Levels of a mixture of heavy metals in blood and urine and all-cause, cardiovascular disease and cancer mortality: A population-based cohort study
Levels of a mixture of heavy metals in blood and urine and all-cause, cardiovascular disease and cancer mortality: A population-based cohort study
复制标题
血液和尿液中的重金属混合物水平与全因、心血管疾病和癌症死亡率：一项基于人群的队列研究
DOI：
10.1016/j.envpol.2020.114630
复制
发表时间：
2020-08-01
影响因子：
8.9
通讯作者：
Gu, Aihua
中科院分区：
文献类型：
--
作者：
Duan, Weiwei;Xu, Cheng;Gu, Aihua
人们在日常生活中以多种方式接触重金属。然而，重金属混合物对美国普通人群死亡率的影响尚不清楚。我们的目的是调查重金属浓度（血液[铅、镉和汞]和尿液[钡、镉、钴、铯、钼、铅、锑、钛、钨和铀]）与全因、心血管疾病（CVD）和癌症死亡率之间的关系。数据来自1999-2014年国家健康和营养检查调查（NHANES）。使用泊松回归分析单金属和多金属暴露与死亡率之间的关系。以下变量被调整为协变量：人口统计学变量（年龄、教育程度、性别和种族）、人体测量变量（体重指数）、生活方式变量（家庭收入、血清可替宁类别和身体活动）和医学合并症（心血管疾病和糖尿病）。本研究共纳入了来自NHANES的26,056名受试者（平均随访7.4年）。参与者的年龄从20岁到85岁不等。血液金属混合物与全因死亡率（RR = 1.38, 95% CI 1.25, 1.51）、心血管疾病死亡率（RR = 1.43, 95% CI 1.06, 1.94）和癌症死亡率（RR = 1.41, 95% CI 1.12, 1.76）相关，在所有关联的加权分位数和（WQS）回归中，镉的权重最高。尿中金属混合物与全因风险（RR = 1.48, 95% CI 1.30, 1.68）和癌症死亡率（RR = 1.60, 95% CI 1.02, 2.52）增加相关。在血液和尿液金属混合物与癌症死亡率的关系中发现了性别差异。我们的研究表明，基于美国普通人群的大量样本，重金属混合物的浓度与总体、心血管疾病和癌症死亡率之间存在潜在的正相关。然而，需要进一步的研究来证实这些重要的发现。(c) 2020 Elsevier Ltd.版权所有。
People are exposed to heavy metals in many ways during the course of their daily life. However, the effect of mixtures of heavy metals on mortality in the U.S. general population is unclear. We aimed to investigate the association between heavy metal concentrations (blood [lead, cadmium and mercury] and urine [barium, cadmium, cobalt, cesium, molybdenum, lead, antimony, titanium, tungsten and uranium]) and all-cause, cardiovascular disease (CVD) and cancer mortality. Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 1999-2014. Poisson regression was performed to analyze the associations between single-metal and multimetal exposure and mortality. The following variables were adjusted as covariates: demographic variables (age, education, sex and ethnicity), anthropometric variables (body mass index), lifestyle variables (family income, serum cotinine category and physical activity) and medical comorbidities (CVD and diabetes). A total of 26,056 subjects from the NHANES were included in the present study (mean follow-up, 7.4 years). The age of the participants ranged from 20 to 85 years. The blood metal mixture was associated with all-cause mortality (RR = 1.38, 95% CI 1.25, 1.51), CVD mortality (RR = 1.43, 95% CI 1.06, 1.94) and cancer mortality (RR = 1.41, 95% CI 1.12, 1.76) and cadmium had the highest weight in the weighted quantile sum (WQS) regression for all associations. The urinary metal mixture was associated with an increased risk of all-cause (RR = 1.48, 95% CI 1.30, 1.68) and cancer mortality (RR = 1.60, 95% CI 1.02, 2.52). Sex differences were found in the associations of both blood and urine metal mixtures with cancer mortality. Our study suggests a potential positive association for the concentrations of heavy metal mixtures with overall, CVD and cancer mortality based on a large sample of the U.S. general population. Nevertheless, further studies are needed to confirm these important findings. (c) 2020 Elsevier Ltd. All rights reserved.