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The association between essential trace element mixture and atherosclerotic cardiovascular disease risk among Chinese community-dwelling older adults


The evidence about the association of the essential trace element (ETE) mixture with atherosclerotic cardiovascular disease (ASCVD) amongst older adults is limited. This study aims to evaluate the associations of single ETEs and the ETE mixture with the 10-year ASCVD risks and its predicting factors in Chinese community-dwelling older adults. A total of 607 community-dwelling older adults were included in this study. Blood levels of vanadium (V), chromium (Cr), manganese (Mn), cobalt (Co), nickel (Ni), and selenium (Se) were assessed by inductively coupled plasma mass spectrometry. The predicted 10-year ASCVD risk was calculated using the Prediction for ASCVD Risk in China (China-PAR) equations. Traditional linear regressions and Bayesian kernel machine regression (BKMR) were used to assess the associations of single ETEs and the ETE mixture with the 10-year ASCVD risks and its predicting factors such as systolic blood pressure (SBP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), diabetes, and waist circumference (WC). In linear regression models, blood Cr levels were negatively associated with the 10-year ASCVD risks after adjustment for covariates (β =  − 0.07, 95% CI =  − 0.11 ~  − 0.03); The 3th quartile (Q3) of Se levels was also associated with a lower 10-year ASCVD risks when compared with the lowest quartile (Q1) of Se levels (βQ3 vs. Q1: − 0.12, 95% CI =  − 0.22 ~  − 0.02). In BKMR models, the negative associations of Cr and Se with the 10-year ASCVD risks were observed. Higher blood levels of ETE mixture were associated with decreased 10-year ASCVD risks in a dose–response pattern, with Cr having the highest value of the posterior inclusion probability (PIP) within the mixture. Furthermore, a positive association between Cr and HDL-C and a negative association between Se and SBP were found in both linear regression and BKMR models. Cr and Se were negatively associated with the 10-year ASCVD risks, individually and as a mixture. ETE mixture showed a linear dose–response association with decreased 10-year ASCVD risks, with Cr being the most important component within the mixture. The negative association of the ETE mixture with the 10-year ASCVD risks may be attributed to Cr and Se, mainly mediated by HDL-C and SBP, respectively. Further cohort studies are needed to clarify this association.

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Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.


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The authors are grateful to the research group of Older Adults Health and Modifiable Factors, the Lu’an Center for Disease Control and Prevention.


This study was funded by the National Key R&D Program of China (grant number 2016YFC1305900), Major Projects on College Leading Talent Team Introduced of Anhui (grant number 0303011224), the Key Scientific Research Fund of Anhui Provincial Education Department (grant number KJ2017A189), and Grants for Scientific Research of BSKY from Anhui Medical University (grant number Xj201525).

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Conceptualization: Xiang-long Meng, Lin-sheng Yang; methodology: Xiang-long Meng, Yuan Wang, Hong-li Wang; investigation: Hong-juan Cao, Xiu-de Li, Su-fang Wang, Gui-mei Chen, Fang-biao Tao, Jie Sheng, Lin-sheng Yang; data curation: Hong-juan Cao, Xiu-de Li, Su-fang Wang, Gui-mei Chen, Fang-biao Tao, Jie Sheng, Lin-sheng Yang; formal analysis: Xiang-long Meng, Huan-huan Nie, Bei-jing Cheng; writing — original draft preparation: Xiang-long Meng, Yuan Wang, Hong-li Wang; writing — review and editing: Xiang-long Meng, Lin-sheng Yang; supervision: Xiang-long Meng, Lin-sheng Yang; validation: Yuan Wang, Hong-li Wang, Bei-jing Cheng.

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Correspondence to Lin-sheng Yang.

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The study was approved by the biomedical ethical committee of Anhui Medical University (No. 2017028).

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Each participant had provided written informed consent according to the principles of the Helsinki

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The authors declare no competing interests.

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Meng, Xl., Wang, Y., Wang, Hl. et al. The association between essential trace element mixture and atherosclerotic cardiovascular disease risk among Chinese community-dwelling older adults. Environ Sci Pollut Res (2022).

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  • Older adults
  • Essential trace element mixture
  • Atherosclerotic cardiovascular disease
  • The China-PAR Equations
  • Bayesian kernel machine regression