PMID- 35324741
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220421
IS  - 2305-6304 (Electronic)
IS  - 2305-6304 (Linking)
VI  - 10
IP  - 3
DP  - 2022 Mar 1
TI  - Exposure to Metal Mixtures in Association with Cardiovascular Risk Factors and 
      Outcomes: A Scoping Review.
LID - 10.3390/toxics10030116 [doi]
LID - 116
AB  - Since the National Institute of Environmental Health Sciences (NIEHS) declared 
      conducting combined exposure research as a priority area, literature on chemical 
      mixtures has grown dramatically. However, a systematic evaluation of the current 
      literature investigating the impacts of metal mixtures on cardiovascular disease 
      (CVD) risk factors and outcomes has thus far not been performed. This scoping 
      review aims to summarize published epidemiology literature on the cardiotoxicity 
      of exposure to multiple metals. We performed systematic searches of MEDLINE 
      (PubMed), Scopus, and Web of Science to identify peer-reviewed studies employing 
      statistical mixture analysis methods to evaluate the impact of metal mixtures on 
      CVD risk factors and outcomes among nonoccupationally exposed populations. The 
      search was limited to papers published on or after 1998, when the first dedicated 
      funding for mixtures research was granted by NIEHS, through 1 October 2021. 
      Twenty-nine original research studies were identified for review. A notable 
      increase in relevant mixtures publications was observed starting in 2019. The 
      majority of eligible studies were conducted in the United States (n = 10) and 
      China (n = 9). Sample sizes ranged from 127 to 10,818. Many of the included 
      studies were cross-sectional in design. Four primary focus areas included: (i) 
      blood pressure and/or diagnosis of hypertension (n = 15), (ii) risk of 
      preeclampsia (n = 3), (iii) dyslipidemia and/or serum lipid markers (n = 5), and 
      (iv) CVD outcomes, including stroke incidence or coronary heart disease (n = 8). 
      The most frequently investigated metals included cadmium, lead, arsenic, and 
      cobalt, which were typically measured in blood (n = 15). The most commonly 
      utilized multipollutant analysis approaches were Bayesian kernel machine 
      regression (BKMR), weighted quantile sum regression (WQSR), and principal 
      component analysis (PCA). To our knowledge, this is the first scoping review to 
      assess exposure to metal mixtures in relation to CVD risk factors and outcomes. 
      Recommendations for future studies evaluating the associations of exposure to 
      metal mixtures with risk of CVDs and related risk factors include extending 
      environmental mixtures epidemiologic studies to populations with wider metals 
      exposure ranges, including other CVD risk factors or outcomes outside 
      hypertension or dyslipidemia, using repeated measurement of metals to detect 
      windows of susceptibility, and further examining the impacts of potential effect 
      modifiers and confounding factors, such as fish and seafood intake.
FAU - Yim, Gyeyoon
AU  - Yim G
AD  - Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH 
      03756, USA.
FAU - Wang, Yuting
AU  - Wang Y
AD  - Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH 
      03756, USA.
FAU - Howe, Caitlin G
AU  - Howe CG
AUID- ORCID: 0000-0002-4935-9298
AD  - Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH 
      03756, USA.
FAU - Romano, Megan E
AU  - Romano ME
AUID- ORCID: 0000-0003-4932-2492
AD  - Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH 
      03756, USA.
LA  - eng
GR  - R00 ES030400/ES/NIEHS NIH HHS/United States
GR  - P20 GM104416/GM/NIGMS NIH HHS/United States
PT  - Journal Article
PT  - Review
DEP - 20220301
PL  - Switzerland
TA  - Toxics
JT  - Toxics
JID - 101639637
PMC - PMC8955637
OTO - NOTNLM
OT  - blood pressure
OT  - cardiovascular diseases
OT  - dyslipidemia
OT  - hypertension
OT  - metal mixtures
OT  - preeclampsia
COIS- The authors declare no conflict of interest.
EDAT- 2022/03/25 06:00
MHDA- 2022/03/25 06:01
PMCR- 2022/03/01
CRDT- 2022/03/24 17:24
PHST- 2022/01/17 00:00 [received]
PHST- 2022/02/24 00:00 [revised]
PHST- 2022/02/26 00:00 [accepted]
PHST- 2022/03/24 17:24 [entrez]
PHST- 2022/03/25 06:00 [pubmed]
PHST- 2022/03/25 06:01 [medline]
PHST- 2022/03/01 00:00 [pmc-release]
AID - toxics10030116 [pii]
AID - toxics-10-00116 [pii]
AID - 10.3390/toxics10030116 [doi]
PST - epublish
SO  - Toxics. 2022 Mar 1;10(3):116. doi: 10.3390/toxics10030116.