State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei 430030, China.
Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, #1277 Jiefang Road, Wuhan, Hubei 430022, China.
Sci Total Environ. 2018 May 1;622-623:184-191. doi: 10.1016/j.scitotenv.2017.11.343. Epub 2017 Dec 13.
Hypertension contributes largely to the global burden of disease and mortality. Environmental exposure to metals might be a causative factor for hypertension, but the association remains unclear. The present case-control study of 502 hypertension patients and 502 healthy participants aimed to evaluate the potential relationships between the concentrations of 20 metal in urine and the risk of hypertension in a Chinese population. Multivariate logistic analyses adjusted for potential confounders were performed separately considering the effects of single and multi-metal. We found the increasing trends of urinary Fe, Co, Ni, Cu, Zn and Sr quartiles and the decreasing trends of urinary V and Rb quartiles with the ORs for hypertension. These dose-response associations were confirmed in the RCS models and remained robust in the multi-metal model. Urinary Hg quartiles were positively associated with the risk of hypertension in the models of single-metal and multi-metal. Urinary Cd quartiles were inversely associated with the risk of hypertension in the multi-metal model. Besides, modification effects of gender, BMI and smoking status on the associations of the exposure to various metals with the risk of hypertension were also suggested in the subgroup analysis. Our findings suggest that environmental exposure to V, Fe, Co, Ni, Cu, Zn, Rb, Sr, Cd and Hg might be related with the prevalence of hypertension. Further studies with prospective design should be conducted to confirm these findings.
高血压是导致全球疾病负担和死亡率的主要原因之一。环境暴露于金属可能是导致高血压的一个致病因素，但这种关联尚不清楚。本病例对照研究纳入了 502 名高血压患者和 502 名健康对照者，旨在评估中国人群尿液中 20 种金属浓度与高血压风险之间的潜在关系。在分别考虑单金属和多金属效应的情况下，采用多变量 logistic 分析对潜在混杂因素进行了调整。我们发现，随着尿液中 Fe、Co、Ni、Cu、Zn 和 Sr 四分位数的升高以及 V 和 Rb 四分位数的降低，高血压的 OR 值呈上升趋势。这些剂量-反应关联在 RCS 模型中得到了证实，并在多金属模型中仍然稳健。在单金属和多金属模型中，Hg 四分位数与高血压风险呈正相关。在多金属模型中，Cd 四分位数与高血压风险呈负相关。此外，在亚组分析中还提示了性别、BMI 和吸烟状况对各种金属暴露与高血压风险之间关联的修饰作用。我们的研究结果表明，环境暴露于 V、Fe、Co、Ni、Cu、Zn、Rb、Sr、Cd 和 Hg 可能与高血压的患病率有关。需要进一步开展前瞻性研究来证实这些发现。
