School of Public Health, Chongqing Medical University, Chongqing, China.
Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China.
Front Public Health. 2022 Sep 9;10:981749. doi: 10.3389/fpubh.2022.981749. eCollection 2022.
Research on the association between blood lead (Pb) and lipid biomarkers have yielded inconsistent results, and epidemiological studies on blood Pb levels and hyperlipidemia are scarce. The present study aimed to examine the association between blood Pb levels and hyperlipidemia in adults from the National Health and Nutrition Examination Survey (NHANES).
A total of 43,196 participants in the NHANES from 1999 to 2018 were included in the final analysis. Hyperlipidemia was determined based on the National Cholesterol Education Program guidelines. Blood Pb levels were assessed using inductively-coupled plasma mass spectrometry. Weighted multivariable logistic regression analysis and subgroup analysis were conducted to determine the correlation between blood Pb levels and hyperlipidemia.
In the multivariable logistic regression model, high blood Pb levels were significantly associated with hyperlipidemia after adjusting for confounders (OR 1.41; 95%CI: 1.18-1.67). Furthermore, elevated blood Pb levels were associated with an increased risk of hyperlipidemia across the four quartile (Q) groups (Q1: OR 1.00; Q2: OR 1.16 [95%CI: 1.04-1.29]; Q3: OR 1.39 [95%CI: 1.21-1.59]; and Q4: OR 1.33 [95%CI: 1.15-1.54]; for trend <0.05). Significant moderating effects were found in the subgroup analysis stratified by age, education, hypertension, and diabetes ( < 0.05). In sensitivity analysis, the ORs for hyperlipidemia across the quartiles of blood Pb levels were 1.00, 1.17 (95%CI: 1.05-1.30), 1.42 (95%CI: 1.24-1.62), and 1.38 (95%CI: 1.19-1.60) for Q1, Q2, Q3, and Q4, respectively ( for trend <0.001) after removing adults with arteriosclerotic cardiovascular disease, and the ORs were 1.00, 1.13 (95%CI: 1.01-1.25), 1.38 (95%CI: 1.21-1.56), and 1.32 (95%CI: 1.16-1.52) for Q1, Q2, Q3, and Q4, respectively ( for trend <0.001) after including pregnant women.
The current study showed a positive association between blood lead levels and hyperlipidemia.
关于血铅（Pb）与血脂生物标志物之间关联的研究结果并不一致，且关于血铅水平与高血脂症的流行病学研究也较为匮乏。本研究旨在通过美国国家健康与营养调查（NHANES）来探究成年人血铅水平与高血脂症之间的关联。
本研究共纳入了 1999 年至 2018 年 NHANES 中 43196 名参与者，并对其进行了最终分析。高血脂症的判断依据是国家胆固醇教育计划指南。血铅水平采用电感耦合等离子体质谱法进行评估。采用加权多变量逻辑回归分析和亚组分析来确定血铅水平与高血脂症之间的相关性。
在多变量逻辑回归模型中，在校正混杂因素后，高水平血铅与高血脂症显著相关（OR 1.41；95%CI：1.18-1.67）。此外，在四个四分位（Q）组中，升高的血铅水平与高血脂症的风险增加相关（Q1：OR 1.00；Q2：OR 1.16 [95%CI：1.04-1.29]；Q3：OR 1.39 [95%CI：1.21-1.59]；Q4：OR 1.33 [95%CI：1.15-1.54]；趋势检验<0.05）。在按年龄、教育程度、高血压和糖尿病分层的亚组分析中，均发现了显著的调节作用（<0.05）。在敏感性分析中，血铅水平四分位数的高血脂症 OR 值分别为 Q1 为 1.00、Q2 为 1.17（95%CI：1.05-1.30）、Q3 为 1.42（95%CI：1.24-1.62）和 Q4 为 1.38（95%CI：1.19-1.60）（趋势检验<0.001），剔除了动脉粥样硬化性心血管疾病患者后，OR 值分别为 Q1 为 1.00、Q2 为 1.13（95%CI：1.01-1.25）、Q3 为 1.38（95%CI：1.21-1.56）和 Q4 为 1.32（95%CI：1.16-1.52）（趋势检验<0.001），纳入了孕妇后，OR 值分别为 Q1 为 1.00、Q2 为 1.13（95%CI：1.01-1.25）、Q3 为 1.38（95%CI：1.21-1.56）和 Q4 为 1.32（95%CI：1.16-1.52）（趋势检验<0.001）。
本研究表明血铅水平与高血脂症之间呈正相关。
