School of Medicine and Health Sciences Poster Presentations

Title

Exposure to heavy metals may increase Cardiovascular Risk by elevation of serum Lipid levels and hemoglobin a1c- A National Health and Nutrition Examination Survey Based Study

Document Type

Poster

Abstract Category

Cardiology/Cardiovascular Research

Keywords

Heavy metals, Cholesterol, Glycated hemoglobin A1c

Publication Date

Spring 5-1-2019

Abstract

Introduction: Heavy metals (HM), defined as metals with densities higher than 5g/cm3, have the ability to interact with various physiological processes in the body with cardiovascular consequences. We sought to understand the relationship of serum levels of HM and serum total (TC) and LDL-cholesterol (LDL-C) and glycated hemoglobin (HbA1c) Hypothesis: Serum total and LDL cholesterol, HbA1c may be related to serum HM Methods: Cross-sectional survey involving multistage stratified sampling using NHANES 2009-2012 database. Age,gender, ethnicity, education were considered as covariates. TC (normal <200 mg/dl), LDL-C (normal < 100 mg/dl) and HbA1c (normal <=6.5) were related to levels of lead, cadmium and mercury. Results: 50.27% females, mean age 36.93 years (SE = 0.443776). Non-Hispanic Whites 36.54% (7158), Non-Hispanic Black 22.89%, Hispanics 18.48%, others 22.09%. We divided subjects into 3 tertiles, T1, T2 and T3 based on levels of heavy metals. There was a significant difference in the level of LDL-C and TC from first to third tertile for lead with progressively increasing values. (p <0.0001). After running a multivariate analysis, odds of having higher TC was higher in T3 for lead when compared with T1 (OR 1.567,1.376-1.786), odds were also higher in T3 for mercury (OR 1.730,95CI 1.512-1.981) and for cadmium (OR 1.412, 95CI1.184-1.700). For LDL-C, odds of having higher LDL was more in T3 for lead compared to T1( OR 1.225, 95CI 0.835-1.739), also odds of having higher LDL-C was higher in T2 for mercury (OR 1.233, 95CI 1.004-1.515). When compared to the reference group T1, odds of having higher TC level was statistically significant (p < 0.01) in T3 for all metals studied and odds of having higher LDL-C was more in the T2 for mercury (p < 0.01) . Odds of having diabetes was high in T2 for lead when compared to T1(OR 1.291, 95 CI 1.001-1.663). We did not find any positive effect due to mercury. Odds of having DM was higher in T2 (OR 1.136,95CI 0.870,1.484) and T3 (OR 1.157,95CI 0.844,1.586) for cadmium but not statistically significant. Conclusions: Our study demonstrates increasing serum levels of heavy metals are significantly associated with increasing TC and LDL-C, also with HbA1C. This in turn may be associated with cardiovascular consequences in populations exposed to heavy metals such as areas with natural disaster water crises (i.e. Flint and Puerto Rico) and in areas with other environmental concerns raising consideration of screening for heavy metals as a risk for cardiovascular disease.

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Presented at Research Days 2019.

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Exposure to heavy metals may increase Cardiovascular Risk by elevation of serum Lipid levels and hemoglobin a1c- A National Health and Nutrition Examination Survey Based Study

Introduction: Heavy metals (HM), defined as metals with densities higher than 5g/cm3, have the ability to interact with various physiological processes in the body with cardiovascular consequences. We sought to understand the relationship of serum levels of HM and serum total (TC) and LDL-cholesterol (LDL-C) and glycated hemoglobin (HbA1c) Hypothesis: Serum total and LDL cholesterol, HbA1c may be related to serum HM Methods: Cross-sectional survey involving multistage stratified sampling using NHANES 2009-2012 database. Age,gender, ethnicity, education were considered as covariates. TC (normal <200 mg>/dl), LDL-C (normal < 100 mg/dl) and HbA1c (normal <=6.5) were related to levels of lead, cadmium and mercury. Results: 50.27% females, mean age 36.93 years (SE = 0.443776). Non-Hispanic Whites 36.54% (7158), Non-Hispanic Black 22.89%, Hispanics 18.48%, others 22.09%. We divided subjects into 3 tertiles, T1, T2 and T3 based on levels of heavy metals. There was a significant difference in the level of LDL-C and TC from first to third tertile for lead with progressively increasing values. (p <0.0001). After running a multivariate analysis, odds of having higher TC was higher in T3 for lead when compared with T1 (OR 1.567,1.376-1.786), odds were also higher in T3 for mercury (OR 1.730,95CI 1.512-1.981) and for cadmium (OR 1.412, 95CI1.184-1.700). For LDL-C, odds of having higher LDL was more in T3 for lead compared to T1( OR 1.225, 95CI 0.835-1.739), also odds of having higher LDL-C was higher in T2 for mercury (OR 1.233, 95CI 1.004-1.515). When compared to the reference group T1, odds of having higher TC level was statistically significant (p < 0.01) in T3 for all metals studied and odds of having higher LDL-C was more in the T2 for mercury (p < 0.01) . Odds of having diabetes was high in T2 for lead when compared to T1(OR 1.291, 95 CI 1.001-1.663). We did not find any positive effect due to mercury. Odds of having DM was higher in T2 (OR 1.136,95CI 0.870,1.484) and T3 (OR 1.157,95CI 0.844,1.586) for cadmium but not statistically significant. Conclusions: Our study demonstrates increasing serum levels of heavy metals are significantly associated with increasing TC and LDL-C, also with HbA1C. This in turn may be associated with cardiovascular consequences in populations exposed to heavy metals such as areas with natural disaster water crises (i.e. Flint and Puerto Rico) and in areas with other environmental concerns raising consideration of screening for heavy metals as a risk for cardiovascular disease.