Association of Heavy Metals with Overall Mortality in a Taiwanese Population
Abstract
:1. Introduction
2. Materials and Methods
2.1. Subject Recruitment
2.2. Ethics Statement
2.3. Collection of Demographic, Medical, and Laboratory Data
2.4. Measurement of Blood and Urine Heavy Metal Concentrations
2.5. Definition of Overall Mortality
2.6. Statistical Analysis
3. Results
Predictors of Overall Mortality
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | All (n = 2497) | Survival (n = 2457) | Death (n = 40) | p |
---|---|---|---|---|
Age (year) | 54.3 ± 14.0 | 54.1 ± 14.0 | 69.1 ± 11.4 | <0.001 |
Male gender (%) | 40.1 | 40.0 | 45.0 | 0.523 |
DM (%) | 10.3 | 9.9 | 32.5 | 0.005 |
Hypertension (%) | 24.8 | 24.3 | 55.0 | <0.001 |
Hyperlipidemia (%) | 2.2 | 2.2 | 2.5 | 0.912 |
BMI (kg/m2) | 25.0 ± 3.9 | 25.0 ± 3.9 | 25.2 ± 4.5 | 0.834 |
SBP (mmHg) | 131.8 ± 19.8 | 131.7 ± 19.7 | 137.2 ± 21.3 | 0.083 |
DBP (mmHg) | 77.4 ± 11.7 | 77.4 ± 11.7 | 78.1 ± 11.6 | 0.691 |
Laboratory parameters | ||||
Fasting glucose (mg/dL) | 99.6 ± 27.2 | 99.5 ± 27.1 | 106.9 ± 31.7 | 0.087 |
Serum Creatinine (mg/dL) | 0.95 ± 0.29 | 0.94 ± 0.28 | 1.18 ± 0.53 | 0.007 |
Triglyceride (mg/dL) | 126.1 ± 97.4 | 126.0 ± 97.3 | 138.2 ± 100.2 | 0.428 |
Total cholesterol (mg/dL) | 199.2 ± 37.5 | 199.3 ± 37.4 | 191.4 ± 43.3 | 0.186 |
HDL-cholesterol (mg/dL) | 53.0 ± 13.6 | 53.0 ± 13.6 | 50.5 ± 15.4 | 0.237 |
LDL-cholesterol (mg/dL) | 118.9 ± 34.0 | 119.1 ± 33.9 | 108.4 ± 36.1 | 0.048 |
Blood | ||||
Pb (μg/dL) | 1.5 (1.0–2.2) | 1.8 (1.0–2.2) | 2.1 (1.3–2.8) | 0.201 |
Urine | ||||
Cd (μg/L) | 0.8 (0.3–1.4) | 1.1 (0.2–1.4) | 1.5 (0.5–2.4) | 0.017 |
Ni (μg/L) | 2.5 (1.5–3.7) | 3.3 (1.5–3.7) | 3.8 (1.9–5.4) | 0.829 |
Cu (μg/dL) | 1.5 (1.0–2.0) | 1.6 (1.0–2.0) | 2.55 (1.5–3.6) | <0.001 |
Cr (μg/L) | 0.1 (0.1–0.1) | 0.1 (0.1–0.1) | 0.1 (0.1–0.1) | 0.787 |
Mn (μg/L) | 1.7 (0.9–3.0) | 2.2 (0.9–3.0) | 1.5 (0.6–2.0) | 0.019 |
As (μg/L) | 77.9 (44.5–140.2) | 118.2 (44.0–139.4) | 159.9 (69.9–205.4) | 0.064 |
Parameters | Univariable Analysis | |
---|---|---|
HR (95% CI) | p | |
Age (per 1 year) | 1.097 (1.066–1.128) | <0.001 |
Male (vs. female) | 1.259 (0.675–2.347) | 0.469 |
DM | 4.049 (2.089–7.848) | <0.001 |
Hypertension | 3.478 (1.865–6.485) | <0.001 |
Hyperlipidemia | 1.193 (0.164–8.685) | 0.862 |
BMI (per 1 kg/m2) | 1.007 (0.929–1.090) | 0.873 |
SBP (per 1 mmHg) | 1.012 (0.998–1.027) | 0.090 |
DBP (per 1 mmHg) | 1.007 (0.981–1.033) | 0.615 |
Labortaory data | ||
Fasting glucose (per 1 mg/dL) | 1.006 (0.998–1.014) | 0.141 |
Creatinine (per 1 mg/dL) | 1.998 (1.482–2.695) | <0.001 |
Total cholesterol (per 1 mg/dl) | 0.994 (0.985–1.002) | 0.155 |
Triglyceride (per 1 mg/dL) | 1.001 (0.999–1.003) | 0.366 |
HDL-cholesterol (per 1 mg/dL) | 0.986 (0.962–1.010) | 0.254 |
LDL-cholesterol (per 1 mg/dL) | 0.990 (0.980–0.999) | 0.037 |
Blood | ||
Pb (per 1 μg/dL) | 1.067 (0.931–1.222) | 0.350 |
Urine | ||
Cd (per 1 μg/L) | 1.290 (1.070–1.554) | 0.008 |
Ni (per 1 μg/L) | 1.001 (0.989–1.013) | 0.866 |
Cu (per 1 μg/dL | 1.378 (1.241–1.529) | <0.001 |
Cr (per 1 μg/L) | 1.101 (0.534–2.268) | 0.795 |
Mn (per 1 μg/L) | 0.726 (0.567–0.930) | 0.011 |
As (per 1 μg/L) | 1.001 (1.000–1.003) | 0.127 |
Heavy Metals | Multivariable | |
---|---|---|
HR (95% CI) | p | |
Blood | ||
Pb (per 1 μg/dL) | 1.024 (0.865–1.231) | 0.780 |
Urine | ||
Cd (per 1 μg/L) | 1.352 (1.089–1.680) | 0.006 |
Ni (per 1 μg/L) | 1.004 (0.990–1.018) | 0.599 |
Cu (per 1 μg/dL) | 1.350 (1.151–1.583) | <0.001 |
Cr (per 1 μg/L) | 1.015 (0.513–2.009) | 0.966 |
Mn (per 1 μg/L) | 0.717 (0.557–0.923) | 0.010 |
As (per 1 μg/L) | 1.001 (0.999–1.003) | 0.424 |
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Liu, Y.-H.; Wang, C.-W.; Wu, D.-W.; Lee, W.-H.; Chen, Y.-C.; Li, C.-H.; Tsai, C.-C.; Lin, W.-Y.; Chen, S.-C.; Hung, C.-H.; et al. Association of Heavy Metals with Overall Mortality in a Taiwanese Population. Nutrients 2021, 13, 2070. https://doi.org/10.3390/nu13062070
Liu Y-H, Wang C-W, Wu D-W, Lee W-H, Chen Y-C, Li C-H, Tsai C-C, Lin W-Y, Chen S-C, Hung C-H, et al. Association of Heavy Metals with Overall Mortality in a Taiwanese Population. Nutrients. 2021; 13(6):2070. https://doi.org/10.3390/nu13062070
Chicago/Turabian StyleLiu, Yi-Hsueh, Chih-Wen Wang, Da-Wei Wu, Wen-Hsien Lee, Ying-Chih Chen, Chiu-Hui Li, Chun-Chi Tsai, Wen-Yi Lin, Szu-Chia Chen, Chih-Hsing Hung, and et al. 2021. "Association of Heavy Metals with Overall Mortality in a Taiwanese Population" Nutrients 13, no. 6: 2070. https://doi.org/10.3390/nu13062070