Qin Zheng, Li Hancong, Xu Yingfei, Li Jiameng, Su Baihai, Liao Ruoxi
Department of Nephrology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
Med+ Biomaterial Institute of West China Hospital, West China School of Medicine of Sichuan University, Chengdu, China.
Front Cardiovasc Med. 2021 Oct 14;8:747498. doi: 10.3389/fcvm.2021.747498. eCollection 2021.
This study aimed to evaluate the association between blood lead level (BLL) and abdominal aortic calcification (AAC) in US adults aged ≥40 years. We obtained data from 2013 to 2014 National Health and Nutrition Examination Survey (NHANES). Participants missing the data of BLL and AAC scores were excluded. BLL was measured using inductively coupled plasma mass spectrometry directly. AAC scores were quantified by Kauppila score system, and severe AAC was defined as AAC score >6. Weighted multivariable regression analysis and subgroup analysis were conducted to explore the independent relationship between BLL with AAC score and severe AAC. A total of 1,530 participants were included with the mean BLL of 1.45 ± 1.31 ng/dl and mean AAC score of 1.40 ± 3.13. The prevalence of severe AAC was 7.98% overall, and participants in higher BLL quartile showed higher prevalence of severe AAC (Quartile 1: 3.55%, Quartile 2: 7.28%, Quartile 3: 9.88%, Quartile 4: 12.58%, < 0.0001). BLL was positively associated with higher AAC score (β = 0.15, 95% CI: 0.02, 0.27, = 0.021) and increased risk of severe AAC (OR = 1.11; 95% CI: 1.00-1.22; = 0.047). Subgroup analysis and interaction test indicated that the association between BLL and AAC was similar in different population settings. Higher BLL was associated with higher AAC score and increased risk of severe AAC. Lead burden should be considered for people with AAC in clinical settings.
本研究旨在评估美国40岁及以上成年人的血铅水平（BLL）与腹主动脉钙化（AAC）之间的关联。我们获取了2013年至2014年国家健康与营养检查调查（NHANES）的数据。缺失BLL和AAC评分数据的参与者被排除。BLL直接采用电感耦合等离子体质谱法测量。AAC评分通过考皮拉评分系统进行量化，严重AAC定义为AAC评分>6。进行加权多变量回归分析和亚组分析，以探讨BLL与AAC评分及严重AAC之间的独立关系。共纳入1530名参与者，平均BLL为1.45±1.31 ng/dl，平均AAC评分为1.40±3.13。总体上严重AAC的患病率为7.98%，BLL四分位数较高的参与者严重AAC的患病率更高（四分位数1：3.55%，四分位数2：7.28%，四分位数3：9.88%，四分位数4：12.58%，<0.0001）。BLL与较高的AAC评分呈正相关（β=0.15，95%CI：0.02，0.27，P=0.021），且严重AAC的风险增加（OR=1.11；95%CI：1.00 - 1.22；P=0.047）。亚组分析和交互作用检验表明，在不同人群背景下，BLL与AAC之间的关联相似。较高的BLL与较高的AAC评分及严重AAC风险增加相关。在临床环境中，对于患有AAC的患者应考虑铅负荷情况。
