Heavy metal exposure and risk of all-cause and cardiovascular mortality in population with cardiovascular-kidney-metabolic syndrome stage 0-3: a cohort study.

Authors

Yiyang Liu, Fujian Li, Ying Huang, Jiansheng Cai, You Li

Published in

Environmental health and preventive medicine. Volume 31. Pages 45.

Abstract

Evidence on the association between blood metal exposure and mortality among adults with cardiovascular-kidney-metabolic (CKM) syndrome stages 0-3 remains limited. We examined the associations of blood lead (Pb), cadmium (Cd), mercury (Hg), selenium (Se), and manganese (Mn) with all-cause and cardiovascular mortality in this population.
We analyzed data from 4,394 adults with CKM stages 0-3 from the National Health and Nutrition Examination Survey (NHANES) 2011-2018 linked to mortality records. Blood metal concentrations were measured using inductively coupled plasma mass spectrometry. Weighted Cox proportional hazards models, restricted cubic spline (RCS) analyses, and weighted quantile sum (WQS) regression were used to assess associations of individual and mixed metal exposures with mortality outcomes.
In the fully adjusted model, elevated blood Cd levels were associated with a higher risk of all-cause mortality (HR = 1.71, 95% CI: 1.26-2.33). In contrast, blood Se showed an inverse association with all-cause mortality, with lower risks observed in Q2 (HR = 0.61, 95% CI: 0.41-0.90) and Q4 (HR = 0.59, 95% CI: 0.38-0.93). RCS analyses showed nonlinear associations of Cd and Se with all-cause mortality. Cd exhibited an inverted U-shaped pattern, whereas Se showed an L-shaped inverse association. WQS regression suggested a positive association between mixed metal exposure and all-cause mortality (HR = 1.16, 95% CI: 0.99-1.34; P = 0.046). Associations with cardiovascular mortality were weaker and less consistent.
Among U.S. adults with stage 0-3 cardiovascular-kidney-metabolic syndrome, elevated blood cadmium levels and reduced blood selenium levels were potentially associated with a higher risk of all-cause mortality.

PMID:
42402419
Bibliographic data and abstract were imported from PubMed on 06 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.