He Chunhui, Gao Min, He Ting, Xing Fuwei
Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, 100029, China.
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
BMC Public Health. 2025 May 13;25(1):1757. doi: 10.1186/s12889-025-22753-w.
Cobalt exposure is recognized as a potential risk factor for cardiovascular disease (CVD). However, the impact of cobalt exposure on mortality, particularly concerning CVD-related deaths, in the U.S. remains uncertain.
Data from the National Health and Nutrition Examination Surveys (NHANES) spanning 1999-2018 were utilized to assess urinary cobalt levels in participants aged 20 years and older (n = 15,873). For the analysis of blood cobalt, data from NHANES covering the years 2015-2018 were considered, limited to participants aged 40 years and older (n = 6,692). The follow-up period extended until December 31, 2019.
The median values of ln-transformed urinary cobalt (creatinine corrected) and blood cobalt were - 1.10 ln(µg/g) and - 1.90 ln(µg/L), respectively. For urinary cobalt, during a median follow-up period of 130.0 months (interquartile range: 70.25-189.0), 2,304 participants died, with 613 deaths attributed to CVD. After adjusting for potential covariates, an increase in urinary cobalt level was significantly associated with a higher risk of all-cause mortality and CVD mortality (per 1 ln-unit increment, HR: 1.19, 95% CI: 1.07, 1.32; HR: 1.30, 95% CI: 1.06, 1.60, respectively). For blood cobalt, the adjusted HRs were 1.57 (95% CI: 1.15, 2.14) for all-cause mortality and 2.02 (95% CI: 1.10, 3.72) for CVD mortality.
In the U.S., low-level environmental cobalt exposure is a significant risk factor for both all-cause mortality and CVD mortality.
Cobalt, a metallic element commonly encountered by the general population through food, water, or air inhalation, emerges as a novel risk factor for cardiovascular disease mortality.
钴暴露被认为是心血管疾病（CVD）的一个潜在风险因素。然而，在美国，钴暴露对死亡率的影响，尤其是与CVD相关的死亡，仍不确定。
利用1999 - 2018年国家健康与营养检查调查（NHANES）的数据，评估20岁及以上参与者（n = 15,873）的尿钴水平。对于血钴分析，考虑了NHANES 2015 - 2018年的数据，仅限于40岁及以上参与者（n = 6,692）。随访期延长至2019年12月31日。
对数转换后的尿钴（肌酐校正）和血钴的中位数分别为-1.10 ln（μg/g）和-1.90 ln（μg/L）。对于尿钴，在中位随访期130.0个月（四分位间距：70.25 - 189.0）内，2304名参与者死亡，其中613例死亡归因于CVD。在调整潜在协变量后，尿钴水平升高与全因死亡率和CVD死亡率风险增加显著相关（每增加1个对数单位，HR：1.19，95%CI：1.07，1.32；HR：1.30，95%CI：1.06，1.60）。对于血钴，全因死亡率的调整后HR为1.57（95%CI：1.15，2.14），CVD死亡率的调整后HR为2.02（95%CI：1.10，3.72）。
在美国，低水平环境钴暴露是全因死亡率和CVD死亡率的一个重要风险因素。
钴是一种普通人群通过食物、水或吸入空气普遍接触到的金属元素，已成为心血管疾病死亡率的一个新风险因素。
