeirão Preto, São Paulo Brazil
| | - Alissana Ester Iakmiu Camargo
- Graduate Program in Health Sciences, Center of Health Sciences, State University of Londrina - UEL, Londrina, Paraná Brazil
| | - Mariana Ragassi Urbano
- Graduate Program in Public Health, Center of Health Sciences, State University of Londrina - UEL, Londrina, Paraná Brazil
- Department of Statistics, State University of Londrina - UEL, Londrina, Paraná Brazil
| | - Arthur Eumann Mesas
- Graduate Program in Public Health, Center of Health Sciences, State University of Londrina - UEL, Londrina, Paraná Brazil
- Department of Public Health, State University of Londrina – UEL, Londrina, Paraná Brazil
| | - Monica Maria Bastos Paoliello
- Graduate Program in Public Health, Center of Health Sciences, State University of Londrina - UEL, Londrina, Paraná Brazil
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY 10461 USA
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Chen SX, Wiseman CLS, Chakravartty D, Cole DC. Metal Concentrations in Newcomer Women and Environmental Exposures: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030277. [PMID: 28282863 PMCID: PMC5369113 DOI: 10.3390/ijerph14030277] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 02/21/2017] [Accepted: 03/04/2017] [Indexed: 01/30/2023]
Abstract
Newcomer women from developing countries are recognized to be at risk for elevated exposures to environmental contaminants and associated negative health effects. As such, data on exposure sources and contaminant body burden concentrations is critical in the development of effective public health policies and interventions in support of newcomer health. We conducted a scoping review to gather evidence on important toxic metals of health concern, lead (Pb), mercury (Hg) and cadmium (Cd), and their concentrations and potential exposure sources among newcomer women. An initial 420 articles were identified through the databases MEDLINE, EMBASE and Scopus, many reporting by ethnicity rather than newcomer/immigrant status. Several articles reported metal concentrations for other biomarkers but did not include blood, nor stratify results. From the remainder, we selected a total of 10 articles for full textual review, which reported blood Pb, Hg or Cd levels for newcomer women and/or stratified blood metal results according to foreign birth or country of origin. Three of the articles reported higher Pb, Hg and Cd concentrations in newcomer women compared to their native-borne counterparts. Exposures identified as contributing to elevated Pb, Hg and Cd blood concentrations included: pica behaviour, the use of lead-glazed cookware or eye cosmetics, and fish/shellfish consumption. The review revealed a limited availability of data on metal body burden concentrations, exposure sources and routes among newcomer women specifically. More research is needed to better understand the extent to which newcomer women are disproportionately at risk of elevated metal exposures due to either country of origin or current exposures and to inform relevant, multi-national risk management strategies.
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Affiliation(s)
- Shirley X Chen
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada.
- School of the Environment, University of Toronto, 33 Willcocks Street, Toronto, ON M5S 3E8, Canada.
| | - Clare L S Wiseman
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada.
- School of the Environment, University of Toronto, 33 Willcocks Street, Toronto, ON M5S 3E8, Canada.
| | - Dolon Chakravartty
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada.
| | - Donald C Cole
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada.
- School of the Environment, University of Toronto, 33 Willcocks Street, Toronto, ON M5S 3E8, Canada.
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Satarug S, Vesey DA, Gobe GC. Kidney Cadmium Toxicity, Diabetes and High Blood Pressure: The Perfect Storm. TOHOKU J EXP MED 2017; 241:65-87. [DOI: 10.1620/tjem.241.65] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Soisungwan Satarug
- Centre for Kidney Disease Research, Translational Research Institute and The University of Queensland Diamantina Institute
| | - David A. Vesey
- Centre for Kidney Disease Research, Translational Research Institute and The University of Queensland Diamantina Institute
| | - Glenda C. Gobe
- Centre for Kidney Disease Research, Translational Research Institute and The University of Queensland Diamantina Institute
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Lee BK, Ahn J, Kim NS, Lee CB, Park J, Kim Y. Association of Blood Pressure with Exposure to Lead and Cadmium: Analysis of Data from the 2008-2013 Korean National Health and Nutrition Examination Survey. Biol Trace Elem Res 2016; 174:40-51. [PMID: 27087554 DOI: 10.1007/s12011-016-0699-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 04/06/2016] [Indexed: 12/22/2022]
Abstract
We examined the association of blood pressure with blood levels of cadmium, lead, and their combination in a representative sample of adults from South Korea (Korean National Health and Nutrition Examination Survey, 2008-2013). This cross-sectional study enrolled subjects who were at least 19 years-old, completed a health examination survey, and had blood measurements of lead and cadmium. We estimated the adjusted mean differences in diastolic and systolic blood pressure associated with doubling of blood lead and cadmium by regression of blood pressure against log2-transformed blood metals and their tertiles after covariate adjustment. Adjusted odds ratios for hypertension and prehypertension were calculated for log2-transformed blood levels of lead and cadmium and their tertiles. In the general population of Korea, blood lead level was associated with increased BP and risk of hypertension. Blood cadmium levels had a stronger association with elevated blood pressure and risk of hypertension than blood lead levels, and these associations remained significant after statistical adjustment for blood lead. The combination of blood lead and cadmium was more strongly associated with elevated blood pressure than exposure to each individual metal. In females, there was a stronger relationship between blood pressure and blood levels of these metals by analyzing interaction model. After adjustment for confounding factors, there were significant associations of blood pressure with the level of blood lead, cadmium, and their combination in adults from South Korea.
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Affiliation(s)
- Byung-Kook Lee
- Department of Preventive Medicine, Soonchunhyang University, Asan, South Korea
- Cheonan Medical Center, Cheonan, South Korea
| | - Jaeouk Ahn
- Department of Medical IT Engineering, Soonchunhyang University, Asan, South Korea
| | - Nam-Soo Kim
- Institute of Occupational and Environmental Medicine, Soonchunhyang University, Asan, South Korea
| | - Chan Boo Lee
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 290-3 Cheonha-Dong, Dong-Gu, Ulsan, 682-060, South Korea
| | - Jungsun Park
- Department of Occupational Health, Catholic University of Daegu, Daegu, South Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 290-3 Cheonha-Dong, Dong-Gu, Ulsan, 682-060, South Korea.
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Jain RB. Trends and variability in blood lead concentrations among US adults aged 20-64 years and senior citizens aged ≥65 years. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:14056-14067. [PMID: 27044289 DOI: 10.1007/s11356-016-6583-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 03/27/2016] [Indexed: 06/05/2023]
Abstract
Using data from National Health and Nutrition Examination Survey for the period 2003-2012, the objective of this study was to evaluate trends in blood lead levels (BLL) among adults aged 20-64 years (adults) and seniors aged ≥65 years (seniors). In addition, the contribution of other factors like gender, race/ethnicity, smoking, and exposure to secondhand smoke at home in explaining variability in BLL was also evaluated by fitting regression models with log10 transformed values of BLL as dependent variables. BLL decreased over 2003-2012 (p < 0.01). Irrespective of gender, race/ethnicity, and smoking status, seniors were found to have higher BLL than adults. Based on the magnitude of differences between the 5th and 95th percentiles, variability in the levels of blood lead was found to be substantially higher among seniors than among adults. Males had statistically significantly higher adjusted BLL than females (2.32 vs. 1.76 μg/dL for seniors, p < 0.01 and 1.66 vs. 1.13 μg/dL for adults, p < 0.01). Non-Hispanic whites had statistically significantly lower adjusted BLL than non-Hispanic blacks (1.99 vs. 2.42 μg/dL for seniors, p < 0.01 and 1.22 vs. 1.42 μg/dL for adults, p < 0.01). When compared with non-smokers, smokers had statistically significantly higher BLL (2.19 vs. 1.86 μg/dL for seniors, p < 0.01 and 1.54 vs. 1.22 μg/dL for adults, p < 0.01). Non-obese had statistically significantly higher BLL than obese individuals (2.11 vs. 1.93 μg/dL for seniors, p < 0.01 and 1.48 vs. 1.27 μg/dL for adults, p < 0.01). Exposure to secondhand smoke at home (SHS) was associated with statistically significantly higher BLL than when there was no exposure to SHS (β = 0.0683, p = 0.03 for seniors; β = 0.034, p = 0.034, p < 0.01 for adults).
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Affiliation(s)
- Ram B Jain
- , 2959 Estate View Court, Dacula, GA, USA.
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43
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Lee W, Yoon JH, Roh J, Lee S, Seok H, Lee JH, Jung PK, Rhie J, Won JU. The association between low blood lead levels and the prevalence of prehypertension among nonhypertensive adults in Korea. Am J Hum Biol 2016; 28:729-35. [DOI: 10.1002/ajhb.22857] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 12/10/2015] [Accepted: 03/20/2016] [Indexed: 11/11/2022] Open
Affiliation(s)
- Wanhyung Lee
- Department of Preventive Medicine; The Institute for Occupational Health; Seoul South Korea
| | - Jin-ha Yoon
- Department of Preventive Medicine; The Institute for Occupational Health; Seoul South Korea
| | - Jaehoon Roh
- Department of Preventive Medicine; The Institute for Occupational Health; Seoul South Korea
| | - Seunghyun Lee
- Department of Preventive Medicine; The Institute for Occupational Health; Seoul South Korea
| | - Hongdeok Seok
- Department of Preventive Medicine; The Institute for Occupational Health; Seoul South Korea
| | - June-hee Lee
- Department of Preventive Medicine; The Institute for Occupational Health; Seoul South Korea
| | - Pil Kyun Jung
- Department of Preventive Medicine; The Institute for Occupational Health; Seoul South Korea
| | - Jeongbae Rhie
- Department of Preventive Medicine; The Institute for Occupational Health; Seoul South Korea
| | - Jong-uk Won
- Department of Preventive Medicine; The Institute for Occupational Health; Seoul South Korea
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King KE, Darrah TH, Money E, Meentemeyer R, Maguire RL, Nye MD, Michener L, Murtha AP, Jirtle R, Murphy SK, Mendez MA, Robarge W, Vengosh A, Hoyo C. Geographic clustering of elevated blood heavy metal levels in pregnant women. BMC Public Health 2015; 15:1035. [PMID: 26449855 PMCID: PMC4599656 DOI: 10.1186/s12889-015-2379-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 10/02/2015] [Indexed: 01/06/2023] Open
Abstract
Background Cadmium (Cd), lead (Pb), mercury (Hg), and arsenic (As) exposure is ubiquitous and has been associated with higher risk of growth restriction and cardiometabolic and neurodevelopmental disorders. However, cost-efficient strategies to identify at-risk populations and potential sources of exposure to inform mitigation efforts are limited. The objective of this study was to describe the spatial distribution and identify factors associated with Cd, Pb, Hg, and As concentrations in peripheral blood of pregnant women. Methods Heavy metals were measured in whole peripheral blood of 310 pregnant women obtained at gestational age ~12 weeks. Prenatal residential addresses were geocoded and geospatial analysis (Getis-Ord Gi* statistics) was used to determine if elevated blood concentrations were geographically clustered. Logistic regression models were used to identify factors associated with elevated blood metal levels and cluster membership. Results Geospatial clusters for Cd and Pb were identified with high confidence (p-value for Gi* statistic <0.01). The Cd and Pb clusters comprised 10.5 and 9.2 % of Durham County residents, respectively. Medians and interquartile ranges of blood concentrations (μg/dL) for all participants were Cd 0.02 (0.01–0.04), Hg 0.03 (0.01–0.07), Pb 0.34 (0.16–0.83), and As 0.04 (0.04–0.05). In the Cd cluster, medians and interquartile ranges of blood concentrations (μg/dL) were Cd 0.06 (0.02–0.16), Hg 0.02 (0.00–0.05), Pb 0.54 (0.23–1.23), and As 0.05 (0.04–0.05). In the Pb cluster, medians and interquartile ranges of blood concentrations (μg/dL) were Cd 0.03 (0.02–0.15), Hg 0.01 (0.01–0.05), Pb 0.39 (0.24–0.74), and As 0.04 (0.04–0.05). Co-exposure with Pb and Cd was also clustered, the p-values for the Gi* statistic for Pb and Cd was <0.01. Cluster membership was associated with lower education levels and higher pre-pregnancy BMI. Conclusions Our data support that elevated blood concentrations of Cd and Pb are spatially clustered in this urban environment compared to the surrounding areas. Spatial analysis of metals concentrations in peripheral blood or urine obtained routinely during prenatal care can be useful in surveillance of heavy metal exposure.
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Affiliation(s)
- Katherine E King
- Biodemography of Aging Research Unit (BARU), Duke University, Room A110C, Erwin Mill Building, 2024 W. Main St, Durham, NC, 27708, USA.
| | - Thomas H Darrah
- Division of Water, Climate, and the Environment, School of Earth Sciences, The Ohio State University, 275 Mendenhall Laboratory, 125th South Oval, Columbus, OH, USA.
| | - Eric Money
- Center for Geospatial Analytics, North Carolina State University, 5125 Jordan Hall, Campus Box 7106, Raleigh, NC, USA.
| | - Ross Meentemeyer
- Center for Geospatial Analytics, North Carolina State University, 5125 Jordan Hall, Campus Box 7106, Raleigh, NC, USA.
| | - Rachel L Maguire
- Department of Biological Sciences, and Center for Human Health and the Environment, North Carolina State University, 850 Man Campus Dr, Campus Box 7633, Raleigh, NC, USA.
| | - Monica D Nye
- Biological Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, USA.
| | - Lloyd Michener
- Department of Community and Family Medicine, Duke University, 2200 Main St, Durham, NC, USA.
| | - Amy P Murtha
- Department of Obstetrics and Gynecology, Duke University, 2608 Erwin Rd, Suite 210, Durham, NC, USA.
| | - Randy Jirtle
- Department of Biological Sciences, and Center for Human Health and the Environment, North Carolina State University, 850 Man Campus Dr, Campus Box 7633, Raleigh, NC, USA.
| | - Susan K Murphy
- Department of Obstetrics and Gynecology, Duke University, 2608 Erwin Rd, Suite 210, Durham, NC, USA.
| | - Michelle A Mendez
- Department of Nutrition, University of North Carolina, 101 Manning Dr, Chapel Hill, NC, USA.
| | - Wayne Robarge
- Department of Soil Science, North Carolina State University, PO Box 7619, Raleigh, NC, USA.
| | - Avner Vengosh
- Nicholas School of the Environment, Duke University, 450 Research Dr, Durham, NC, USA.
| | - Cathrine Hoyo
- Department of Biological Sciences, and Center for Human Health and the Environment, North Carolina State University, 850 Man Campus Dr, Campus Box 7633, Raleigh, NC, USA.
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Liu K, Mao X, Shi J, Lu Y, Liu C. Evaluation of lead and essential elements in whole blood during pregnancy: a cross-sectional study. Ir J Med Sci 2015. [PMID: 26223338 DOI: 10.1007/s11845-015-1339-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
AIM Physiological concentrations of some elements fluctuate during pregnancy due to the increased requirements of growing fetus and changes in the maternal physiology. The aim of the study is to evaluate the distribution at different stages of pregnancy in healthy Chinese women and to show the association between trace elements and gestational age-specific reference intervals. METHODS A cross-sectional study was performed in 1089 pregnant women and 677 nonpregnant control women. Five element concentrations, including Cu, Zn, Ca, Mg, Pb in the blood were determined by atomic absorption spectrometry. Spearman's rank correlation test was used to assess the relationship between weeks of gestation and blood element concentrations. RESULTS The mean levels of Cu and Mg were 23.64 ± 4.69 μmol/L and 1.36 ± 0.12 mmol/L, respectively, in the control women. While 0.68 % of all pregnant women showed Cu levels below the normal ranges, the levels of Mg were comparable in different groups. Though the overall mean blood zinc and Ca concentrations (83.84 ± 17.50 μmol/L and 1.60 ± 0.15 mmol/L, respectively) increased gradually with the progress of gestation, the Zn and Ca deficiency levels (16.6 and 3.6 %, respectively) decreased with the advance of gestation. Compared with nonpregnant group, the concentrations of Cu, Zn, Ca, Mg, Pb during the different stages of pregnancy, as a whole, were significantly different. Positive correlations were observed between weeks of gestation and blood Cu, Ca, Pb concentrations (r = 0.301, 0.221, 0.223; P < 0.05). There was a negative correlation blood Mg concentrations and weeks of gestation (r = -0.321; P < 0.05). A weak positive correlation was noted between Zn concentrations and weeks of gestation (r = 0.125; P < 0.05). CONCLUSION The importance of Cu and Mg deficiency and supplementation is well realized, but, Zn/Ca deficiency and Pb exposure is still exist; the overall deficiency of pregnant women was not so optimistic. During pregnancy, the established reference values will provide an important guidance for the reasonable supplementation of essential elements and surveillance of lead overexposure.
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Affiliation(s)
- K Liu
- Department of Clinical Laboratory, State Key Laboratory of Reproductive Medicine, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, 210029, China
| | - X Mao
- Endocrine and Diabetes Center, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing University of Traditional Chinese Medicine, Jiangsu Branch of China Academy of Chinese Medical Science, No. 100 Hongshang Road, Nanjing, 210028, China
| | - J Shi
- Department of Maternity and Child Health Care, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210004, China
| | - Y Lu
- Department of Obstetrical, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210004, China
| | - C Liu
- Endocrine and Diabetes Center, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing University of Traditional Chinese Medicine, Jiangsu Branch of China Academy of Chinese Medical Science, No. 100 Hongshang Road, Nanjing, 210028, China.
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Hara A, Thijs L, Asayama K, Gu YM, Jacobs L, Zhang ZY, Liu YP, Nawrot TS, Staessen JA. Blood Pressure in Relation to Environmental Lead Exposure in the National Health and Nutrition Examination Survey 2003 to 2010. Hypertension 2015; 65:62-9. [DOI: 10.1161/hypertensionaha.114.04023] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Azusa Hara
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (A.H., L.T., Y.-M.G., L.J., Z.-Y.Z., Y.-P.L., J.A.S.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A.); Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium (T.S.N.); and Research and Development Group VitaK, Maastricht University, Maastricht,
| | - Lutgarde Thijs
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (A.H., L.T., Y.-M.G., L.J., Z.-Y.Z., Y.-P.L., J.A.S.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A.); Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium (T.S.N.); and Research and Development Group VitaK, Maastricht University, Maastricht,
| | - Kei Asayama
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (A.H., L.T., Y.-M.G., L.J., Z.-Y.Z., Y.-P.L., J.A.S.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A.); Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium (T.S.N.); and Research and Development Group VitaK, Maastricht University, Maastricht,
| | - Yu-Mei Gu
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (A.H., L.T., Y.-M.G., L.J., Z.-Y.Z., Y.-P.L., J.A.S.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A.); Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium (T.S.N.); and Research and Development Group VitaK, Maastricht University, Maastricht,
| | - Lotte Jacobs
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (A.H., L.T., Y.-M.G., L.J., Z.-Y.Z., Y.-P.L., J.A.S.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A.); Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium (T.S.N.); and Research and Development Group VitaK, Maastricht University, Maastricht,
| | - Zhen-Yu Zhang
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (A.H., L.T., Y.-M.G., L.J., Z.-Y.Z., Y.-P.L., J.A.S.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A.); Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium (T.S.N.); and Research and Development Group VitaK, Maastricht University, Maastricht,
| | - Yan-Ping Liu
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (A.H., L.T., Y.-M.G., L.J., Z.-Y.Z., Y.-P.L., J.A.S.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A.); Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium (T.S.N.); and Research and Development Group VitaK, Maastricht University, Maastricht,
| | - Tim S. Nawrot
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (A.H., L.T., Y.-M.G., L.J., Z.-Y.Z., Y.-P.L., J.A.S.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A.); Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium (T.S.N.); and Research and Development Group VitaK, Maastricht University, Maastricht,
| | - Jan A. Staessen
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (A.H., L.T., Y.-M.G., L.J., Z.-Y.Z., Y.-P.L., J.A.S.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A.); Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium (T.S.N.); and Research and Development Group VitaK, Maastricht University, Maastricht,
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Cardiovascular responses to lead are biphasic, while methylmercury, but not inorganic mercury, monotonically increases blood pressure in rats. Toxicology 2014; 328:1-11. [PMID: 25478804 DOI: 10.1016/j.tox.2014.11.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 11/18/2014] [Accepted: 11/30/2014] [Indexed: 11/24/2022]
Abstract
Cardiovascular diseases, such as heart attack and stroke, are the major cause of death worldwide. It is well known that a high number of environmental and physiological risk factors contribute to the development of cardiovascular diseases. Although risk factors are additive, increased blood pressure (hypertension) is the greatest risk factor. Over the last two decades, a growing number of epidemiological studies associate environmental exposure to lead or mercury species with hypertension. However, cardiovascular effects beyond blood pressure are rarely studied and thresholds for effect are not yet clear. To explore effects of lead or mercury species on the cardiovascular system, normal male Wistar rats were exposed to a range of doses of lead, inorganic mercury or methylmercury through the drinking water for four weeks. High-resolution ultrasound was used to measure heart and vascular function (carotid artery blood flow) at baseline and at the end of the exposure, while blood pressure was measured directly in the femoral artery at the end of the 4-week exposure. After 4 weeks, blood pressure responses to lead were biphasic. Low lead levels decreased blood pressure, dilated the carotid artery and increased cardiac output. At higher lead doses, rats had increased blood pressure. In contrast, methylmercury-exposed rats had increased blood pressure at all doses despite dilated carotid arteries. Inorganic mercury did not show any significant cardiovascular effects. Based on the current study, the benchmark dose level 10% (BMDL10s) for systolic blood pressure for lead, inorganic mercury and methylmercury are 1.1, 1.3 and 1.0 μg/kg-bw/d, respectively. However, similar total mercury blood levels attributed to inorganic mercury or methylmercury produced strikingly different results with inorganic mercury having no observable effect on the cardiovascular system but methylmercury increasing systolic and pulse pressures. Therefore, adverse cardiovascular effects cannot be predicted by total blood mercury level alone and the mercury species of exposure must be taken into account.
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Rambousková J, Krsková A, Slavíková M, Cejchanová M, Cerná M. Blood levels of lead, cadmium, and mercury in the elderly living in institutionalized care in the Czech Republic. Exp Gerontol 2014; 58:8-13. [PMID: 25016213 DOI: 10.1016/j.exger.2014.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 07/04/2014] [Accepted: 07/08/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is limited research examining the chemical load of toxic metals in the elderly. The aim of the present study was two-fold: to determine the body burden of lead, cadmium and mercury in association with age, gender, locality, lifestyle factors and potential health impacts among this population and to compare the values with blood values from the general Czech population aged 18-64 years. METHODS Lead, cadmium and mercury were examined in the blood of institutionalized senior citizens (46 males, 151 females aged 61-100 years) from two localities in the Czech Republic (Prague and Teplice) from 2009 through 2011. Measurements were made using inductively coupled plasma mass spectrometry (Pb, Cd) and a single purpose spectrometer AMA 254 (Hg). RESULTS Geometric means (GM) of whole blood lead (B-Pb), cadmium (B-Cd) and mercury (B-Hg) levels were 25.3μg/l, 0.55μg/l and 0.21μg/l, respectively. No age-related differences were found for B-Pb and B-Cd levels but a negative correlation with age was observed for B-Hg levels (p=0.04). B-Pb levels in men were significantly higher than in women (GM 29.9μg/l vs. 24.1μg/l). B-Cd was significantly higher in women (GM 0.57μg/l) than in men (0.50μg/l) (p=0.007) and in smokers (GM 1.29μg/l) than in nonsmokers (GM 0.53μg/l) (p=<0.001) and in seniors from Prague (GM 0.60μg/l) compared to those from Teplice (GM 0.43μg/l) (p=<0.001). Seniors with a history of chronic kidney disease, stroke and those using psycho-pharmaceuticals had higher B-Pb levels (p=0.008, 0.04 and 0.05, resp.), seniors diagnosed with atherosclerosis had higher B-Cd levels (p=0.002) and seniors using psycho-pharmaceuticals had higher B-Hg levels (p=0.07). B-Hg levels were also positively correlated with blood albumin levels (p=0.015). CONCLUSIONS This study provides data on levels of heavy metals in a group of elderly people. Such information is very scarce. Associations with diseases should be the subject of further investigation.
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Affiliation(s)
- Jolana Rambousková
- Centre for Research of Diabetes, Metabolism and Nutrition, Department of Nutrition, Third Faculty of Medicine, Charles University in Prague, Ruská 87, 100 00 Prague 10, Czech Republic.
| | - Andrea Krsková
- Environmental and Population Health Monitoring, National Institute of Public Health, Šrobárova 48, 100 42 Prague 10, Czech Republic
| | - Miroslava Slavíková
- Centre for Research of Diabetes, Metabolism and Nutrition, Department of Nutrition, Third Faculty of Medicine, Charles University in Prague, Ruská 87, 100 00 Prague 10, Czech Republic
| | - Mája Cejchanová
- Environmental and Population Health Monitoring, National Institute of Public Health, Šrobárova 48, 100 42 Prague 10, Czech Republic
| | - Milena Cerná
- Environmental and Population Health Monitoring, National Institute of Public Health, Šrobárova 48, 100 42 Prague 10, Czech Republic; Department of General Hygiene, Third Faculty of Medicine, Charles University in Prague, Ruská 87, 100 00 Prague 10, Czech Republic
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Environmental risk score as a new tool to examine multi-pollutants in epidemiologic research: an example from the NHANES study using serum lipid levels. PLoS One 2014; 9:e98632. [PMID: 24901996 PMCID: PMC4047033 DOI: 10.1371/journal.pone.0098632] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 05/05/2014] [Indexed: 11/28/2022] Open
Abstract
Objective A growing body of evidence suggests that environmental pollutants, such as heavy metals, persistent organic pollutants and plasticizers play an important role in the development of chronic diseases. Most epidemiologic studies have examined environmental pollutants individually, but in real life, we are exposed to multi-pollutants and pollution mixtures, not single pollutants. Although multi-pollutant approaches have been recognized recently, challenges exist such as how to estimate the risk of adverse health responses from multi-pollutants. We propose an “Environmental Risk Score (ERS)” as a new simple tool to examine the risk of exposure to multi-pollutants in epidemiologic research. Methods and Results We examined 134 environmental pollutants in relation to serum lipids (total cholesterol, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL) and triglycerides) using data from the National Health and Nutrition Examination Survey between 1999 and 2006. Using a two-stage approach, stage-1 for discovery (n = 10818) and stage-2 for validation (n = 4615), we identified 13 associated pollutants for total cholesterol, 9 for HDL, 5 for LDL and 27 for triglycerides with adjustment for sociodemographic factors, body mass index and serum nutrient levels. Using the regression coefficients (weights) from joint analyses of the combined data and exposure concentrations, ERS were computed as a weighted sum of the pollutant levels. We computed ERS for multiple lipid outcomes examined individually (single-phenotype approach) or together (multi-phenotype approach). Although the contributions of ERS to overall risk predictions for lipid outcomes were modest, we found relatively stronger associations between ERS and lipid outcomes than with individual pollutants. The magnitudes of the observed associations for ERS were comparable to or stronger than those for socio-demographic factors or BMI. Conclusions This study suggests ERS is a promising tool for characterizing disease risk from multi-pollutant exposures. This new approach supports the need for moving from a single-pollutant to a multi-pollutant framework.
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50
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Moon SS. Additive effect of heavy metals on metabolic syndrome in the Korean population: the Korea National Health and Nutrition Examination Survey (KNHANES) 2009-2010. Endocrine 2014; 46:263-71. [PMID: 24065312 DOI: 10.1007/s12020-013-0061-5] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 09/12/2013] [Indexed: 01/20/2023]
Abstract
There have been increasing concerns regarding health problems due to endocrine disrupting chemicals (EDCs). We investigated association of heavy metals, including lead, mercury, and cadmium, with metabolic syndrome (MS) and its individual components in the Korean population. Participants included 1,961 males and 1,989 females 20 years of age or older from the fourth and fifth Korea National Health and Nutritional Examination Surveys of the Korean population (2009 and 2010). We examined the relationship of blood lead, mercury, and cadmium levels with MS and the additive effect of three heavy metals on MS after adjustment for age, sex, body mass index (BMI), region, smoking, alcohol consumption, and regular exercise. Blood concentration of lead showed a significant but modest association with prevalence of MS (P = 0.04). Other heavy metals did not show such a relationship with MS. When the participants were classified according to the sum of category numbers of the three heavy metals, adjusted odds ratios were 1.0, 1.355, 1.638, and 1.556 (P < 0.01). Among components of MS, significant relationship of the sum of heavy metals with hypertension and elevated triglyceride was demonstrated. Blood concentration of lead was positively associated with the prevalence of MS. Of particular interest, cumulative effect of a mixture of lead, mercury, and cadmium on prevalence of MS was stronger than the sum of effect of each heavy metal. Accumulative effect of exposure to heavy metals could be more additive or synergistic than individual exposure in the general population.
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Affiliation(s)
- Seong-Su Moon
- Department of Internal Medicine, Dongguk University College of Medicine, Dongdae-ro 87, Gyeongju, Gyeongbuk Province, 780-350, South Korea,
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