Abstract
Although metal exposure has been associated with hypertension, the conclusions remain controversial, and studies investigating the predictive effect of multiple metals on hypertension are limited. In this study, we aimed to evaluate the nonlinear dose–response relationship between a single urinary metal and the risk of hypertension, and to assess the predictive effect of multiple urinary metals on hypertension. Of the Yinchuan community-dwelling elderly cohort launched in 2020, 3,733 participants (803 with hypertension and 2,930 without hypertension) were analysed in this study, and the concentrations of 13 metal elements in urine were measured. We found that urinary vanadium (odds ratio (OR): 1.16, 95% confidence interval [CI]: 1.08–1.25), molybdenum (OR: 1.08, 95% CI: 1.01–1.16), and tellurium (OR: 1.14, 95% CI: 1.06–1.22) were associated with higher risk of hypertension, whereas iron (OR: 0.92, 95% CI: 0.85–0.98) and strontium (0.92, 95% CI: 0.85–0.99) were significantly associated with lower risk of hypertension. Restricted cubic splines analysis was conducted in patients with iron concentrations of ≥ 15.48 μg/g and ≤ 399.41 μg/g and a strontium concentration of ≤ 69.41 μg/g, results showed that the risk of hypertension decreased gradually as the urinary concentrations of these metals increased. With an increase in the vanadium concentration in urine, the risk of hypertension gradually increased. In patients with a molybdenum concentration of ≥ 56.82 μg/g and a tellurium concentration of ≥ 21.98 μg/g, the risk of hypertension gradually decreased as the urinary concentrations of these metals increased. Predictive scores based on the 13 metallic elements were significantly associated with a higher risk of hypertension (OR: 1.34 (95% CI: 1.25–1.45). After additionally including urinary metal concentrations as a parameter variable in the traditional hypertension risk assessment model, integrated discrimination and net reclassification increased by 8.00% (P < 0.001) and 2.41% (P < 0.001), respectively. Urinary vanadium, Mo, and Te concentrations were associated with a higher risk of hypertension, while iron and strontium concentrations were associated with a lower risk of hypertension. Multiple urinary metal concentrations can significantly improve the predictive ability of traditional hypertension risk-assessment models.
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References
Ames BN, Atamna H, Killilea DW (2005) Mineral and vitamin deficiencies can accelerate the mitochondrial decay of aging. Mol Aspects Med 26(4–5):363–378. https://doi.org/10.1016/j.mam.2005.07.007
Brewer GJ, Dick RD, Grover DK, LeClaire V, Tseng M, Wicha M et al (2000) Treatment of metastatic cancer with tetrathiomolybdate, an anticopper, antiangiogenic agent: phase I study. Clin Cancer Res 6(1):1–10
Chan DC, Pang J, Barrett PH, Sullivan DR, Mori TA, Burnett JR et al (2016) Effect of omega-3 fatty acid supplementation on arterial elasticity in patients with familial hypercholesterolaemia on statin therapy. Nutr Metab Cardiovasc Dis 26(12):1140–1145. https://doi.org/10.1016/j.numecd.2016.07.012
Chemical Mixtures in Environmental Health (1998) | RFA Text | Research Project Database | Grantee Research Project | ORD | US EPA. Available at: https://cfpub.epa.gov/ncer_abstracts/index.cfm/fuseaction/display.rfatext/rfa_id/99. Accessed January 10, 1998
Cosselman KE, Navas-Acien A, Kaufman JD (2015) Environmental factors in cardiovascular disease. Nat Rev Cardiol 12(11):627–642. https://doi.org/10.1038/nrcardio.2015.152
Cui Y, Zhong Q, Hu M, Sheng J, Yang Y, Liang L et al (2017) Human biomonitoring of eight trace elements in urine of residents living in rural areas along the Yangtze River, China. Environ Sci Pollut Res Int 24(36):27963–27973. https://doi.org/10.1007/s11356-017-0414-3
Dahl SG, Allain P, Marie PJ, Mauras Y, Boivin G, Ammann P et al (2001) Incorporation and distribution of strontium in bone. Bone 28(4):446–453. https://doi.org/10.1016/s8756-3282(01)00419-7
Dhanda A, Atkinson S, Vergis N, Enki D, Fisher A, Clough R et al (2020) Trace element deficiency is highly prevalent and associated with infection and mortality in patients with alcoholic hepatitis. Aliment Pharmacol Ther 52(3):537–544. https://doi.org/10.1111/apt.15880
El-Megharbel SM, Hamza RZ, Refat MS (2015) Synthesis, spectroscopic and thermal studies of Mg(II), Ca(II), Sr(II) and Ba(II) diclofenac sodium complexes as anti-inflammatory drug and their protective effects on renal functions impairment and oxidative stress. Spectrochim Acta A Mol Biomol Spectrosc 135:915–928. https://doi.org/10.1016/j.saa.2014.07.101
Eum KD, Lee MS, Paek D (2008) Cadmium in blood and hypertension. Sci Total Environ 407(1):147–153. https://doi.org/10.1016/j.scitotenv.2008.08.037
Fang X, Ardehali H, Min J, Wang F (2022) The molecular and metabolic landscape of iron and ferroptosis in cardiovascular disease. Nat Rev Cardiol. https://doi.org/10.1038/s41569-022-00735-4
Fortoul TI, Rojas-Lemus M, Rodriguez-Lara V, Gonzalez-Villalva A, Ustarroz-Cano M, Cano-Gutierrez G et al (2014) Overview of environmental and occupational vanadium exposure and associated health outcomes: an article based on a presentation at the 8th International Symposium on Vanadium Chemistry, Biological Chemistry, and Toxicology, Washington DC, August 15–18, 2012. J Immunotoxicol 11(1):13–18. https://doi.org/10.3109/1547691X.2013.789940
Galan P, Vergnaud AC, Tzoulaki I, Buyck JF, Blacher J, Czernichow S et al (2010) Low total and nonheme iron intakes are associated with a greater risk of hypertension. J Nutr 140(1):75–80. https://doi.org/10.3945/jn.109.114082
GBDRF Collaborators (2020) Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 396(10258):1223–1249. https://doi.org/10.1016/S0140-6736(20)30752-2
Gibson EA, Nunez Y, Abuawad A, Zota AR, Renzetti S, Devick KL et al (2019) An overview of methods to address distinct research questions on environmental mixtures: an application to persistent organic pollutants and leukocyte telomere length. Environ Health 18(1):76. https://doi.org/10.1186/s12940-019-0515-1
Gimou MM, Charrondiere UR, Leblanc JC, Noel L, Guerin T, Pouillot R (2013) Dietary exposure and health risk assessment for 11 minerals and trace elements in Yaounde: the Cameroonian Total Diet Study. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 30(9):1556–1572. https://doi.org/10.1080/19440049.2013.813649
Graf C, Assoud A, Mayasree O, Kleinke H (2009) Solid state polyselenides and polytellurides: a large variety of Se-Se and Te-Te interactions. Molecules 14(9):3115–3131. https://doi.org/10.3390/molecules14093115
Horning KJ, Caito SW, Tipps KG, Bowman AB, Aschner M (2015) Manganese is essential for neuronal health. Annu Rev Nutr 35:71–108. https://doi.org/10.1146/annurev-nutr-071714-034419
Hu J, Xia W, Pan X, Zheng T, Zhang B, Zhou A et al (2017) Association of adverse birth outcomes with prenatal exposure to vanadium: a population-based cohort study. Lancet Planet Health 1(6):e230–e241. https://doi.org/10.1016/S2542-5196(17)30094-3
Jiang J, Liu M, Parvez F, Wang B, Wu F, Eunus M et al (2015) Association between arsenic exposure from drinking water and longitudinal change in blood pressure among HEALS cohort participants. Environ Health Perspect 123(8):806–812. https://doi.org/10.1289/ehp.1409004
Jiang S, Zhou S, Liu H, Peng C, Zhang X, Zhou H et al (2021) Concentrations of vanadium in urine with hypertension prevalence and blood pressure levels. Ecotoxicol Environ Saf 213:112028. https://doi.org/10.1016/j.ecoenv.2021.112028
Kraemer D, Poudel B, Feng HP, Caylor JC, Yu B, Yan X et al (2011) High-performance flat-panel solar thermoelectric generators with high thermal concentration. Nat Mater 10(7):532–538. https://doi.org/10.1038/nmat3013
Lajin B, Kuehnelt D, Jensen KB, Francesconi KA (2016) Investigating the intra-individual variability in the human metabolic profile of urinary selenium. J Trace Elem Med Biol 37:31–36. https://doi.org/10.1016/j.jtemb.2016.06.008
Lee MS, Park SK, Hu H, Lee S (2011) Cadmium exposure and cardiovascular disease in the 2005 Korea National Health and Nutrition Examination Survey. Environ Res 111(1):171–176. https://doi.org/10.1016/j.envres.2010.10.006
Liu J, Cui H, Liu X, Peng X, Deng J, Zuo Z et al (2012) Dietary high vanadium causes oxidative damage-induced renal and hepatic toxicity in broilers. Biol Trace Elem Res 145(2):189–200. https://doi.org/10.1007/s12011-011-9185-8
Llurba E, Gratacos E, Martin-Gallan P, Cabero L, Dominguez C (2004) A comprehensive study of oxidative stress and antioxidant status in preeclampsia and normal pregnancy. Free Radic Biol Med 37(4):557–570. https://doi.org/10.1016/j.freeradbiomed.2004.04.035
Lowe NM, Fekete K, Decsi T (2009) Methods of assessment of zinc status in humans: a systematic review. Am J Clin Nutr 89(6):2040S-2051S. https://doi.org/10.3945/ajcn.2009.27230G
Pavlyushchik O, Afonin V, Fatykhava S, Shabunya P, Sarokina V, Khapaliuk A (2017) Macro- and Microelement Status in Animal and Human Hypertension: the Role of the ACE Gene I/D Polymorphism. Biol Trace Elem Res 180(1):110–119. https://doi.org/10.1007/s12011-017-0990-6
Perez-D’Gregorio RE, Miller RK (1988) Teratogenicity of tellurium dioxide: prenatal assessment. Teratology 37(4):307–316. https://doi.org/10.1002/tera.1420370404
Pors Nielsen S (2004) The biological role of strontium. Bone 35(3):583–588. https://doi.org/10.1016/j.bone.2004.04.026
Presentato A, Turner RJ, Vasquez CC, Yurkov V, Zannoni D (2019) Tellurite-dependent blackening of bacteria emerges from the dark ages. Environ Chem 16(4):266–288. https://doi.org/10.1071/En18238
Qu Y, Lv Y, Ji S, Ding L, Zhao F, Zhu Y et al (2022) Effect of exposures to mixtures of lead and various metals on hypertension, pre-hypertension, and blood pressure: a cross-sectional study from the China National Human Biomonitoring. Environ Pollut 299:118864. https://doi.org/10.1016/j.envpol.2022.118864
Rehman K, Fatima F, Waheed I, Akash MSH (2018) Prevalence of exposure of heavy metals and their impact on health consequences. J Cell Biochem 119(1):157–184. https://doi.org/10.1002/jcb.26234
Sandoval JM, Leveque P, Gallez B, Vasquez CC, Buc Calderon P (2010) Tellurite-induced oxidative stress leads to cell death of murine hepatocarcinoma cells. Biometals 23(4):623–632. https://doi.org/10.1007/s10534-010-9316-2
Seravalle G, Dell’Oro R, Quarti-Trevano F, Spaziani D, Bertoli S, Airoldi F et al (2020) Sympathetic overactivation in patients with essential hypertension and hepatic iron overload. Hypertension 76(5):1444–1450. https://doi.org/10.1161/HYPERTENSIONAHA.120.15511
Shi P, Jing H, Xi S (2019) Urinary metal/metalloid levels in relation to hypertension among occupationally exposed workers. Chemosphere 234:640–647. https://doi.org/10.1016/j.chemosphere.2019.06.099
Shiue I (2014) Higher urinary heavy metal, arsenic, and phthalate concentrations in people with high blood pressure: US NHANES, 2009–2010. Blood Press 23(6):363–369. https://doi.org/10.3109/08037051.2014.925228
Sobhanardakani S (2019) Ecological and human health risk assessment of heavy metal content of atmospheric dry deposition, a case study: Kermanshah, Iran. Biol Trace Elem Res 187(2):602–610. https://doi.org/10.1007/s12011-018-1383-1
Sobhanardakani S, Tayebi L, Hosseini SV (2018) Health risk assessment of arsenic and heavy metals (Cd, Cu Co, Pb, and Sn) through consumption of caviar of Acipenser persicus from Southern Caspian Sea. Environ Sci Pollut Res Int 25(3):2664–2671. https://doi.org/10.1007/s11356-017-0705-8
Sofianopoulou E, Kaptoge S, Graf S, Hadinnapola C, Treacy CM, Church C et al (2019) Traffic exposures, air pollution and outcomes in pulmonary arterial hypertension: a UK cohort study analysis. Eur Respir J 53(5):1801429. https://doi.org/10.1183/13993003.01429-2018
Tang Y, Xia W, Xu SQ, Liu HX, Li YY (2021) Association of urinary strontium levels with pregnancy-induced hypertension. Curr Med Sci 41(3):535–541. https://doi.org/10.1007/s11596-021-2366-6
Valdivia-Gonzalez M, Perez-Donoso JM, Vasquez CC (2012) Effect of tellurite-mediated oxidative stress on the Escherichia coli glycolytic pathway. Biometals 25(2):451–458. https://doi.org/10.1007/s10534-012-9518-x
Waldmann P, Meszaros G, Gredler B, Fuerst C, Solkner J (2013) Evaluation of the lasso and the elastic net in genome-wide association studies. Front Genet 4:270. https://doi.org/10.3389/fgene.2013.00270
Wu W, Jiang S, Zhao Q, Zhang K, Wei X, Zhou T et al (2018a) Environmental exposure to metals and the risk of hypertension: a cross-sectional study in China. Environ Pollut 233:670–678. https://doi.org/10.1016/j.envpol.2017.10.111
Wu W, Jiang S, Zhao Q, Zhang K, Wei X, Zhou T et al (2018b) Associations of environmental exposure to metals with the risk of hypertension in China. Sci Total Environ 622–623:184–191. https://doi.org/10.1016/j.scitotenv.2017.11.343
Xiao Y (2017) Association of plasma multiple metals with hypertension risk and blood pressure level in a retired population Available at: https://kns.cnki.net/kcms2/article/abstract?v=3uoqIhG8C475KOm_zrgu4lQARvep2SAkVtq-vp-8QbjqyhlE-4l1YikXxhK_c1IhpjCB8fQ4ZNjEJF9U8Sv0OVXv6_3JQ7P1&uniplatform=NZKPT
Xiao Y, Yuan Y, Liu Y, Yu Y, Jia N, Zhou L et al (2019) Circulating multiple metals and incident stroke in Chinese adults. Stroke 50(7):1661–1668. https://doi.org/10.1161/STROKEAHA.119.025060
Xing Z (2020) Association of blood lead and blood strontium with hypertension in people aged 60 and above in lu 'an city. Available at: https://kreader.cnki.net/Kreader/CatalogViewPage.aspx?dbCode=CMFD&filename=1020317086.nh&tablename=CMFD202201&compose=&first=1&uid=WEEvREcwSlJHSldSdmVqM1BLYmxielBGM0h1NXA5Tk9kY1Q2S2hab2FrYz0=$9A4hF_YAuvQ5obgVAqNKPCYcEjKensW4IQMovwHtwkF4VYPoHbKxJw. Accessed 1 Mar 2020
Yarema MC, Curry SC (2005) Acute tellurium toxicity from ingestion of metal-oxidizing solutions. Pediatrics 116(2):e319-321. https://doi.org/10.1542/peds.2005-0172
Zoroddu MA, Aaseth J, Crisponi G, Medici S, Peana M, Nurchi VM (2019) The essential metals for humans: a brief overview. J Inorg Biochem 195:120–129. https://doi.org/10.1016/j.jinorgbio.2019.03.013
Acknowledgements
The authors would like to thank the editor and reviewers for improving the quality of the manuscript.
Funding
This project was supported by the Natural Science Foundation of Ningxia, China (no.2022AAC05028).
Jian Sun has received research support from the foundation.
This project was supported The Key Research and Development Project of Ningxia (no. 2021BEG02030). Zhihong Liu has received research support from the foundation.
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Siyu Duan: Conceptualisation, methodology, investigation, writing – original draft, and data curation.
Rui Wang: conceptualisation, methodology, formal analysis, writing of the original draft, and data curation.
Pei He: Methodology, investigation, formal analysis, and data curation.
Jian Sun: Conceptualisation, Methodology, Investigation, Writing – original draft, and data curation HuiFang Yang: Conceptualisation, investigation, formal analysis, writing – original draft, and supervision.
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Highlights
• Pathogenic concentration of single metal related to hypertension were calculated.
• Mixture metal predictive scores were associated with higher risk of hypertension.
• Mixture metal can increase hypertension predictive ability significantly.
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Duan, S., Wang, R., He, P. et al. Associations between multiple urinary metals and the risk of hypertension in community-dwelling older adults. Environ Sci Pollut Res 30, 76543–76554 (2023). https://doi.org/10.1007/s11356-023-27797-2
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DOI: https://doi.org/10.1007/s11356-023-27797-2