| Objective: Multiple metals enter human body through digestive tract, respiratory tract and skin contact, which consequently increase risk of chronic diseases including hypertension. As reported by several studies, exposure to certain metals such as lead,arsenic, cadmium is associated with increased risk of hypertension. However,systematic investigations of the association between internal exposure of multiple metals and the risk of hypertension are scarce. Therefore, our study aims to explore the associations between plasma concentrations of multiple metals with the risk of hypertension and blood pressure levels among Chinese population.Methods: We conducted a cross-sectional study based on the control group of two nested case-control studies within the prospective Dongfeng-Tongji(DFTJ)cohort. Plasma levels of 23 metals were determined by using the inductively coupled plasma mass spectrometer(ICP-MS). One-way ANOVA for continuous variables and Chi-square tests for categorical variables were used to compare the baseline characteristics of study participants. Meanwhile, multivariate logistic regression and linear regression were applied to assess the associations of 23 plasma metals with hypertension and blood pressure. Principal component analysis was further performed to explore the main metal components which are potentially risk factors for hypertension.Results: A total of 567 hypertension events were observed in the cross-sectionalstudy. We found that(1) Plasma aluminum, titanium, vanadium, chromium,manganese, zinc, arsenic, strontium, molybdenum, barium and lead concentration were positively associated with the risk of hypertension(Ptrend < 0.05 for all).(2)Positive dose-response relationships were observed between the plasma vanadium,copper, zinc, rubidium and strontium concentration with the level of systolic blood pressure [β = 1.584, 95% CI: 0.385~2.783; P = 0.010), 3.705(95% CI: 0.173~7.236;P = 0.040), 1.046(95% CI: 0.289~1.802; P = 0.007), 5.958(95% CI: 2.187~9.729; P= 0.002), 3.641(95% CI: 1.116~6.167; P = 0.005) respectively]; Moreover, plasma aluminum, vanadium, chromium, iron, arsenic, rubidium, strontium, barium and lead concentration were dose-dependently associated with increased diastolic blood pressure [β = 1.146(95% CI: 0.727~1.565; P ≤ 0.001), 2.364(95% CI: 1.578~3.151;P ≤ 0.001), 1.414(95% CI: 0.516~2.312; P = 0.002), 1.911(95% CI: 0.605~3.216; P= 0.004), 1.923(95% CI: 1.432~2.415; P ≤ 0.001), 2.028(95% CI: 1.430~2.626; P ≤0.001), 5.058(95% CI: 2.562~7.555; P ≤ 0.001), 1.835(95% CI: 0.156~3.514; P =0.032), 1.556(95% CI: 1.002~2.110; P ≤ 0.001), 1.501(95% CI: 0.987~2.015; P ≤0.001) respectively].(3) Principal component analysis(PCA) extracted 5 principal components and each principal component was mainly composed of several relevant metals. The first principal component(PC1) mainly represented the plasma level of aluminum, vanadium, zinc, arsenic, barium and lead, and these metals were positively associated with increased risk of hypertension. In contrast, the second principal component(PC2) mainly signified the plasma level of cobalt, antimony and thallium and was inversely associated with the risk of hypertension(Ptrend < 0.05 for all).Conclusions: Our findings suggest that exposure to multiple metals(aluminum,vanadium, zinc, arsenic, barium and lead) is associated with the increased risk of hypertension, and plasma levels of several metals are correlated with the elevation of blood pressure. These findings provide support that multiple metals exposure could be a risk factor of hypertension. Our results warrant further investigation in other population and prospective cohort study. |
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