Zhao Minyao, Gu Sijie, Liu Tingchao, Gao Shipeng, Qiao Zheng, Wang Kui, Niu Qiang, Ma Rulin, Guo Heng, Guo Shuxia, He Jia
Department of Public Health, Shihezi University School of Medicine, Shihezi, 832000, China.
NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, First Affiliated Hospital of Shihezi University, Shihezi, 832000, China.
Cardiovasc Toxicol. 2025 May 27. doi: 10.1007/s12012-025-10009-3.
Previous studies have inconclusively examined the associations of metals or polycyclic aromatic hydrocarbons (PAHs) with cardiovascular disease (CVD) separately, highlighting the need to explore their combined association with CVD. Based on the 2011-2016 National Health and Nutrition Examination Survey, the association of 12 metals and six PAHs in urine with CVD was analyzed using weighted logistic regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR). Crucial metals and PAHs were screened, and dose-response, subgroup, interactions, and mediation analyses were conducted. 4306 participants were included, of whom 406 had CVD. Weighted logistic regression showed that cadmium (OR = 1.41, 95% CI 1.11-1.78), tin (OR = 1.63, 95% CI 1.03-2.60), and 1-hydroxypyrene (1-PYR) (OR = 1.40, 95% CI 1.15-1.69) were positively correlated with CVD. These factors also showed a linear relation with CVD. The WQS and BKMR models indicated that the combined association of 12 metals and six PAHs was positively associated with CVD. Cadmium, cesium, tin, uranium, and 1-PYR played critical roles (all weights > 0.050). Subgroup analysis revealed that these substances were mostly positively associated with CVD in young and middle-aged people, smokers, drinkers, and those who were overweight. There was an interaction between tin and smoking status (P for interaction < 0.05). Cadmium and tin mediated 18.40% and 6.90% of the association of 1-PYR with CVD, respectively, whereas the proportions of the mediating effects of 1-PYR in the association of cadmium and tin with CVD were 8.10% and 7.90%, respectively. Overall, higher levels of urinary metals and PAHs mixtures may be associated with higher CVD prevalence. Cadmium, cesium, tin, uranium, and 1-PYR played crucial roles in this association. Cadmium and tin played mediating roles in the association between 1-PYR and CVD. Meanwhile, 1-PYR also played a mediating role in the association between cadmium and tin and CVD.
以往的研究对金属或多环芳烃（PAHs）与心血管疾病（CVD）之间的关联进行了单独研究，但结果尚无定论，这凸显了探索它们与CVD联合关联的必要性。基于2011 - 2016年全国健康与营养检查调查，使用加权逻辑回归、加权分位数和（WQS）回归以及贝叶斯核机器回归（BKMR）分析了尿液中12种金属和6种PAHs与CVD的关联。筛选出关键金属和PAHs，并进行了剂量反应、亚组、相互作用和中介分析。纳入了4306名参与者，其中406人患有CVD。加权逻辑回归显示，镉（OR = 1.41，95% CI 1.11 - 1.78）、锡（OR = 1.63，95% CI 1.03 - 2.60）和1-羟基芘（1-PYR）（OR = 1.40，95% CI 1.15 - 1.69）与CVD呈正相关。这些因素与CVD也呈线性关系。WQS和BKMR模型表明，12种金属和6种PAHs的联合关联与CVD呈正相关。镉、铯、锡、铀和1-PYR起关键作用（所有权重>0.050）。亚组分析显示，这些物质在年轻人、中年人、吸烟者、饮酒者和超重者中大多与CVD呈正相关。锡与吸烟状态之间存在相互作用（相互作用P<0.05）。镉和锡分别介导了1-PYR与CVD关联的18.40%和6.90%，而1-PYR在镉和锡与CVD关联中的中介作用比例分别为8.10%和7.90%。总体而言，尿液中金属和PAHs混合物水平较高可能与CVD患病率较高有关。镉、铯、锡、铀和1-PYR在这种关联中起关键作用。镉和锡在1-PYR与CVD的关联中起中介作用。同时，1-PYR在镉和锡与CVD的关联中也起中介作用。
