Abstract P174: Toxic Heavy Metals Are Associated With Increased Risk Of Cardiometabolic Disorders

Abstract

Background: Cardiometabolic disorders (CMDs) are the leading cause of morbidity and mortality globally. For decades, heart disease, stroke, diabetes mellitus (DM) and chronic kidney disease (CKD) have remained leading causes of death for both men and women in the US. Identification of preventable risk factors is needed to help ameliorate the burden of CMDs. While exposure to toxic heavy metals may contribute to the risk of CMDs, the results of studies examining their association have been inconsistent. Objective: To evaluate the association between blood levels of toxic heavy metals - cadmium, lead and mercury - and coronary heart disease (CHD), stroke, CKD, DM, metabolic syndrome (MetS), dyslipidemia, hypertension, and central obesity in a representative sample of US adults. Methods: We analyzed data from 36,862 adults aged 20 to 80 years in the US National Health and Nutrition Examination Survey (NHANES) 1999 to 2018 cycles. We dichotomized the levels of each metal using the median levels of the individuals without the outcomes, as the cut point. Results: A total of 816 adults had CHD, 1,251 had stroke, 653 had CKD, 6,341 had DM, 6,692 had IR, 18,251 had MetS, 3,597 had dyslipidemia, 20,024 had hypertension and 20,388 had central obesity. In models adjusted for sociodemographic factors and underlying medical diagnoses, we found that cadmium levels were positively associated with CHD [odds ratio: 1.28 (95% confidence interval: 1.06 - 1.55)], stroke [1.21 (1.03 - 1.41)], CKD [1.62 (1.51 - 1.74)] and dyslipidemia [1.17 (1.08 - 1.28)]; and inversely associated with DM [0.65 (0.60 - 0.70)], MetS [0.77 (0.72 - 0.82)] and central obesity [0.72 (0.68 - 0.76)]. In similarly adjusted models, lead levels were positively associated with CKD [1.90 (1.77 - 2.04)] and dyslipidemia [1.18 (1.08 - 1.12)]; and inversely associated with DM [0.51 (0.48 - 0.55)] and central obesity [0.72 (0.68 - 0.76)]. Mercury was positively associated with stroke [1.27 (1.12 - 1.45)], CKD [2.38 (2.23 - 2.54)], MetS [1.14 (1.08 - 1.21)], dyslipidemia [1.09 (1.01 - 1.17)], hypertension [1.19 (1.13 - 1.25)] and central obesity [1.10 (1.04 - 1.15)]. Conclusion: The results of this large cross-sectional analyses support the findings that cadmium, lead and mercury are significantly associated with several CMDs.