Urine Metals Predictive of CVD and Mortality

A US prospective study indicates that urinary metal levels are associated with increased mortality and cardiovascular disease (CVD) risk. The study included a racially diverse population of 6599 participants (mean age, 62.1 years; 53% female) with urinary metals available at baseline (2000 to 2001) and followed through December 2019. During follow-up, 1844 participants died, and 1162 participants developed CVD. Adjusted by behavioral and clinical indicators, the hazard ratio (HR) for incident CVD and all-cause mortality comparing the highest with the lowest quartile were, respectively: 1.25 and 1.68 for cadmium; 1.20 and 1.16 for tungsten; 1.32 and 1.32 for uranium; 1.24 and 1.37 for cobalt; 1.42 and 1.50 for copper; and 1.21 and 1.38 for zinc. There was a positive linear dose-response for cadmium and copper with both incident CVD and mortality. The interquartile range increase in the mixture of these 6 urinary metals was associated with 29% more CVD and 66% more all-cause mortality after accounting for demographic, lifestyle, and clinical risk factors. The findings are consistent with their previous finding that these six metals were associated with higher levels of coronary artery calcification, supporting that atherosclerosis is a major underlying pathway explaining the association of metals with clinical events, and may inform the development of novel preventive strategies to improve cardiovascular health. Cobalt, copper, and zinc are essential metals and tightly regulated in the body, and elevated levels in the urine may indicate an excess in exposure or loss of body reserves of these nutrients. Arsenic, cadmium, and lead are known CVD risk factors. Smoking is a major source of cadmium. Uranium and tungsten are common exposures in the U.S. from drinking water, food, air pollution, and indoor dust. Source: https://www.ahajournals.org/