Low-Level Environmental Metals Exposures, Biomarkers of Myocardial Injury and Hemodynamic Stress, and Mortality Risk
Authors' conclusion
Our results suggest that the associations of low-level lead and cadmium exposures with mortality risks may be potentially mediated by worsening myocardial injury and stress.
Study context
- Population
- Participants with studied measurements from the National Health and Nutrition Examination Survey between 1999 and 2004participants included
- Participants
- 11,193 participants
- Exposure
- Associations of whole blood lead and cadmium with cardiac-specific biomarkers, inflammation, oxidative stress and mortality
- Outcome
- Lead levels below WHO guideline (5 μg/dL)
Methodological detailsgeneralized linear regression, mediation analyses
- Generalized linear regression
- Mediation analyses
Main finding
As reported in the abstract
Individuals with lead levels below the World Health Organization guidelines for the clinical management of lead (5 μg/dL)
nearly 93.9%
Observational data: associations, not effects.
Further findings
Myocardial injury (high-sensitivity troponin T and I), myocardial stress (NT-proBNP), inflammation and oxidative stress (C-reactive protein, total homocysteine, methylmalonic acid), and mortality risks
- Lead and cadmium levels positively associated
High-sensitivity troponin T and NT-proBNP per SD increase in lead
- Increase in high-sensitivity troponin T per SD increase in lead
- 2.23%
- Increase in NT-proBNP per SD increase in lead
- 7.05%
Mediation by troponin and NT-proBNP of associations of cardiovascular mortality with lead and cadmium
- Proportion mediated, up to
- 33.10%
- Associations greater in older participants and those who had diabetes and hypertension
Original publication
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