Blood Lead and Other Metal Biomarkers as Risk Factors for Cardiovascular Disease Mortality

Details

• Alternative Title:
  Medicine (Baltimore)
• Personal Author:
  Aoki, Yutaka ; Brody, Debra J. ; Flegal, Katherine M. ; Fakhouri, Tala H.I. ; Parker, Jennifer D. ; Axelrad, Daniel A.
• Description:
  Analyses of the Third National Health and Nutrition Examination Survey (NHANES III) in 1988 to 1994 found an association of increasing blood lead levels <10 μg/dL with a higher risk of cardiovascular disease (CVD) mortality. The potential need to correct blood lead for hematocrit/hemoglobin and adjust for biomarkers for other metals, for example, cadmium and iron, had not been addressed in the previous NHANES III-based studies on blood lead-CVD mortality association.We analyzed 1999 to 2010 NHANES data for 18,602 participants who had a blood lead measurement, were ≥40 years of age at the baseline examination and were followed for mortality through 2011. We calculated the relative risk for CVD mortality as a function of hemoglobin- or hematocrit-corrected log-transformed blood lead through Cox proportional hazard regression analysis with adjustment for serum iron, blood cadmium, serum C-reactive protein, serum calcium, smoking, alcohol intake, race/Hispanic origin, and sex.The adjusted relative risk for CVD mortality was 1.44 (95% confidence interval = 1.05, 1.98) per 10-fold increase in hematocrit-corrected blood lead with little evidence of nonlinearity. Similar results were obtained with hemoglobin-corrected blood lead. Not correcting blood lead for hematocrit/hemoglobin resulted in underestimation of the lead-CVD mortality association while not adjusting for iron status and blood cadmium resulted in overestimation of the lead-CVD mortality association.In a nationally representative sample of U.S. adults, log-transformed blood lead was linearly associated with increased CVD mortality. Correcting blood lead for hematocrit/hemoglobin and adjustments for some biomarkers affected the association.
• Subjects:
  Adult Aged Alcohol Drinking Biomarkers C-Reactive Protein Cadmium/blood Cardiovascular Diseases/ethnology Cardiovascular Diseases/mortality Cause Of Death Female Hematocrit Hemoglobins Humans Iron/blood Lead/blood Male Middle Aged Nutrition Surveys Proportional Hazards Models Residence Characteristics Risk Factors Sex Factors Smoking

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• Source:
  Medicine (Baltimore). 2016; 95(1).
• Pubmed ID:
  26735529
• Pubmed Central ID:
  PMC4706249
• Document Type:
  Journal Article
• Place as Subject:
  United States
• Volume:
  95
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:9560483e257e31b02485194cb1ba689728c6dc238a055236532f5fceedf71be1
• Download URL:
  https://stacks.cdc.gov/view/cdc/37743/cdc_37743_DS1.pdf
• File Type:
  [PDF - 425.38 KB ]