Nonlinear association between blood lead and hyperhomocysteinemia among adults in the United States

Abstract

Evidence regarding the association between blood lead levels (BLL) and hyperhomocysteinemia (HHcy) in US adults was limited. We aimed to investigate the association of BLL with the risk of HHcy, and to examine possible effect modifiers using US National Health and Nutrition Examination Survey (NHANES) database. We performed a cross-sectional study using data from up to 9,331 participants aged ≥ 20 years of NHANES from 2001 to 2006. BLL was measured by atomic absorption spectrometry. HHcy was defined as plasma homocysteine level > 15 µmol/L. The weighted prevalence of HHcy was 6.87%. The overall mean BLL was 1.9 μg/dL. Overall, there was a nonlinear positive association between Ln-transformed BLL (LnBLL) and the risk of HHcy. The Odds ratios (95% CI) for participants in the second (0.04–0.49 μg/dL), third (0.5–0.95 μg/dL) and fourth quartiles (> 0.95 μg/dL) were 1.12 (95% CI: 0.71, 1.76), 1.13 (95% CI: 0.73, 1.77), and 1.67 (95% CI: 1.07, 2.61), respectively, compared with those in quartile 1. Consistently, a significantly higher risk of HHcy (OR: 1.49; 95% CI: 1.19, 1.88) was found in participants in quartile 4 compared with those in quartiles 1–3. Furthermore, a strongly positive association between LnBLL and HHcy was observed in participants with estimated glomerular filtration rate (eGFR) < 60 mL/min−1/1.73 m−2. Our results suggested that a higher level of BLL (LnBLL > 0.95 μg/dL) was associated with increased risk of HHcy compared with a lower level of BLL (LnBLL ≤ 0.95 μg/dL) among U.S. adults, and the association was modified by the eGFR.

Prevalence of Hyperhomocysteinemia in China: An Updated Meta-Analysis

“…The prevalence of HHcy in China was updated to 37.2% in our study, as compared with the previous rate of 27.5% prior to 2012, as reported by Yang et al [13]. It remains high when compared with other developed countries, such as the United States (6.9%) [30] and Canada (19.1%) [31], but lower than Iran (73.1%) [32] and Africa (62.3%) [33]. Both subgroup analyses on the year of data collection and publication showed that the prevalence of HHcy varied substantially over time.…”

Association and mediation analyses among multiple metals exposure, plasma folate, and community-based impaired estimated glomerular filtration rate in central Taiwan

“…In addition, folate insufficiency may impede arsenic (As) methylation and thereby aggravate arsenic toxicity [ 13 ]. Particularly, low levels of folate from dietary intake or in plasma can modify the associations between blood lead (Pb) and high hyperhomocysteinemia, an established risk factor for chronic vascular diseases [ 14 , 15 ]. However, correlations of the blood levels of metals and folate in plasma are not clearly known.…”

Prevalence and correlative factors of hyperhomocysteinemia in elderly patients with femoral neck fracture: A cross‐sectional study

“…The reported prevalence of HHcy varied among populations residing in different regions. Based on a survey data from 2001 to 2006, Li et al found the prevalence of HHcy was 6.87% among 9331 US adult populations (aged ≥20 years) 23 . de Bree et al revealed in 2005 that the prevalence of HHcy was 10.9% among 25,489 European adult populations (aged ≥20 years) 24 .…”