Department of Epidemiology and Environmental Health, University at Buffalo, SUNY, Buffalo, NY, USA.
Department of Epidemiology and Environmental Health, University at Buffalo, SUNY, Buffalo, NY, USA.
Int J Hyg Environ Health. 2022 May;242:113950. doi: 10.1016/j.ijheh.2022.113950. Epub 2022 Mar 14.
Hypertension and diabetes are highly prevalent among US adults. Arsenic exposure is associated with these cardiometabolic morbidities but the relationship between arsenic exposure and cholesterol markers of cardiometabolic disease has not been elucidated, especially at younger ages, when many chronic diseases may initiate. This study examined the association of total urinary arsenic with total cholesterol (TC) and high-density lipoprotein cholesterol (HDL) and explored effect modification by weight status.
The study sample consisted of 12-17-year-old participants with complete data from the 2009-2016 National Health and Nutrition Examination Survey cycles. The cross-sectional associations of creatinine-adjusted total urinary arsenic with TC and HDL were assessed using multivariable linear regression models with survey weights. Three models were built, adjusting for varying combinations of age, gender, race/ethnicity, weight status, survey cycle, family income to poverty ratio, reference person education level, arsenobetaine, and dimethylarsinic acid (DMA). Model adjustments for arsenobetaine approximated inorganic arsenic exposure, and further adjustment for DMA approximated unmethylated inorganic arsenic exposure. We also explored weight status (underweight/healthy, overweight, and obese) as a potential effect modifier of these relationships using stratified analyses and interaction tests.
The final analytical sample consisted of 1,177 12-17-year-old participants. After adjusting for covariates and arsenobetaine, creatinine-adjusted arsenic was positively associated with HDL levels (β = 0.063; 95% CI: 0.007, 0.119). Upon further adjustment for DMA, creatinine-adjusted arsenic was positively associated with HDL levels (β = 0.079; 95% CI: 0.015, 0.143) and TC levels (β = 0.258; 95% CI: 0.002, 0.515). No effect modification by weight status was observed.
We found a positive association of approximated unmethylated inorganic arsenic exposure with TC, and contrary to our expectation, with HDL. There was no effect modification by weight status. Our findings should be confirmed by conducting longitudinal studies among adolescents exposed to low-level arsenic and focusing specifically on urinary inorganic arsenic concentrations.
高血压和糖尿病在美国成年人中发病率很高。砷暴露与这些心血管代谢疾病有关，但砷暴露与心血管代谢疾病的胆固醇标志物之间的关系尚未阐明，尤其是在许多慢性疾病可能开始的年龄较轻时。本研究检测了总尿砷与总胆固醇（TC）和高密度脂蛋白胆固醇（HDL）的关系，并探讨了体重状况的修饰作用。
研究样本包括来自 2009-2016 年全国健康与营养调查周期的具有完整数据的 12-17 岁参与者。使用带有调查权重的多变量线性回归模型评估肌酐调整后的总尿砷与 TC 和 HDL 的横断面相关性。建立了三个模型，分别调整了年龄、性别、种族/民族、体重状况、调查周期、家庭收入与贫困比例、参考人教育水平、砷甜菜碱和二甲基砷酸（DMA）的不同组合。砷甜菜碱的模型调整近似于无机砷暴露，进一步调整 DMA 近似于未甲基化的无机砷暴露。我们还通过分层分析和交互测试探索了体重状况（体重不足/健康、超重和肥胖）作为这些关系的潜在修饰作用。
最终分析样本包括 1177 名 12-17 岁的参与者。在调整了协变量和砷甜菜碱后，肌酐调整后的砷与 HDL 水平呈正相关（β=0.063；95%CI：0.007，0.119）。进一步调整 DMA 后，肌酐调整后的砷与 HDL 水平呈正相关（β=0.079；95%CI：0.015，0.143）和 TC 水平（β=0.258；95%CI：0.002，0.515）。体重状况没有观察到修饰作用。
我们发现近似未甲基化无机砷暴露与 TC 呈正相关，与我们的预期相反，与 HDL 呈正相关。体重状况没有修饰作用。我们的发现应该通过在暴露于低水平砷的青少年中进行纵向研究来证实，并特别关注尿无机砷浓度。
