Associations of plasma metal concentrations with the risks of all-cause and cardiovascular disease mortality in Chinese adults

Shi, Limei; Yuan, Yu; Xiao, Yang; Long, Pinpin; Li, Wending; Yu, Yanqiu; Liu, Yiyi; Kang, Lillian; Wang, Hao; Zhou, Lue; Yang, Handong; Li, Xiulou; He, Meian; Wu, Tangchun

doi:10.1016/j.envint.2021.106808

Cited by 64 publications

(28 citation statements)

References 61 publications

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“…Mean plasma levels of Se are comparable to previous studies [ 124 , 126 , 128 , 129 ]. In the case of Mn, mean plasma values in this Mediterranean population are within the range provided by several authors [ 130 , 131 , 132 ], higher than those described in some previous studies [ 124 , 126 , 129 ], and lower than those observed by Shen et al [ 128 ].…”

Section: Discussionsupporting

confidence: 77%

“…Depending on the biomarker utilized, these low correlations may account for the disparity in results across published studies [ 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 ]. Although the majority of published studies analyzed plasma, serum, or blood concentrations, other studies used urine biomarkers [ 97 , 124 , 127 , 128 , 129 , 130 , 131 , 132 , 133 ]. In the single-trace-element association analysis, we identified a number of statistically significant associations between cardiovascular risk factors and trace elements.…”

Section: Discussionmentioning

confidence: 99%

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Single and Combined Associations of Plasma and Urine Essential Trace Elements (Zn, Cu, Se, and Mn) with Cardiovascular Risk Factors in a Mediterranean Population

et al. 2022

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Trace elements are micronutrients that are required in very small quantities through diet but are crucial for the prevention of acute and chronic diseases. Despite the fact that initial studies demonstrated inverse associations between some of the most important essential trace elements (Zn, Cu, Se, and Mn) and cardiovascular disease, several recent studies have reported a direct association with cardiovascular risk factors due to the fact that these elements can act as both antioxidants and pro-oxidants, depending on several factors. This study aims to investigate the association between plasma and urine concentrations of trace elements and cardiovascular risk factors in a general population from the Mediterranean region, including 484 men and women aged 18–80 years and considering trace elements individually and as joint exposure. Zn, Cu, Se, and Mn were determined in plasma and urine using an inductively coupled plasma mass spectrometer (ICP-MS). Single and combined analysis of trace elements with plasma lipid, blood pressure, diabetes, and anthropometric variables was undertaken. Principal component analysis, quantile-based g-computation, and calculation of trace element risk scores (TERS) were used for the combined analyses. Models were adjusted for covariates. In single trace element models, we found statistically significant associations between plasma Se and increased total cholesterol and systolic blood pressure; plasma Cu and increased triglycerides and body mass index; and urine Zn and increased glucose. Moreover, in the joint exposure analysis using quantile g-computation and TERS, the combined plasma levels of Zn, Cu, Se (directly), and Mn (inversely) were strongly associated with hypercholesterolemia (OR: 2.03; 95%CI: 1.37–2.99; p < 0.001 per quartile increase in the g-computation approach). The analysis of urine mixtures revealed a significant relationship with both fasting glucose and diabetes (OR: 1.91; 95%CI: 1.01–3.04; p = 0.046). In conclusion, in this Mediterranean population, the combined effect of higher plasma trace element levels (primarily Se, Cu, and Zn) was directly associated with elevated plasma lipids, whereas the mixture effect in urine was primarily associated with plasma glucose. Both parameters are relevant cardiovascular risk factors, and increased trace element exposures should be considered with caution.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Single and Combined Associations of Plasma and Urine Essential Trace Elements (Zn, Cu, Se, and Mn) with Cardiovascular Risk Factors in a Mediterranean Population

et al. 2022

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“…Dietary selenium intake (µg/day) P-value Almost all studies from Chinese population have found that selenium has a negative effect on stroke (3,28,(40)(41)(42)(43). However, selenium in these studies was assessed by blood selenium, lack of evidence of dietary selenium and stroke.…”

Section: Characteristicsmentioning

confidence: 99%

Association of habitually low intake of dietary selenium with new-onset stroke: A retrospective cohort study (2004–2015 China Health and Nutrition Survey)

Zhang

Qiu

Wang

et al. 2023

Front. Public Health

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BackgroundAs an essential trace element in the body, selenium is associated with the development of many diseases. The purpose of this study was to explore the association between dietary selenium intake and new-onset stroke risk in Chinese adults.MethodsAdults aged ≥18 years in the China Health and Nutrition Survey (CHNS) from 2004 to 2015 were enrolled. Participants were divided into five groups according to the quintile of dietary selenium intake: Q1 (≤ 29.80 μg/day), Q2 (29.80–38.53 μg/day), Q3 (38.53–47.23 μg/day), Q4 (47.23–60.38 μg/day), Q 5(>60.38 μg/day). Cox proportional-hazards model was used to explore the effect of dietary selenium on new-onset stroke. Restricted cubic spline (RCS) was used to visualize the dose-response relationship between dietary selenium and the risk of morbidity.ResultsA total of 11,532 subjects were included, and 271 (2.35%) of them developed stroke during a mean follow-up of 6.78 person-years. Compared with the lowest selenium intake group, the HR and 95%CI of stroke in the participants with selenium intake of Q2, Q3, Q4 and Q5 were: 0.85 (0.59, 1.21), 0.62 (0.42, 0.92), 0.43 (0.28, 0.68), 0.49 (0.30, 0.82), respectively. There was an L-shaped relationship between dietary selenium and stroke (nonlinear P-value = 0.0420). The HR and 95%CI of developing stroke was 0.75 (0.65, 0.87) in participants with selenium intake ≤ 60 μg/day.ConclusionsThe L-shaped negative association between dietary selenium and stroke in Chinese adults which indicated that dietary selenium should be improved to a certain level to prevent stroke.

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“…Oxidative stress has recently been considered a critical pathophysiological mechanism in stroke [ 8 ]. Previous observational studies have reported the beneficial effects of selenium on cardiovascular diseases, including stroke [ 9 , 10 ]. However, secondary analyses in the Nutritional Prevention of Cancer (NPC) trial did not reveal any benefit of selenium supplementation on the risk of stroke [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Correlation between dietary selenium intake and stroke in the National Health and Nutrition Examination Survey 2003–2018

et al. 2022

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Associations of plasma metal concentrations with the risks of all-cause and cardiovascular disease mortality in Chinese adults

Cited by 64 publications

References 61 publications

Single and Combined Associations of Plasma and Urine Essential Trace Elements (Zn, Cu, Se, and Mn) with Cardiovascular Risk Factors in a Mediterranean Population

Single and Combined Associations of Plasma and Urine Essential Trace Elements (Zn, Cu, Se, and Mn) with Cardiovascular Risk Factors in a Mediterranean Population

Association of habitually low intake of dietary selenium with new-onset stroke: A retrospective cohort study (2004–2015 China Health and Nutrition Survey)

Correlation between dietary selenium intake and stroke in the National Health and Nutrition Examination Survey 2003–2018

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