Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Mailstop 1518-002-2BB, Atlanta, GA, 30322, USA.
Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Environ Health. 2021 Feb 14;20(1):15. doi: 10.1186/s12940-021-00695-1.
The objective of this study was to identify conditional relationships between multiple metal biomarkers that predict systolic and diastolic blood pressure in the non-institutionalized United States adult population below the age of 60.
We used inorganic exposure biomarker data and blood pressure data from three cycles (1999-2004) of the National Health and Nutrition Examination Survey (NHANES) to construct regression trees for blood pressure among adults ages 20-60 (adjusted for age, sex, body mass index, race, and smoking status) to identify predictors of systolic (SBP) and diastolic blood pressure (DBP). We also considered relationships among non-Hispanic black, Mexican-American, and white adults separately.
The following metal exposure biomarkers were conditionally predictive of SBP and/or DBP in the full sample: antimony (Sb), barium (Ba), cadmium (Cd), cesium (Cs), lead (Pb), tungsten (W) and molybdenum (Mo). The highest average SBP (> 120 mmHg) was observed among those with low Sb (≤ 0.21 μg/dL) high Cd (> 0.22 μg/g creatinine) and high Pb (> 2.55 μg/dL) biomarkers. Those with the highest average DBP had high urinary W levels (> 0.10 μg/g creatinine) in combination with either urinary Sb > 0.17 μg/g creatinine or those with urinary Sb ≤ 0.17 μg/g creatinine, but with high blood Pb levels (> 1.35 μg/dL). Predictors differed by ethnicity, with Cd as the main predictor of SBP among non-Hispanic black adults, and Pb not selected by the algorithm as a predictor of SBP among non-Hispanic white adults.
Combinations of metal biomarkers have different apparent relationships with blood pressure. Additional research in toxicological experimental models and in epidemiological studies is warranted to evaluate the suggested possible toxicological interactions between Sb, Cd, and Pb; and between W, Sb, and Pb; for cardiovascular (e.g., blood pressure) health. We also think future epidemiological research on inorganic exposure sets in relation to health outcomes like blood pressure might benefit from stratification by race and ethnicity.
本研究的目的是确定多个金属生物标志物之间的条件关系，这些标志物可以预测美国 60 岁以下非机构化成年人的收缩压和舒张压。
我们使用无机暴露生物标志物数据和来自国家健康和营养检查调查（NHANES）三个周期（1999-2004 年）的血压数据，构建了 20-60 岁成年人的血压回归树（调整年龄、性别、体重指数、种族和吸烟状况），以确定收缩压（SBP）和舒张压（DBP）的预测因子。我们还分别考虑了非西班牙裔黑人、墨西哥裔美国人和白人成年人之间的关系。
以下金属暴露生物标志物在全样本中条件性地预测 SBP 和/或 DBP：锑（Sb）、钡（Ba）、镉（Cd）、铯（Cs）、铅（Pb）、钨（W）和钼（Mo）。在 Sb 水平较低（≤0.21μg/dL）、Cd 水平较高（>0.22μg/g 肌酐）和 Pb 水平较高（>2.55μg/dL）的个体中，SBP 平均值最高（>120mmHg）。那些尿 W 水平最高（>0.10μg/g 肌酐）的人，结合尿 Sb>0.17μg/g 肌酐，或尿 Sb≤0.17μg/g 肌酐但血 Pb 水平较高（>1.35μg/dL），他们的 DBP 平均值最高。预测因子因种族而异，Cd 是非西班牙裔黑人成年人 SBP 的主要预测因子，而 Pb 未被算法选为非西班牙裔白成年人 SBP 的预测因子。
金属生物标志物的组合与血压有不同的明显关系。需要在毒理学实验模型和流行病学研究中进一步研究，以评估 Sb、Cd 和 Pb 之间以及 W、Sb 和 Pb 之间可能存在的毒理学相互作用对心血管（如血压）健康的影响。我们还认为，未来与血压等健康结果相关的无机暴露组的流行病学研究可能会受益于按种族和族裔进行分层。
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