Association of Urinary Metals With Cardiovascular Disease Incidence and All-Cause Mortality in the Multi-Ethnic Study of Atherosclerosis (MESA)
Authors' conclusion
This epidemiological study in US adults indicates that urinary metal levels are associated with increased CVD risk and mortality.
Study context
- Population
- Racially diverse US adults from MESA with urinary metals at baseline (2000 to 2001), followed through December 2019
- Participants
- 6,599 adults
- Exposure
- Highest vs lowest quartile of baseline urinary metals
- Outcome
- Incident CVD and all-cause mortality
Methodological detailsmulti-ethnic
- Multi-ethnic
Main finding
As reported in the abstract
Incident CVD and all-cause mortality, highest vs lowest quartile
Highest quartile vs Lowest quartileHazard ratio (95% CI)
Cadmium, incident CVD
1.25(1.03–1.53)
Cadmium, all-cause mortality
1.68(1.43–1.96)
Tungsten, incident CVD
1.20(1.01–1.42)
Tungsten, all-cause mortality
1.16(1.01–1.33)
Uranium, incident CVD
1.32(1.08–1.62)
Uranium, all-cause mortality
1.32(1.12–1.56)
Cobalt, incident CVD
1.24(1.03–1.48)
Cobalt, all-cause mortality
1.37(1.19–1.58)
Copper, incident CVD
1.42(1.18–1.70)
Copper, all-cause mortality
1.50(1.29–1.74)
Zinc, incident CVD
1.21(1.01–1.45)
Zinc, all-cause mortality
1.38(1.20–1.59)
- Events during follow-up: incident cardiovascular disease (CVD)
- 1162
- Events during follow-up: deaths
- 1844
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Mixture of 6 urinary metals, per IQR increase (Cox Elastic-Net) — IQR increase in metal mixture · incident CVD | 1.29 (1.11–1.56) | |
| Mixture of 6 urinary metals, per IQR increase (Cox Elastic-Net) — IQR increase in metal mixture · all-cause mortality | 1.66 (1.47–1.91) | |
| 0.512Hazard ratio (log scale) |
| Outcome | 10-year survival probability difference (%) (95% CI) | |
|---|---|---|
| Mixture of 6 urinary metals, per IQR increase (Cox Elastic-Net) — IQR increase in metal mixture · incident CVD | −1.1 (−2.0 to −0.05) | |
| Mixture of 6 urinary metals, per IQR increase (Cox Elastic-Net) — IQR increase in metal mixture · all-cause mortality | −2.0 (−2.6 to −1.5) | |
| −4−202Difference, % (linear scale) |
Dose-response
- Positive linear dose-response for cadmium and copper with both end points
Original publication
Association of Urinary Metals With Cardiovascular Disease Incidence and All-Cause Mortality in the Multi-Ethnic Study of Atherosclerosis (MESA). Circulation. Published 1 August 2024. doi:10.
Summarised from the published abstract; every number is checked against it