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. 2023 Jun 8:1-9.
doi: 10.1007/s12403-023-00579-4. Online ahead of print.

Environmental Nickel Exposure and Cardiovascular Disease in a Nationally Representative Sample of U.S. Adults

Joshua Cheek  1   2 , Sara Shuger Fox  1 , Hans-Joachim Lehmler  3   4 , Tyler J Titcomb  2   5
Affiliations

Environmental Nickel Exposure and Cardiovascular Disease in a Nationally Representative Sample of U.S. Adults

Joshua Cheek et al. Expo Health. .

Abstract

Background: Laboratory studies have linked nickel with the pathogenesis of cardiovascular disease (CVD); however, few observational studies in humans have confirmed this association.

Objective: This study aimed to use urinary nickel concentrations, as a biomarker of environmental nickel exposure, to evaluate the cross-sectional association between nickel exposure and CVD in a nationally representative sample of U.S. adults.

Methods: Data from a nationally representative sample (n = 2702) in the National Health and Nutrition Examination Survey 2017-20 were used. CVD (n = 326) was defined as self-reported physicians' diagnoses of coronary heart disease, angina, heart attack, or stroke. Urinary nickel concentrations were determined by inductively coupled plasma mass spectrometry. Logistic regression with sample weights was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of CVD.

Results: Urinary nickel concentrations were higher in individuals with CVD (weighted median 1.34 μg/L) compared to those without CVD (1.08 μg/L). After adjustment for demographic, socioeconomic, lifestyle, and other risk factors for CVD, the ORs (95% CIs) for CVD compared with the lowest quartile of urinary nickel were 3.57 (1.73-7.36) for the second quartile, 3.61 (1.83-7.13) for the third quartile, and 2.40 (1.03-5.59) for the fourth quartile. Cubic spline regression revealed a non-monotonic, inverse U-shaped, association between urinary nickel and CVD (Pnonlinearity < 0.001).

Conclusions: Nickel exposure is associated with CVD in a non-monotonic manner among U.S. adults independent of well-known CVD risk factors.

Supplementary information: The online version contains supplementary material available at 10.1007/s12403-023-00579-4.

Keywords: Cardiovascular disease; Epidemiology; Nickel; U.S. adults.

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Conflict of interest statement

Competing interestsThe authors declared that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Adjusted cubic spline regression model showing the association between urinary nickel (mcg/L) and the odds of cardiovascular disease. Models adjusted for age, sex, race, and urinary creatinine. The solid and dashed lines represent the odds and 95% confidence interval for cardiovascular disease. Knots are located at the 5th, 27.5th, 50th, 72.5th, and 95th percentiles for urinary nickel
See this image and copyright information in PMC

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