Recent epidemiological research based on the Multi-Ethnic Study of Atherosclerosis (MESA) has shed light on the relationship between urinary metal levels and cardiovascular disease (CVD) and all-cause mortality. Findings from this study indicate that certain non-essential and essential metals found in urine are associated with an increased risk of CVD and mortality over a period of more than 17 years.
The study revealed that various metals such as cadmium, tungsten, uranium, cobalt, copper, and zinc were linked to incident CVD events and mortality when comparing the highest to lowest quartiles. For instance, cadmium showed a hazard ratio (HR) of 1.25 for CVD and 1.68 for death, while copper exhibited an HR of 1.42 for CVD and 1.50 for death. These associations remained significant even after adjusting for demographic, lifestyle, and clinical risk factors.
The study authors, led by Irene Martinez-Morata, emphasized the importance of understanding the role of urinary metal levels as predictors of CVD risk and mortality. The findings suggest that atherosclerosis may be a key underlying pathway explaining the association between metals and clinical events, highlighting the clinical relevance of these subclinical associations.
While arsenic, cadmium, and lead have long been recognized as contaminant metals with established CVD risks, other metals like uranium and tungsten remain less studied. Exposure to these metals, particularly through sources like drinking water, food, and air pollution, warrants further investigation to determine their impact on human health. Regulatory bodies such as the Environmental Protection Agency need to consider addressing these unregulated metals to safeguard public health.
More research is needed to assess the sources of excess exposure to both essential and non-essential metals. Martinez-Morata and colleagues underscored the critical need for understanding how drinking water, food, and air contribute to internal metal dose levels. Federal regulators are encouraged to take action to reduce environmental exposure to harmful metals, especially in communities disproportionately affected by metal contamination.
Essential metals like cobalt, copper, and zinc are tightly regulated in the body, and elevated levels in urine may signal early cardiometabolic dysregulation. Monitoring these essential metals can offer insights into nutrient reserves and metabolism function, particularly in the context of cardiovascular disease progression. Further research is warranted to explore the impact of these essential metals on cardiovascular health.
The study on urinary metal levels and their impact on CVD and mortality underscores the need for greater awareness of environmental exposures to metals. By understanding the associations between metal exposure and clinical events, healthcare providers and policymakers can take proactive steps to mitigate the potential risks associated with metal contamination. This research highlights the importance of ongoing monitoring of metal levels in the body and the need for targeted interventions to reduce harmful exposures in at-risk communities.
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