Prenatal metal mixtures and child blood pressure in the Rhea mother-child cohort in Greece

Abstract

Background Child blood pressure (BP) is predictive of future cardiovascular risk. Prenatal exposure to metals has been associated with higher BP in childhood, but most studies have evaluated elements individually and measured BP at a single time point. We investigated impacts of prenatal metal mixture exposures on longitudinal changes in BP during childhood and elevated BP at 11 years of age. Methods The current study included 176 mother-child pairs from the Rhea Study in Heraklion, Greece and focused on eight elements (antimony, arsenic, cadmium, cobalt, lead, magnesium, molybdenum, selenium) measured in maternal urine samples collected during pregnancy (median gestational age at collection: 12 weeks). BP was measured at approximately 4, 6, and 11 years of age. Covariate-adjusted Bayesian Varying Coefficient Kernel Machine Regression and Bayesian Kernel Machine Regression (BKMR) were used to evaluate metal mixture impacts on baseline and longitudinal changes in BP (from ages 4 to 11) and the development of elevated BP at age 11, respectively. BKMR results were compared using static versus percentile-based cutoffs to define elevated BP. Results Molybdenum and lead were the mixture components most consistently associated with BP. J-shaped relationships were observed between molybdenum and both systolic and diastolic BP at age 4. Similar associations were identified for both molybdenum and lead in relation to elevated BP at age 11. For molybdenum concentrations above the inflection points (~ 40–80 μg/L), positive associations with BP at age 4 were stronger at high levels of lead. Lead was positively associated with BP measures at age 4, but only at high levels of molybdenum. Potential interactions between molybdenum and lead were also identified for BP at age 11, but were sensitive to the cutoffs used to define elevated BP. Conclusions Prenatal exposure to high levels of molybdenum and lead, particularly in combination, may contribute to higher BP at age 4. These early effects appear to persist throughout childhood, contributing to elevated BP in adolescence. Future studies are needed to identify the major sources of molybdenum and lead in this population.

In Utero Exposure to Heavy Metals and Trace Elements and Childhood Blood Pressure in a U.S. Urban, Low-Income, Minority Birth Cohort

“…Howe et al also did not find an association of Se (measured in maternal urine samples in pregnancy) with child BP at 4, 6, or 11 y (Howe et al 2021). Different findings between these two studies with ours could possibly be due to the differences in the biomarkers used, time points at biomarker collection and outcome assessment, metal mixtures that the children were exposed to, and unmeasured susceptibility factors and confounders.…”

“…The authors also did not observe evidence of interactions of these metals on BP. More recently, Howe et al found in a Greek cohort a potential interaction of Pb and molybdenum on child BP at 11 years of age (Howe et al 2021).…”

Humidifier Disinfectant Consumption and Humidifier Disinfectant-Associated Lung Injury in South Korea: A Nationwide Population-Based Study

“…Thus, the actual correlation between annual HD sales and annual diagnosed HDLIs might be higher than our observation. Finally, we cannot rule out the possibility that annual changes in air pollution may affect the annual changes in the volume of lung injury, because previous studies reported that air pollution is associated with lung injuries such as IPF [ 33 , 34 ], interstitial lung disease [ 35 ], and pneumonia [ 36 ].…”

Invited Perspective: Metal Mixtures and Child Health: The Complex Interplay of Essential and Toxic Elements

“…We have certainly known for decades that nutritional status can affect the toxicity of some pollutants (Mahaffey and Vanderveen 1979). Other examples of interactions between trace elements and metals related to a variety of child health outcomes also are beginning to emerge (Howe et al 2020a(Howe et al , 2020b(Howe et al , 2021Liu et al 2018). However, in many of these cases, the results suggest that the positive association between the trace element and these outcomes may be attenuated at higher levels of the toxic metal.…”