PMID- 38231351
OWN - NLM
STAT- MEDLINE
DCOM- 20240205
LR  - 20240206
IS  - 1559-0259 (Electronic)
IS  - 1530-7905 (Print)
IS  - 1530-7905 (Linking)
VI  - 24
IP  - 1
DP  - 2024 Jan
TI  - Blood Homocysteine Levels Mediate the Association Between Blood Lead Levels and 
      Cardiovascular Mortality.
PG  - 62-70
LID - 10.1007/s12012-023-09819-0 [doi]
AB  - Lead 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.
CI  - (c) 2024. The Author(s).
FAU - Shibeeb, Sapha
AU  - Shibeeb S
AD  - School of Health and Biomedical Sciences, RMIT University, PO Box 71, Bundoora, 
      Melbourne, VIC, 3083, Australia. sapha.shibeeb@rmit.edu.au.
FAU - Abdallah, Atiyeh
AU  - Abdallah A
AD  - Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar 
      University, Doha, Qatar.
FAU - Shi, Zumin
AU  - Shi Z
AD  - Human Nutrition Department, College of Health Sciences, QU Health, Qatar 
      University, Doha, Qatar.
LA  - eng
PT  - Journal Article
DEP - 20240117
PL  - United States
TA  - Cardiovasc Toxicol
JT  - Cardiovascular toxicology
JID - 101135818
RN  - 2P299V784P (Lead)
SB  - IM
MH  - Adult
MH  - Humans
MH  - *Lead/adverse effects
MH  - Nutrition Surveys
MH  - *Cardiovascular Diseases
MH  - Incidence
PMC - PMC10838245
OTO - NOTNLM
OT  - Cardiovascular diseases
OT  - Homocysteine
OT  - Lead exposure
OT  - Mortality
OT  - NHANES
COIS- The authors declare no competing interests.
EDAT- 2024/01/17 12:44
MHDA- 2024/02/05 06:43
PMCR- 2024/01/17
CRDT- 2024/01/17 11:13
PHST- 2022/10/24 00:00 [received]
PHST- 2023/12/02 00:00 [accepted]
PHST- 2024/02/05 06:43 [medline]
PHST- 2024/01/17 12:44 [pubmed]
PHST- 2024/01/17 11:13 [entrez]
PHST- 2024/01/17 00:00 [pmc-release]
AID - 10.1007/s12012-023-09819-0 [pii]
AID - 9819 [pii]
AID - 10.1007/s12012-023-09819-0 [doi]
PST - ppublish
SO  - Cardiovasc Toxicol. 2024 Jan;24(1):62-70. doi: 10.1007/s12012-023-09819-0. Epub 
      2024 Jan 17.