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Blood Lead and Other Metal Biomarkers as Risk Factors for Cardiovascular Disease Mortality.

ABSTRACT: Analyses of the Third National Health and Nutrition Examination Survey (NHANES III) in 1988 to 1994 found an association of increasing blood lead levels < 10 ?g/dL with a higher risk of cardiovascular disease (CVD) mortality. The potential need to correct blood lead for hematocrit/hemoglobin and adjust for biomarkers for other metals, for example, cadmium and iron, had not been addressed in the previous NHANES III-based studies on blood lead-CVD mortality association. We analyzed 1999 to 2010 NHANES data for 18,602 participants who had a blood lead measurement, were ? 40 years of age at the baseline examination and were followed for mortality through 2011. We calculated the relative risk for CVD mortality as a function of hemoglobin- or hematocrit-corrected log-transformed blood lead through Cox proportional hazard regression analysis with adjustment for serum iron, blood cadmium, serum C-reactive protein, serum calcium, smoking, alcohol intake, race/Hispanic origin, and sex. The adjusted relative risk for CVD mortality was 1.44 (95% confidence interval = 1.05, 1.98) per 10-fold increase in hematocrit-corrected blood lead with little evidence of nonlinearity. Similar results were obtained with hemoglobin-corrected blood lead. Not correcting blood lead for hematocrit/hemoglobin resulted in underestimation of the lead-CVD mortality association while not adjusting for iron status and blood cadmium resulted in overestimation of the lead-CVD mortality association. In a nationally representative sample of U.S. adults, log-transformed blood lead was linearly associated with increased CVD mortality. Correcting blood lead for hematocrit/hemoglobin and adjustments for some biomarkers affected the association.

SUBMITTER: Aoki Y

PROVIDER: S-EPMC4706249 | biostudies-literature | 2016 Jan

REPOSITORIES: biostudies-literature

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Blood Lead and Other Metal Biomarkers as Risk Factors for Cardiovascular Disease Mortality.

Aoki Yutaka Y Brody Debra J DJ Flegal Katherine M KM Fakhouri Tala H I THI Axelrad Daniel A DA Parker Jennifer D JD

Medicine 20160101 1

Analyses of the Third National Health and Nutrition Examination Survey (NHANES III) in 1988 to 1994 found an association of increasing blood lead levels < 10 μg/dL with a higher risk of cardiovascular disease (CVD) mortality. The potential need to correct blood lead for hematocrit/hemoglobin and adjust for biomarkers for other metals, for example, cadmium and iron, had not been addressed in the previous NHANES III-based studies on blood lead-CVD mortality association. We analyzed 1999 to 2010 NH ...[more]

PMID: 26735529

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Dataset Information

Blood Lead and Other Metal Biomarkers as Risk Factors for Cardiovascular Disease Mortality.

Publications

Blood Lead and Other Metal Biomarkers as Risk Factors for Cardiovascular Disease Mortality.

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