Untitled Item <strong>The effects of trace elements on cardiovascular diseases and type 2 diabetes in adults of RaNCD cohort: A multi-pollutant approach using g-computation</strong>

There is an increasing concern about the health effects of exposure to a mixture of pollutants. This study aimed to evaluate the associations between serum levels of heavy/essential metals ( [Arsenic (As), Cadmium (Cd), Mercury (Hg), Lead (Pb), Nickle (Ni), Chromium (Cr), Cobalt (Cu), Iron (Fe), and Zinc (Zn)]) and the risk of developing cardiovascular diseases (CVDs) and type 2 diabetes mellitus (T2D). Data were collected from 450 participants (150 with CVDs, 150 with T2D, and 150 health subjects) randomly selected from Ravansar Non-Communicable Disease (RaNCD) cohort in Western Iran, 2018-2023. Trace element levels in the serum samples were assayed using ICP-MS. Logistic regression was performed to estimate the adjusted risk of exposure to single and multi-metal and CVD/T2D. Odds ratios were adjusted for age, sex, education, residential areas, hypertension, and BMI. The mixture effect of exposure to multi-metals and CVD/T2D was obtained using Quantile G-computation (QGC). In the logistic regression model, chromium, nickle, and zinc levels were associated with CVD, and significant trends were observed for these chemical quartiles (<em>p </em>&lt; 0.001). Arsenic, chromium, and copper levels were also associated with T2D. The weight quartile sum (WQS) index was significantly associated with both CVD (<em>OR </em>= 4.17, 95% CI: 2.16–7.69) and T2D (<em>OR </em>= 11.96, 95% CI: 5.65–18.26). Cd, Pb, and Ni were the most heavily weighed chemicals in these models. The results showed the significant role of toxic and essential elements in CVDs and T2D risk. This association may be driven primarily by cadmium and lead for CVDs and T2D, respectively. Prospective studies with higher sample sizes are necessary to confirm or refute our preliminary results as well as to determine other important elements.人们对混合污染物暴露的健康影响愈发关注。本研究旨在评估血清中重金属/必需金属（砷（Arsenic, As）、镉（Cadmium, Cd）、汞（Mercury, Hg）、铅（Lead, Pb）、镍（Nickle, Ni）、铬（Chromium, Cr）、钴（Cobalt, Cu）、铁（Iron, Fe）及锌（Zinc, Zn））水平与心血管疾病（cardiovascular diseases, CVDs）及2型糖尿病（type 2 diabetes mellitus, T2D）发病风险之间的关联。研究数据采集自伊朗西部拉万萨尔非传染性疾病（Ravansar Non-Communicable Disease, RaNCD）队列2018-2023年间随机招募的450名受试者，其中包括150名心血管疾病患者、150名2型糖尿病患者及150名健康受试者。采用电感耦合等离子体质谱法（Inductively Coupled Plasma Mass Spectrometry, ICP-MS）对血清样本中的微量元素水平进行检测。采用logistic回归分析评估单一及多种金属暴露与心血管疾病/2型糖尿病的校正后发病风险，并针对年龄、性别、受教育程度、居住地区、高血压状态及体质量指数（BMI）对比值比（OR）进行校正。采用分位数G计算法（Quantile G-computation, QGC）分析多种金属联合暴露对心血管疾病及2型糖尿病的混合效应。在logistic回归模型中，铬、镍及锌的血清水平与心血管疾病存在显著关联，且各化学物四分位数分组均呈现出显著的剂量反应趋势（p<0.001）；砷、铬及钴的血清水平同样与2型糖尿病存在关联。加权四分位数和（Weight Quartile Sum, WQS）指数与心血管疾病（OR=4.17，95%置信区间：2.16–7.69）及2型糖尿病（OR=11.96，95%置信区间：5.65–18.26）均存在显著关联。在上述模型中，镉、铅及镍为权重占比最高的化学物质。研究结果证实，有毒金属与必需金属在心血管疾病及2型糖尿病的发病风险中均发挥着重要作用。上述关联分别主要由镉与铅所驱动，前者对应心血管疾病，后者对应2型糖尿病。未来需开展更大样本量的前瞻性研究，以验证本研究的初步结果，并明确其他与疾病相关的关键金属元素。