Adetunji Aderonke Gbemi, Obeng-Gyasi Emmanuel
Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA.
Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA.
J Xenobiot. 2025 May 9;15(3):68. doi: 10.3390/jox15030068.
Cardiovascular diseases (CVDs) are the leading cause of mortality globally, accounting for approximately one-third of all deaths. Exposure to toxic metals poses significant risks to cardiovascular health, contributing to the development of CVDs. Essential elements are crucial for maintaining cardiovascular function; however, imbalances or deficiencies in these elements can exacerbate the risk and progression of CVDs. Understanding the interactions between toxic metals and essential elements is crucial for elucidating their impact on cardiovascular health. This study aims to examine the individual and combined effects of toxic metals-lead (Pb), cadmium (Cd), and mercury (Hg)-along with essential elements-manganese (Mn), iron (Fe), and selenium (Se)-on CVDs. We explored the effects of toxic metals and essential elements using data from the National Health and Nutrition Examination Survey (NHANES, 2017-2018). We conducted descriptive analyses and applied advanced statistical methods, including Bayesian kernel machine regression (BKMR), weighted quantile sum regression (WQSR), and quantile g-computation, to assess the associations between these toxic metals and essential elements on key cardiovascular-related biomarkers. The results revealed distinct patterns of influence across the toxic metals and essential elements. Spearman correlation showed a stronger association among toxic metals than essential elements. Bayesian kernel machine regression (BKMR) and posterior inclusion probability (PIP) analysis identified lead, mercury, iron, and selenium as key contributors to CVD risk, with lead strongly linked to high-density lipoprotein (HDL), diastolic blood pressure (DBP), and systolic blood pressure (SBP). Selenium was linked to low-density lipoprotein (LDL) cholesterol and non-high-density lipoprotein (non-HDL) cholesterol. Univariate and bivariate analyses confirmed lead and mercury's strong associations with triglycerides and blood pressure, while lead, selenium, and iron were linked to different cholesterol outcomes. Single-variable analysis revealed an interaction between individual exposures and combined exposures. The overall exposure effect assessing the impact of all exposures combined on CVD markers revealed a steady positive association with triglycerides, total cholesterol, LDL, non-HDL cholesterol, and DBP, with HDL and SBP increasing from the 65th percentile. Quantile g-computation and WQSR confirmed lead's consistent positive association across all outcomes, with variations among other toxic metals and essential elements. In conclusion, our study suggests that toxic metals and essential elements are important factors in CVD outcomes, with different metals and elements associated with variations in specific biomarkers.
心血管疾病（CVDs）是全球主要的死亡原因，约占所有死亡人数的三分之一。接触有毒金属会对心血管健康构成重大风险，促使心血管疾病的发生。必需元素对于维持心血管功能至关重要；然而，这些元素的失衡或缺乏会加剧心血管疾病的风险和进展。了解有毒金属与必需元素之间的相互作用对于阐明它们对心血管健康的影响至关重要。本研究旨在探讨有毒金属——铅（Pb）、镉（Cd）和汞（Hg）——以及必需元素——锰（Mn）、铁（Fe）和硒（Se）——对心血管疾病的单独和联合影响。我们使用国家健康与营养检查调查（NHANES，2017 - 2018年）的数据来探究有毒金属和必需元素的影响。我们进行了描述性分析，并应用了先进的统计方法，包括贝叶斯核机器回归（BKMR）、加权分位数和回归（WQSR）以及分位数g计算，以评估这些有毒金属和必需元素与关键心血管相关生物标志物之间的关联。结果揭示了有毒金属和必需元素之间不同的影响模式。Spearman相关性显示有毒金属之间的关联比必需元素更强。贝叶斯核机器回归（BKMR）和后验包含概率（PIP）分析确定铅、汞、铁和硒是心血管疾病风险的关键因素，铅与高密度脂蛋白（HDL）、舒张压（DBP）和收缩压（SBP）密切相关。硒与低密度脂蛋白（LDL）胆固醇和非高密度脂蛋白（non - HDL）胆固醇有关。单变量和双变量分析证实了铅和汞与甘油三酯和血压之间的强关联，而铅、硒和铁与不同的胆固醇指标有关。单变量分析揭示了个体暴露和联合暴露之间的相互作用。评估所有暴露对心血管疾病标志物综合影响的总体暴露效应显示与甘油三酯、总胆固醇、LDL、非HDL胆固醇和DBP呈稳定的正相关，HDL和SBP从第65百分位数开始增加。分位数g计算和WQSR证实铅在所有结果中始终呈正相关，其他有毒金属和必需元素之间存在差异。总之，我们的研究表明，有毒金属和必需元素是心血管疾病结果的重要因素，不同的金属和元素与特定生物标志物的变化相关。
