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Low-level exposure to lead and atherosclerosis in the carotid arteries : Results from the Swedish population-based cohort SCAPIS

Guldbrand, Carl ; Barregard, Lars ; Sallsten, Gerd ; Forsgard, Niklas ; Lundh, Thomas LU ; Borné, Yan LU ; Fagerberg, Björn ; Engström, Gunnar LU ; Bergström, Göran and Harari, Florencia (2024) In Environmental Research 244.
Abstract

Background: Lead exposure is associated with cardiovascular disease. Atherosclerosis has been hypothesized to be one of the underlying mechanisms behind this association. Aim: To investigate whether lead exposure is associated with an increased risk of atherosclerosis in the carotid arteries in a large Swedish population-based cohort. Methods: We performed a cross-sectional study using data from the population-based Swedish CardioPulmonary bioImage Study (SCAPIS), including 5622 middle-aged men and women, enrolled 2013–2018. Blood lead (B–Pb), measured by inductively coupled plasma mass spectrometry, was used as exposure biomarker. The presence of atherosclerotic plaque in the carotid arteries (yes/no), total plaque area... (More)

Background: Lead exposure is associated with cardiovascular disease. Atherosclerosis has been hypothesized to be one of the underlying mechanisms behind this association. Aim: To investigate whether lead exposure is associated with an increased risk of atherosclerosis in the carotid arteries in a large Swedish population-based cohort. Methods: We performed a cross-sectional study using data from the population-based Swedish CardioPulmonary bioImage Study (SCAPIS), including 5622 middle-aged men and women, enrolled 2013–2018. Blood lead (B–Pb), measured by inductively coupled plasma mass spectrometry, was used as exposure biomarker. The presence of atherosclerotic plaque in the carotid arteries (yes/no), total plaque area (mm2) and the presence of large plaques (>25 mm2) were determined by ultrasonography. Associations between B–Pb and the different outcomes were analysed using Poisson and linear regression models, adjusted for potential confounders. Results: Atherosclerotic plaque was present in 57% of the individuals, for whom the median total plaque area was 16 mm2 (range: 0.2–222). The median B–Pb concentration was 14 μg/L (range: 0.75–203). After adjusting for potential confounders, individuals in the fourth quartile of B–Pb (Q4) had a prevalence ratio (PR) for plaque of 1.08 (95% CI: 1.01, 1.16) when compared with the first quartile (Q1). A 10 μg/L increase in B–Pb concentrations was associated with an increase of 0.92 mm2 (95% CI: 0.14, 1.71) in total plaque area. The PR for large plaque was 1.09 (95% CI: 0.84, 1.42 for Q4 vs Q1). Conclusions: This study shows an association between B–Pb and atherosclerosis in the carotid arteries providing some support for the hypothesis that atherosclerosis is one of the mechanisms underlying the association between lead exposure and cardiovascular disease.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Atherosclerosis, Cardiovascular disease, Environmental epidemiology, Ischaemic stroke, Lead, Plaque
in
Environmental Research
volume
244
article number
117900
pages
7 pages
publisher
Elsevier
external identifiers
  • pmid:38092241
  • scopus:85179880481
ISSN
0013-9351
DOI
10.1016/j.envres.2023.117900
language
English
LU publication?
yes
additional info
Funding Information: The Swedish CArdioPulmonary bioImage Study (SCAPIS) study is mainly supported by the Swedish Heart-Lung Foundation . The SCAPIS study is also funded by the Knut and Alice Wallenberg Foundation , the Swedish Research Council and VINNOVA ( Sweden's Innovation Agency ) and the Swedish Council for Working Life and Social Research (FORTE). The present work was also supported by Lund University and Skåne University Hospital , the University of Gothenburg as well as with grants from the Swedish state under the agreement between the Swedish government and the county councils , the ALF agreement ( ALFGBG-993075 ). The funders played no role in the study design, data collection, analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: © 2023 The Authors
id
9a072a60-ce53-4da2-bf47-edc2d09e87fc
date added to LUP
2024-01-15 13:01:28
date last changed
2025-04-30 11:33:37
@article{9a072a60-ce53-4da2-bf47-edc2d09e87fc,
  abstract     = {{<p>Background: Lead exposure is associated with cardiovascular disease. Atherosclerosis has been hypothesized to be one of the underlying mechanisms behind this association. Aim: To investigate whether lead exposure is associated with an increased risk of atherosclerosis in the carotid arteries in a large Swedish population-based cohort. Methods: We performed a cross-sectional study using data from the population-based Swedish CardioPulmonary bioImage Study (SCAPIS), including 5622 middle-aged men and women, enrolled 2013–2018. Blood lead (B–Pb), measured by inductively coupled plasma mass spectrometry, was used as exposure biomarker. The presence of atherosclerotic plaque in the carotid arteries (yes/no), total plaque area (mm<sup>2</sup>) and the presence of large plaques (&gt;25 mm<sup>2</sup>) were determined by ultrasonography. Associations between B–Pb and the different outcomes were analysed using Poisson and linear regression models, adjusted for potential confounders. Results: Atherosclerotic plaque was present in 57% of the individuals, for whom the median total plaque area was 16 mm<sup>2</sup> (range: 0.2–222). The median B–Pb concentration was 14 μg/L (range: 0.75–203). After adjusting for potential confounders, individuals in the fourth quartile of B–Pb (Q4) had a prevalence ratio (PR) for plaque of 1.08 (95% CI: 1.01, 1.16) when compared with the first quartile (Q1). A 10 μg/L increase in B–Pb concentrations was associated with an increase of 0.92 mm<sup>2</sup> (95% CI: 0.14, 1.71) in total plaque area. The PR for large plaque was 1.09 (95% CI: 0.84, 1.42 for Q4 vs Q1). Conclusions: This study shows an association between B–Pb and atherosclerosis in the carotid arteries providing some support for the hypothesis that atherosclerosis is one of the mechanisms underlying the association between lead exposure and cardiovascular disease.</p>}},
  author       = {{Guldbrand, Carl and Barregard, Lars and Sallsten, Gerd and Forsgard, Niklas and Lundh, Thomas and Borné, Yan and Fagerberg, Björn and Engström, Gunnar and Bergström, Göran and Harari, Florencia}},
  issn         = {{0013-9351}},
  keywords     = {{Atherosclerosis; Cardiovascular disease; Environmental epidemiology; Ischaemic stroke; Lead; Plaque}},
  language     = {{eng}},
  month        = {{03}},
  publisher    = {{Elsevier}},
  series       = {{Environmental Research}},
  title        = {{Low-level exposure to lead and atherosclerosis in the carotid arteries : Results from the Swedish population-based cohort SCAPIS}},
  url          = {{http://dx.doi.org/10.1016/j.envres.2023.117900}},
  doi          = {{10.1016/j.envres.2023.117900}},
  volume       = {{244}},
  year         = {{2024}},
}