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. 2017 Oct 19;125(10):107007.
doi: 10.1289/EHP1521.

Plasma Metal Concentrations and Incident Coronary Heart Disease in Chinese Adults: The Dongfeng-Tongji Cohort

Yu Yuan  1 , Yang Xiao  1 , Wei Feng  1 , Yiyi Liu  1 , Yanqiu Yu  1 , Lue Zhou  1 , Gaokun Qiu  1 , Hao Wang  1 , Bing Liu  1 , Kang Liu  1 , Handong Yang  2 , Xiulou Li  2 , Xinwen Min  2 , Ce Zhang  2 , Chengwei Xu  2 , Xiaomin Zhang  1 , Meian He  1 , Frank B Hu  3 , An Pan  4 , Tangchun Wu  1
Affiliations

Plasma Metal Concentrations and Incident Coronary Heart Disease in Chinese Adults: The Dongfeng-Tongji Cohort

Yu Yuan et al. Environ Health Perspect. .

Abstract

Background: Circulating metals from both the natural environment and pollution have been linked to cardiovascular disease. However, few prospective studies have investigated the associations between exposure to multiple metals and incident coronary heart disease (CHD).

Objectives: We conducted a nested case-control study in the prospective Dongfeng-Tongji cohort, to investigate the prospective association between plasma metal concentrations and incident CHD.

Methods: A total of 1,621 incident CHD cases and 1,621 controls free of major cardiovascular disease at baseline and follow-up visits were matched on age (±5 years) and sex. We measured baseline fasting plasma concentrations of 23 metals and used conditional logistic regression models to estimate odds ratios (ORs) of CHD for metal concentrations categorized according to quartiles in controls.

Results: Five metals (titanium, arsenic, selenium, aluminum, and barium) were significantly associated with CHD based on trend tests from single-metal multivariable models adjusted for established cardiovascular risk factors. When all five were included in the same model, adjusted ORs for barium and aluminum were close to the null, whereas associations with titanium, arsenic, and selenium were similar to estimates from single-metal models, and ORs comparing extreme quartiles were 1.32 (95% CI: 1.03, 1.69; p-trend=0.04), 1.78 (95% CI: 1.29, 2.46; p-trend=0.001), and 0.67 (95% CI: 0.52, 0.85; p-trend=0.001), respectively.

Conclusions: Our study suggested that incident CHD was positively associated with plasma levels of titanium and arsenic, and inversely associated with selenium. Additional research is needed to confirm these findings in other populations. https://doi.org/10.1289/EHP1521.

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Figures

Three histograms plotting odds ratios for the coronary heart disease (left y-axis) and percentage of population (right y-axis) across concentrations of log-transformed plasma titanium, log-transformed plasma arsenic, and log-transformed plasma selenium in micrograms per liter (x-axis) for the log-transformed levels of plasma titanium, arsenic, and selenium.
Figure 1.
The restricted cubic spline for the association between plasma metals and incident CHD. The lines represent adjusted odds ratios based on restricted cubic splines for the log-transformed levels of plasma titanium, arsenic, and selenium in the multiple-metals conditional regression model. Knots were placed at the 20th, 40th, 60th, and 80th percentiles of the plasma metal distribution, and the reference value was set at the 10th percentile. Adjustment factors were BMI, smoking status, pack year, alcohol intake status, education, physical activity, hypertension, hyperlipidemia, family history of CHD, diabetes, and eGFR. The bars represent histograms of plasma metal distribution among the total population. The model included barium and aluminum as well. The numbers in parentheses show the plasma metal concentrations before log-transformation.
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