The association of heavy metals in blood, fish consumption frequency, and risk of cardiovascular diseases among Korean adults: The Korean National Health and Nutrition Examination Survey (2008-2010)

Ji-Ye Shin; Ji-Myung Kim; Yuri Kim

doi:10.4163/kjn.2012.45.4.347

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Shin, Kim, and Kim: The association of heavy metals in blood, fish consumption frequency, and risk of cardiovascular diseases among Korean adults: The Korean National Health and Nutrition Examination Survey (2008-2010)

Research Article

Korean Journal of Nutrition

Korean Journal of Nutrition 2012; 45(4): 347-361.

Published online: 31 August 2012

DOI: https://doi.org/10.4163/kjn.2012.45.4.347

The association of heavy metals in blood, fish consumption frequency, and risk of cardiovascular diseases among Korean adults: The Korean National Health and Nutrition Examination Survey (2008-2010)

Ji-Ye Shin¹, Ji-Myung Kim², Yuri Kim¹

¹Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 120-750, Korea.

²Department of Food and Nutritional Sciences, Hanbuk University, Dongducheon 483-777, Korea.

To whom correspondence should be addressed. (yuri.kim@ewha.ac.kr)

Received 4 March 2012 Revised 6 April 2012 Accepted 17 July 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Limited studies are available concerning the effect of heavy metal exposure on cardiovascular diseases. As environmental pollution increases, food contamination, including heavy metal contamination of fish, also increases. However, researches based on the intake of heavy metals, cardiovascular disease, and fish intakes are inconclusive. We assessed an association of heavy metal exposure with cardiovascular disease and fish intake in a nationally representative group of general Korean adults. We used data from the combined 2008-2010 Korean National Health and Nutrition Examination Survey (KNHANES), and analyzed the data of 5,139 Koreans who participated in KNHANES. All participants were older than 20 years, and were diagnosed with stroke, ischemic heart disease, or hypertension. The mean blood cadmium, lead concentration, and mercury concentration of subjects were 1.07 ± 0.01 µg/L, 2.49 ± 0.02 µg/dL, and 5.19 ± 0.08 µg/L, respectively. We used the survey logistic regression model to account for the complex sample design of the cardiovascular disease risk in order to estimate the odds ratios (OR). After adjusting for age, education, income, alcohol, smoking, and BMI, the increase of serum cadmium in blood was associated with the increase in the prevalence of hypertension. Further, the increase in blood cadmium concentration was associated with the increase of both systolic blood pressure (SBP) and diastolic blood pressure (DBP). Although higher fish intakes were significantly associated with higher blood mercury concentration (p for trend < 0.0001), fish intakes did not affect either blood cadmium or lead concentration. Comparing the highest fish intake group with the lowest intake group, the OR of hypertension was 0.31 (95% CI: 0.19-0.59) in the crude model for total fish. However, these associations were no longer significant after the adjustment for potential confounding factors. In conclusion, cadmium in blood was associated with an increased risk of hypertension in the general Korean adult population. However, we found no evidence of a clear relationship between cardiovascular disease and frequency of fish consumption.

Keywords: KNHANES (2008-2010), cardiovascular disease, heavy metals in blood, fish consumption frequency

Figures and Tables

Table 1

General characteristics of subjects

1) By surveyfreq test

Table 2

Geometric mean of blood heavy metal by general and clinical characteristics

1) By surveyreg test

Table 3

Surveylogistic analysis for cardiovascular diseases associated with blood heavy metal by gender

1) Model 1: Unadjusted 2) Model 2: Adjusted for age, education, income 3) Model 3: Adjusted for age, education, income, BMI, smoke, alcohol, SBP; SBP was not adjusted for in HPT 4) OR: Odds ratio, CI: confidence interval 5) IHD: Ischemic heart diseases 6) HPT: Hypertension

Table 4

Association of blood pressures (95% CI) with blood cadmium

1) Model 1: Unadjusted 2) Model 2: Adjusted for age, education, income 3) Model 3: Adjusted for age, education, income, BMI, smoke, alcohol 4) By surveyreg test

Table 5

General characteristics of subjects according to the frequency of fishes intake

1) From food frequency questionnaire data 2) By surveyfreq test

Table 6

Dietary intakes according to the frequency of fishes intake

1) From food frequency questionnaire data 2) By surveyreg test 3) Adjusted means for energy intake (kcal/day), sex and age

Table 7

Surveylogistic analysis for odds ratio (95% CI) of hypertension associated with fishes intakes

1) From food frequency questionnaire data 2) OR: Odds ratio, CI: confidence interval 3) Model 1: Unadjusted 4) Model 2: Adjusted for age, education, income 5) Model 3: Adjusted for age, education, income, BMI, smoke, alcohol

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