The association of urine metals and metal mixtures with cardiovascular incidence in an adult population from Spain: the Hortega Follow-Up Study.

Autores de INCLIVA

• Arce Domingo Relloso

  Autor

• María Grau Pérez

  Autor

• 

  Felipe Javier Chaves Martínez

  Autor

• 

  Josep Redón Mas

  Autor

Participantes ajenos a INCLIVA

• Briongos-Figuero, Laisa
• Gomez-Ariza, Jose L
• Garcia-Barrera, Tamara
• Duenas-Laita, Antonio
• Bobb, Jennifer F
• Kioumourtzoglou, Marianthi-Anna
• Navas-Acien, Ana
• Martin-Escudero, Juan C
• Tellez-Plaza, Maria

Grupos y Plataformas de I+D+i

• Grupo de Estudio de Riesgo Cardiometabólico y Renal

  

  Established Researcher

  Raquel Cortés Vergaz

• Unidad de Genómica y Diabetes

  

  Established Researcher

  Felipe Javier Chaves Martínez

Abstract

Background: The association of low-level exposure to metals and metal mixtures with cardiovascular incidence in the general population has rarely been studied. We flexibly evaluated the association of urinary metals and metal mixtures concentrations with cardiovascular diseases in a representative sample of a general population from Spain. Methods: Urine antimony (Sb), barium (Ba), cadmium (Cd), chromium (Cr), cobalt (Co), copper (Cu), molybdenum (Mo), vanadium (V) and zinc (Zn) were measured in 1171 adults without clinical cardiovascular diseases, who participated in the Hortega Study. Cox proportional hazard models were used for evaluating the association between single metals and cardiovascular incidence. We used a Probit extension of Bayesian Kernel Machine Regression (BKMR-P) to handle metal mixtures in a survival setting. Results: In single-metal models, the hazard ratios [confidence intervals (CIs)] of cardiovascular incidence, comparing the 80th to the 20th percentiles of metal distributions, were 1.35 (1.06, 1.72) for Cu, 1.43 (1.07, 1.90) for Zn, 1.51 (1.13, 2.03) for Sb, 1.46 (1.13, 1.88) for Cd, 1.64 (1.05, 2.58) for Cr and 1.31 (1.01, 1.71) for V. BKMR-P analysis was confirmatory of these findings, supporting that Cu, Zn, Sb, Cd, Cr and V are related to cardiovascular incidence in the presence of the other metals. Cd and Sb showed the highest posterior inclusion probabilities. Conclusions: Urine Cu, Zn, Sb, Cd, Cr and V were independently associated with increased cardiovascular risk at levels relevant for the general population of Spain. Urine metals in the mixture were also jointly associated with cardiovascular incidence, with Cd and Sb being the most important components of the mixture.

© The Author(s) 2019; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association

Keywords

• Urine metals; cardiovascular incidence; population-based; cohort study; BKMR