Work

Association of single and joint urinary metal exposure with carotid atherosclerosis in non-dyslipidemic middle-aged and elderly adults: A retrospective case-control study

Year: 2025

Type: article

Abstract: BACKGROUND: Carotid atherosclerosis (CAS) is a major contributor to cerebrovascular incidence and mortality, yet its etiology in non-dyslipidemic individuals remains poorly understood. Emerging evidence suggests that environmental metal exposure may play a critical role in CAS development. METHODS: We conducted a retrospective matched case-control study involving 1290 non-dyslipidemic middle-aged and elderly individuals to examine the association between urinary metal exposure and CAS. Twenty-eight urinary metals were measured using inductively coupled plasma mass spectrometry (ICP-MS), and statistical analyses-including conditional logistic regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR)-were applied to assess single and mixed-metal effects. Mediation analysis was performed to evaluate the potential role of metabolic and inflammatory clinical indicator. RESULTS: = 0.59, 95 %CI: 0.41-0.84) was negatively associated with the risk of CAS. Mixed-metal exposure analyses, including WQS (OR=1.35, 95 %CI 1.12-1.63) and BKMR, consistently demonstrated a positive correlation with CAS, primarily driven by Ti. Mediation analysis further revealed that 11.54 % of association between Cu and CAS explained by remnant cholesterol (RC). CONCLUSION: Our findings revealed a significant correlation between environmental metal exposure and CAS, independent of traditional lipid abnormalities. Future prospective studies are warranted to confirm these associations and elucidate the underlying biological mechanisms, potentially guiding targeted prevention strategies.

Source: Ecotoxicology and Environmental Safety

DOI: 10.1016/j.ecoenv.2025.118981