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AuthorShibeeb, Sapha
AuthorAbdallah, Atiyeh
AuthorShi, Zumin
Available date2024-02-26T06:59:04Z
Publication Date2024-01-17
Publication NameCardiovascular Toxicology
Identifierhttp://dx.doi.org/10.1007/s12012-023-09819-0
CitationShibeeb, S., Abdallah, A., & Shi, Z. (2024). Blood homocysteine levels mediate the association between blood lead levels and cardiovascular mortality. Cardiovascular Toxicology, 24(1), 62-70.
ISSN1530-7905
URIhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85182412570&origin=inward
URIhttp://hdl.handle.net/10576/52200
AbstractLead is a heavy, toxic metal and its exposure to humans can lead to increased risk of cardiovascular disease development and mortality. Lead exposure has been shown to induce hyperhomocysteinemia (HHCy) which may be a major pathogenic risk for the risk of CVDs. The aim of this study was to investigate whether homocysteine (Hcy) mediates the effect of lead on cardiovascular mortality. A total of 17,915 adults aged ≥ 20 who participated in the National Health and Nutrition Examination Survey (1999 to 2006). Information on mortality was ascertained via probabilistic matching to the death certificates from the National Death Index recorded up to December 31, 2015. Cox proportional hazards regression was performed to assess the association between blood lead levels and mortality. Mediation via Hcy was examined using a logit model. During a mean follow-up of 11.6 years, the incidences of CVD mortality were 0.73, 2.18, 3.03 and 4.94 per 1000 person-years across quarterlies of blood lead levels from low to high. Following multivariable adjustment, blood lead levels were strongly associated with CVD mortality in all mortality models (p-trend < 0.001). This association remained statistically significant after further adjusting for quartiles of homocysteine (model 3; HR 1.38 (95% CI 1.01—1.89) p-trend < 0.001). Furthermore, blood lead levels increased the odds of CVD mortality via homocysteine (indirect effect) (OR 1.42 (95% CI 1.30—1.55)), demonstrating the mediatory effect of homocysteine. This the first study that demonstrates that increased homocysteine mediates nearly half of CVD mortality related to blood lead levels.
Languageen
PublisherSpringer Nature
SubjectCardiovascular diseases
Homocysteine
Lead exposure
Mortality
NHANES
TitleBlood Homocysteine Levels Mediate the Association Between Blood Lead Levels and Cardiovascular Mortality
TypeArticle
Pagination62-70
Issue Number1
Volume Number24
ESSN1559-0259
dc.accessType Open Access


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