{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T22:21:31Z","timestamp":1784672491249,"version":"3.55.0"},"reference-count":50,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T00:00:00Z","timestamp":1738022400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T00:00:00Z","timestamp":1738022400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cardiovasc Toxicol"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>The impact of lead and cadmium exposure on subclinical cardiovascular disease (CVD), indicated by elevated high-sensitivity cardiac troponin (hs-cTnT) and N-terminal pro b-type natriuretic peptide (NT-proBNP) remains uncertain. We analyzed data from participants aged 20 and older, without overt CVD, in the National Health and Nutrition Examination Survey (NHANES; 1999\u20132004). Elevated lead and cadmium levels were defined as 3.5\u00a0\u03bcg\/dL and 1.0\u00a0\u03bcg\/L (inductively coupled plasma mass spectrometry) and 3.8\u00a0\u03bcg\/dL and 0.9\u00a0\u03bcg\/L (atomic absorption spectrometry), respectively. Elevated hs-cTnT was\u2009\u2265\u200919\u00a0ng\/L, and elevated NT-proBNP was\u2009\u2265\u2009125\u00a0pg\/mL. Multivariate logistic regression estimated the odds ratios (OR) and 95% confidence intervals (CI) for elevated biomarkers. Among 10,197 participants (mean age 48.8\u00a0years; 50.3% female), 5.3% had elevated hs-cTnT and 19.4% had elevated NT-proBNP. Elevated blood lead was associated with increased ORs for elevated hs-cTnT (OR 1.45, 95% CI 1.15\u20131.84) and NT-proBNP (OR 1.66, 95% CI 1.40\u20131.97). The corresponding ORs (95% CI) for elevated blood cadmium were 1.33 (1.02, 1.74) and 1.39 (1.18, 1.65). The effect of elevated blood lead on NT-proBNP was particularly pronounced among non-Hispanic Blacks (OR [95% CI], 3.26 [2.24, 4.74]) compared to Mexican Americans (1.46 [0.99, 2.17]) and non-Hispanic Whites (1.31 [1.02, 1.68]) and was stronger in individuals with impaired kidney function (OR [95% CI], 2.31 [1.43, 3.75]) compared to those with normal kidney function (1.44 [1.18, 1.75]). This study first reveals the association between lead and cadmium exposure and subclinical CVD, underscoring the need for targeted preventive measures to reduce cardiovascular risk and improve health outcomes.<\/jats:p>","DOI":"10.1007\/s12012-024-09955-1","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T15:59:44Z","timestamp":1738079984000},"page":"282-293","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Associations Between Lead and Cadmium Exposure and Subclinical Cardiovascular Disease in U.S. Adults"],"prefix":"10.1007","volume":"25","author":[{"given":"Lin","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aimin","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard M. Y.","family":"Cheung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,28]]},"reference":[{"issue":"25","key":"9955_CR1","doi-asserted-by":"publisher","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","volume":"76","author":"GA Roth","year":"2020","unstructured":"Roth, G. A., Mensah, G. A., Johnson, C. O., Addolorato, G., Ammirati, E., Baddour, L. M., Barengo, N. C., Beaton, A. Z., Benjamin, E. J., Benziger, C. P., Bonny, A., Brauer, M., Brodmann, M., Cahill, T. J., Carapetis, J., Catapano, A. L., Chugh, S. S., Cooper, L. T., Coresh, J., & Group, G. N. J. G. B. O. C. D. W. (2020). Global burden of cardiovascular diseases and risk factors, 1990\u20132019: Update from the GBD 2019 study. Journal of the American College of Cardiology, 76(25), 2982\u20133021. https:\/\/doi.org\/10.1016\/j.jacc.2020.11.010","journal-title":"Journal of the American College of Cardiology"},{"issue":"13","key":"9955_CR2","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.123.029852","volume":"12","author":"GA Lamas","year":"2023","unstructured":"Lamas, G. A., Bhatnagar, A., Jones, M. R., Mann, K. K., Nasir, K., Tellez-Plaza, M., Ujueta, F., & Navas-Acien, A. (2023). Contaminant metals as cardiovascular risk factors: A scientific statement from the american heart association. Journal of the American Heart Association, 12(13), e029852. https:\/\/doi.org\/10.1161\/jaha.123.029852","journal-title":"Journal of the American Heart Association"},{"key":"9955_CR3","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1007\/978-3-7643-8340-4_6","volume":"101","author":"PB Tchounwou","year":"2012","unstructured":"Tchounwou, P. B., Yedjou, C. G., Patlolla, A. K., & Sutton, D. J. (2012). Heavy metal toxicity and the environment. Exp Suppl, 101, 133\u2013164. https:\/\/doi.org\/10.1007\/978-3-7643-8340-4_6","journal-title":"Exp Suppl"},{"key":"9955_CR4","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/j.atherosclerosis.2016.02.013","volume":"248","author":"C Andersson","year":"2016","unstructured":"Andersson, C., Enserro, D., Sullivan, L., Wang, T. J., Januzzi, J. L., Jr., Benjamin, E. J., Vita, J. A., Hamburg, N. M., Larson, M. G., Mitchell, G. F., & Vasan, R. S. (2016). Relations of circulating GDF-15, soluble ST2, and troponin-I concentrations with vascular function in the community: The framingham heart study. Atherosclerosis, 248, 245\u2013251. https:\/\/doi.org\/10.1016\/j.atherosclerosis.2016.02.013","journal-title":"Atherosclerosis"},{"issue":"20","key":"9955_CR5","doi-asserted-by":"publisher","first-page":"1606","DOI":"10.1161\/CIR.0000000000001184","volume":"148","author":"CE Ndumele","year":"2023","unstructured":"Ndumele, C. E., Rangaswami, J., Chow, S. L., Neeland, I. J., Tuttle, K. R., Khan, S. S., Coresh, J., Mathew, R. O., Baker-Smith, C. M., Carnethon, M. R., Despres, J. P., Ho, J. E., Joseph, J. J., Kernan, W. N., Khera, A., Kosiborod, M. N., Lekavich, C. L., Lewis, E. F., Lo, K. B., & American Heart, A. (2023). Cardiovascular-kidney-metabolic health: A presidential advisory from the american heart association. Circulation, 148(20), 1606\u20131635. https:\/\/doi.org\/10.1161\/CIR.0000000000001184","journal-title":"Circulation"},{"key":"9955_CR6","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-023-02003-2","author":"L Liu","year":"2023","unstructured":"Liu, L., Cheng, Y. T., Xu, A., & Cheung, B. M. Y. (2023). Association between high sensitivity cardiac troponin and mortality risk in the non-diabetic population: Findings from the national health and nutrition examination survey. Cardiovascular Diabetology. https:\/\/doi.org\/10.1186\/s12933-023-02003-2","journal-title":"Cardiovascular Diabetology"},{"issue":"22","key":"9955_CR7","doi-asserted-by":"publisher","first-page":"1898","DOI":"10.1001\/jama.2024.5596","volume":"331","author":"JT Neumann","year":"2024","unstructured":"Neumann, J. T., Twerenbold, R., Weimann, J., Ballantyne, C. M., Benjamin, E. J., Costanzo, S., de Lemos, J. A., deFilippi, C. R., Di Castelnuovo, A., Donfrancesco, C., Dorr, M., Eggers, K. M., Engstrom, G., Felix, S. B., Ferrario, M. M., Gansevoort, R. T., Giampaoli, S., Giedraitis, V., Hedberg, P., & Ojeda, F. (2024). Prognostic value of cardiovascular biomarkers in the population. JAMA, 331(22), 1898\u20131909. https:\/\/doi.org\/10.1001\/jama.2024.5596","journal-title":"JAMA"},{"issue":"9","key":"9955_CR8","doi-asserted-by":"publisher","first-page":"1160","DOI":"10.1161\/CIRCRESAHA.123.323617","volume":"134","author":"Z Pan","year":"2024","unstructured":"Pan, Z., Gong, T., & Liang, P. (2024). Heavy metal exposure and cardiovascular disease. Circulation Research, 134(9), 1160\u20131178. https:\/\/doi.org\/10.1161\/CIRCRESAHA.123.323617","journal-title":"Circulation Research"},{"issue":"161","key":"9955_CR9","first-page":"1","volume":"2","author":"CL Johnson","year":"2013","unstructured":"Johnson, C. L., Paulose-Ram, R., Ogden, C. L., Carroll, M. D., Kruszon-Moran, D., Dohrmann, S. M., & Curtin, L. R. (2013). National health and nutrition examination survey: Analytic guidelines, 1999\u20132010. Vital Health Stat, 2(161), 1\u201324.","journal-title":"Vital Health Stat"},{"key":"9955_CR10","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2023.116514","volume":"233","author":"R Gonzalez-Martin","year":"2023","unstructured":"Gonzalez-Martin, R., Grau-Perez, M., Sebastian-Leon, P., Diaz-Gimeno, P., Vidal, C., Tellez-Plaza, M., & Dominguez, F. (2023). Association of blood cadmium and lead levels with self-reported reproductive lifespan and pregnancy loss: The national health and nutrition examination survey 1999\u20132018. Environmental Research, 233, 116514. https:\/\/doi.org\/10.1016\/j.envres.2023.116514","journal-title":"Environmental Research"},{"issue":"11","key":"9955_CR11","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.029083","volume":"12","author":"M Fang","year":"2023","unstructured":"Fang, M., Wang, D., Tang, O., McEvoy, J. W., Echouffo-Tcheugui, J. B., Christenson, R. H., & Selvin, E. (2023). Subclinical cardiovascular disease in US adults with and without diabetes. Journal of the American Heart Association, 12(11), e029083. https:\/\/doi.org\/10.1161\/JAHA.122.029083","journal-title":"Journal of the American Heart Association"},{"key":"9955_CR12","unstructured":"Medicine, T. I. F. o. C. C. a. L. BNP, NT-proBNP, and MR-proANP Assays Analytical Characteristics Designated By Manufacturer v062024. https:\/\/ifcc.org\/ifcc-education-division\/emd-committees\/committee-on-clinical-applications-of-cardiac-bio-markers-c-cb\/biomarkers-reference-tables\/"},{"key":"9955_CR13","unstructured":"Medicine, T. I. F. o. C. C. a. L. High Sensitivity Cardiac Troponin I and T Assay Analytical Characteristics Designated By Manufacturer v062024. https:\/\/ifcc.org\/ifcc-education-division\/emd-committees\/committee-on-clinical-applications-of-cardiac-bio-markers-c-cb\/biomarkers-reference-tables\/"},{"issue":"6","key":"9955_CR14","doi-asserted-by":"publisher","first-page":"461","DOI":"10.7326\/0003-4819-130-6-199903160-00002","volume":"130","author":"AS Levey","year":"1999","unstructured":"Levey, A. S., Bosch, J. P., Lewis, J. B., Greene, T., Rogers, N., & Roth, D. (1999). A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation modification of diet in renal disease study group. Annals of Internal Medicine, 130(6), 461\u2013470. https:\/\/doi.org\/10.7326\/0003-4819-130-6-199903160-00002","journal-title":"Annals of Internal Medicine"},{"issue":"20","key":"9955_CR15","doi-asserted-by":"publisher","first-page":"2028","DOI":"10.1016\/j.jacc.2023.03.403","volume":"81","author":"JW McEvoy","year":"2023","unstructured":"McEvoy, J. W., Tang, O., Wang, D., Ndumele, C. E., Coresh, J., Christenson, R. H., & Selvin, E. (2023). Myocardial injury thresholds for 4 high-sensitivity troponin assays in U.S. adults. Journal of the American College of Cardiology, 81(20), 2028\u20132039.","journal-title":"Journal of the American College of Cardiology"},{"key":"9955_CR16","unstructured":"National Health and Nutrition Examination Survey tutorial. https:\/\/wwwn.cdc.gov\/nchs\/nhanes\/tutorials\/Weighting.aspx"},{"key":"9955_CR17","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k3310","volume":"362","author":"R Chowdhury","year":"2018","unstructured":"Chowdhury, R., Ramond, A., O\u2019Keeffe, L. M., Shahzad, S., Kunutsor, S. K., Muka, T., Gregson, J., Willeit, P., Warnakula, S., Khan, H., Chowdhury, S., Gobin, R., Franco, O. H., & Di Angelantonio, E. (2018). Environmental toxic metal contaminants and risk of cardiovascular disease: Systematic review and meta-analysis. BMJ, 362, k3310. https:\/\/doi.org\/10.1136\/bmj.k3310","journal-title":"BMJ"},{"issue":"3","key":"9955_CR18","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1289\/ehp.9785","volume":"115","author":"A Navas-Acien","year":"2007","unstructured":"Navas-Acien, A., Guallar, E., Silbergeld, E. K., & Rothenberg, S. J. (2007). Lead exposure and cardiovascular disease\u2014a systematic review. Environmental Health Perspectives, 115(3), 472\u2013482. https:\/\/doi.org\/10.1289\/ehp.9785","journal-title":"Environmental Health Perspectives"},{"issue":"6","key":"9955_CR19","doi-asserted-by":"publisher","first-page":"1839","DOI":"10.1093\/ije\/dyz061","volume":"48","author":"A Domingo-Relloso","year":"2019","unstructured":"Domingo-Relloso, A., Grau-Perez, M., Briongos-Figuero, L., Gomez-Ariza, J. L., Garcia-Barrera, T., Duenas-Laita, A., Bobb, J. F., Chaves, F. J., Kioumourtzoglou, M. A., Navas-Acien, A., Redon-Mas, J., Martin-Escudero, J. C., & Tellez-Plaza, M. (2019). The association of urine metals and metal mixtures with cardiovascular incidence in an adult population from Spain: The hortega follow-up study. International Journal of Epidemiology, 48(6), 1839\u20131849. https:\/\/doi.org\/10.1093\/ije\/dyz061","journal-title":"International Journal of Epidemiology"},{"issue":"3","key":"9955_CR20","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1097\/EDE.0b013e31828b0631","volume":"24","author":"M Tellez-Plaza","year":"2013","unstructured":"Tellez-Plaza, M., Guallar, E., Howard, B. V., Umans, J. G., Francesconi, K. A., Goessler, W., Silbergeld, E. K., Devereux, R. B., & Navas-Acien, A. (2013). Cadmium exposure and incident cardiovascular disease. Epidemiology, 24(3), 421\u2013429. https:\/\/doi.org\/10.1097\/EDE.0b013e31828b0631","journal-title":"Epidemiology"},{"issue":"12","key":"9955_CR21","doi-asserted-by":"publisher","first-page":"2594","DOI":"10.1681\/ASN.V12122594","volume":"12","author":"M Marques","year":"2001","unstructured":"Marques, M., Millas, I., Jimenez, A., Garcia-Colis, E., Rodriguez-Feo, J. A., Velasco, S., Barrientos, A., Casado, S., & Lopez-Farre, A. (2001). Alteration of the soluble guanylate cyclase system in the vascular wall of lead-induced hypertension in rats. Journal of the American Society of Nephrology, 12(12), 2594\u20132600. https:\/\/doi.org\/10.1681\/ASN.V12122594","journal-title":"Journal of the American Society of Nephrology"},{"issue":"1","key":"9955_CR22","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1007\/s12011-018-1359-1","volume":"187","author":"TF Oliveira","year":"2019","unstructured":"Oliveira, T. F., Batista, P. R., Leal, M. A., Campagnaro, B. P., Nogueira, B. V., Vassallo, D. V., Meyrelles, S. S., & Padilha, A. S. (2019). Chronic cadmium exposure accelerates the development of atherosclerosis and induces vascular dysfunction in the aorta of ApoE(-\/-) mice. Biological Trace Element Research, 187(1), 163\u2013171. https:\/\/doi.org\/10.1007\/s12011-018-1359-1","journal-title":"Biological Trace Element Research"},{"issue":"4","key":"9955_CR23","doi-asserted-by":"publisher","first-page":"1280","DOI":"10.1007\/s12011-020-02270-0","volume":"199","author":"X Zhu","year":"2021","unstructured":"Zhu, X., Fan, Y., Sheng, J., Gu, L., Tao, Q., Huang, R., Liu, K., Yang, L., Chen, G., Cao, H., Li, K., Tao, F., & Wang, S. (2021). Association between blood heavy metal concentrations and dyslipidemia in the elderly. Biological Trace Element Research, 199(4), 1280\u20131290. https:\/\/doi.org\/10.1007\/s12011-020-02270-0","journal-title":"Biological Trace Element Research"},{"issue":"1\u20132","key":"9955_CR24","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.mrfmmm.2008.12.011","volume":"663","author":"S Chatterjee","year":"2009","unstructured":"Chatterjee, S., Kundu, S., Sengupta, S., & Bhattacharyya, A. (2009). Divergence to apoptosis from ROS induced cell cycle arrest: Effect of cadmium. Mutation Research, 663(1\u20132), 22\u201331. https:\/\/doi.org\/10.1016\/j.mrfmmm.2008.12.011","journal-title":"Mutation Research"},{"issue":"1","key":"9955_CR25","first-page":"2","volume":"11","author":"L Patrick","year":"2006","unstructured":"Patrick, L. (2006). Lead toxicity, a review of the literature. Part 1: Exposure, evaluation, and treatment. Alternative Medicine Review, 11(1), 2\u201322.","journal-title":"Alternative Medicine Review"},{"issue":"2","key":"9955_CR26","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.taap.2015.01.005","volume":"283","author":"MR Simoes","year":"2015","unstructured":"Simoes, M. R., Aguado, A., Fiorim, J., Silveira, E. A., Azevedo, B. F., Toscano, C. M., Zhenyukh, O., Briones, A. M., Alonso, M. J., Vassallo, D. V., & Salaices, M. (2015). MAPK pathway activation by chronic lead-exposure increases vascular reactivity through oxidative stress\/cyclooxygenase-2-dependent pathways. Toxicology and Applied Pharmacology, 283(2), 127\u2013138. https:\/\/doi.org\/10.1016\/j.taap.2015.01.005","journal-title":"Toxicology and Applied Pharmacology"},{"issue":"2","key":"9955_CR27","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1016\/j.ceca.2007.05.003","volume":"43","author":"M Biagioli","year":"2008","unstructured":"Biagioli, M., Pifferi, S., Ragghianti, M., Bucci, S., Rizzuto, R., & Pinton, P. (2008). Endoplasmic reticulum stress and alteration in calcium homeostasis are involved in cadmium-induced apoptosis. Cell Calcium, 43(2), 184\u2013195. https:\/\/doi.org\/10.1016\/j.ceca.2007.05.003","journal-title":"Cell Calcium"},{"issue":"6","key":"9955_CR28","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.1161\/01.hyp.30.6.1487","volume":"30","author":"HC Gonick","year":"1997","unstructured":"Gonick, H. C., Ding, Y., Bondy, S. C., Ni, Z., & Vaziri, N. D. (1997). Lead-induced hypertension: Interplay of nitric oxide and reactive oxygen species. Hypertension, 30(6), 1487\u20131492. https:\/\/doi.org\/10.1161\/01.hyp.30.6.1487","journal-title":"Hypertension"},{"issue":"1","key":"9955_CR29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1139\/o07-146","volume":"86","author":"S Majumder","year":"2008","unstructured":"Majumder, S., Muley, A., Kolluru, G. K., Saurabh, S., Tamilarasan, K. P., Chandrasekhar, S., Reddy, H. B., Purohit, S., & Chatterjee, S. (2008). Cadmium reduces nitric oxide production by impairing phosphorylation of endothelial nitric oxide synthase. Biochemistry and Cell Biology, 86(1), 1\u201310. https:\/\/doi.org\/10.1139\/o07-146","journal-title":"Biochemistry and Cell Biology"},{"key":"9955_CR30","doi-asserted-by":"publisher","first-page":"3180487","DOI":"10.1155\/2018\/3180487","volume":"2018","author":"PR Camaj","year":"2018","unstructured":"Camaj, P. R., Graziano, J. H., Preteni, E., Popovac, D., LoIacono, N., Balac, O., & Factor-Litvak, P. (2018). Long-term effects of environmental lead exposure on blood pressure and plasma soluble cell adhesion molecules in young adults: A follow-up study of a prospective cohort in Kosovo. Journal of Environmental and Public Health, 2018, 3180487. https:\/\/doi.org\/10.1155\/2018\/3180487","journal-title":"Journal of Environmental and Public Health"},{"issue":"9","key":"9955_CR31","doi-asserted-by":"publisher","first-page":"1392","DOI":"10.1161\/atvbaha.109.190082","volume":"29","author":"B Messner","year":"2009","unstructured":"Messner, B., Knoflach, M., Seubert, A., Ritsch, A., Pfaller, K., Henderson, B., Shen, Y. H., Zeller, I., Willeit, J., Laufer, G., Wick, G., Kiechl, S., & Bernhard, D. (2009). Cadmium is a novel and independent risk factor for early atherosclerosis mechanisms and in vivo relevance. Arteriosclerosis, Thrombosis, and Vascular Biology, 29(9), 1392\u20131398. https:\/\/doi.org\/10.1161\/atvbaha.109.190082","journal-title":"Arteriosclerosis, Thrombosis, and Vascular Biology"},{"issue":"5","key":"9955_CR32","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1038\/nrneph.2018.11","volume":"14","author":"X Xu","year":"2018","unstructured":"Xu, X., Nie, S., Ding, H., & Hou, F. F. (2018). Environmental pollution and kidney diseases. Nature Reviews. Nephrology, 14(5), 313\u2013324. https:\/\/doi.org\/10.1038\/nrneph.2018.11","journal-title":"Nature Reviews. Nephrology"},{"issue":"10","key":"9955_CR33","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1161\/CIRCULATIONAHA.124.069414","volume":"150","author":"I Martinez-Morata","year":"2024","unstructured":"Martinez-Morata, I., Schilling, K., Glabonjat, R. A., Domingo-Relloso, A., Mayer, M., McGraw, K. E., Galvez Fernandez, M., Sanchez, T. R., Nigra, A. E., Kaufman, J. D., Vaidya, D., Jones, M. R., Bancks, M. P., Barr, R. G., Shimbo, D., Post, W. S., Valeri, L., Shea, S., & Navas-Acien, A. (2024). Association of urinary metals with cardiovascular disease incidence and all-cause mortality in the multi-ethnic study of atherosclerosis (MESA). Circulation, 150(10), 758\u2013769. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.124.069414","journal-title":"Circulation"},{"key":"9955_CR34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhazmat.2024.135844","volume":"480","author":"Y Wang","year":"2024","unstructured":"Wang, Y., Qiao, M., Yang, H., Chen, Y., Jiao, B., Liu, S., Duan, A., Wu, S., Wang, H., Yu, C., Chen, X., Duan, H., Dai, Y., & Li, B. (2024). Investigating the relationship of co-exposure to multiple metals with chronic kidney disease: An integrated perspective from epidemiology and adverse outcome pathways. Journal of Hazardous Materials, 480, 135844. https:\/\/doi.org\/10.1016\/j.jhazmat.2024.135844","journal-title":"Journal of Hazardous Materials"},{"issue":"5","key":"9955_CR35","doi-asserted-by":"publisher","first-page":"733","DOI":"10.2105\/ajph.92.5.733","volume":"92","author":"SA Bashir","year":"2002","unstructured":"Bashir, S. A. (2002). Home is where the harm is: Inadequate housing as a public health crisis. American Journal of Public Health, 92(5), 733\u2013738. https:\/\/doi.org\/10.2105\/ajph.92.5.733","journal-title":"American Journal of Public Health"},{"issue":"7","key":"9955_CR36","doi-asserted-by":"publisher","first-page":"1682","DOI":"10.1093\/ndt\/gfac302","volume":"38","author":"GL Hundemer","year":"2023","unstructured":"Hundemer, G. L., Ravani, P., Sood, M. M., Zimmerman, D., Molnar, A. O., Moorman, D., Oliver, M. J., White, C., Hiremath, S., & Akbari, A. (2023). Social determinants of health and the transition from advanced chronic kidney disease to kidney failure. Nephrology, Dialysis, Transplantation, 38(7), 1682\u20131690. https:\/\/doi.org\/10.1093\/ndt\/gfac302","journal-title":"Nephrology, Dialysis, Transplantation"},{"issue":"21","key":"9955_CR37","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.031453","volume":"12","author":"T Chaikijurajai","year":"2023","unstructured":"Chaikijurajai, T., Demirjian, S., & Tang, W. H. W. (2023). Prognostic value of natriuretic peptide levels for adverse renal outcomes in patients with moderate to severe acute kidney injury with or without heart failure. Journal of the American Heart Association, 12(21), e031453. https:\/\/doi.org\/10.1161\/JAHA.123.031453","journal-title":"Journal of the American Heart Association"},{"issue":"S7","key":"9955_CR38","doi-asserted-by":"publisher","first-page":"S640","DOI":"10.2105\/AJPH.2022.306972","volume":"112","author":"PN Breysse","year":"2022","unstructured":"Breysse, P. N., Cascio, W. E., Geller, A. M., Choiniere, C. J., & Ammon, M. (2022). Targeting coordinated federal efforts to address persistent hazardous exposures to lead. American Journal of Public Health, 112(S7), S640\u2013S646. https:\/\/doi.org\/10.2105\/AJPH.2022.306972","journal-title":"American Journal of Public Health"},{"issue":"4","key":"9955_CR39","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1001\/jama.1994.03520040046039","volume":"272","author":"JL Pirkle","year":"1994","unstructured":"Pirkle, J. L., Brody, D. J., Gunter, E. W., Kramer, R. A., Paschal, D. C., Flegal, K. M., & Matte, T. D. (1994). The decline in blood lead levels in the United States. The national health and nutrition examination surveys (NHANES). JAMA, 272(4), 284\u2013291.","journal-title":"JAMA"},{"issue":"7","key":"9955_CR40","doi-asserted-by":"publisher","first-page":"1248","DOI":"10.2105\/AJPH.2007.118505","volume":"98","author":"K Theppeang","year":"2008","unstructured":"Theppeang, K., Glass, T. A., Bandeen-Roche, K., Todd, A. C., Rohde, C. A., & Schwartz, B. S. (2008). Gender and race\/ethnicity differences in lead dose biomarkers. American Journal of Public Health, 98(7), 1248\u20131255. https:\/\/doi.org\/10.2105\/AJPH.2007.118505","journal-title":"American Journal of Public Health"},{"key":"9955_CR41","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1186\/1476-069X-13-90","volume":"13","author":"AS Ettinger","year":"2014","unstructured":"Ettinger, A. S., Bovet, P., Plange-Rhule, J., Forrester, T. E., Lambert, E. V., Lupoli, N., Shine, J., Dugas, L. R., Shoham, D., Durazo-Arvizu, R. A., Cooper, R. S., & Luke, A. (2014). Distribution of metals exposure and associations with cardiometabolic risk factors in the \u201cmodeling the epidemiologic transition study.\u201d Environmental Health, 13, 90. https:\/\/doi.org\/10.1186\/1476-069X-13-90","journal-title":"Environmental Health"},{"issue":"1","key":"9955_CR42","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.mehy.2013.11.008","volume":"82","author":"G Ngueta","year":"2014","unstructured":"Ngueta, G. (2014). Racial disparities in children\u2019s blood lead levels: Possible implication of divalent metal transporter 1. Medical Hypotheses, 82(1), 71\u201373. https:\/\/doi.org\/10.1016\/j.mehy.2013.11.008","journal-title":"Medical Hypotheses"},{"issue":"11","key":"9955_CR43","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1161\/CIRCRESAHA.119.315026","volume":"125","author":"N Patel","year":"2019","unstructured":"Patel, N., Russell, G. K., Musunuru, K., Gutierrez, O. M., Halade, G., Kain, V., Lv, W., Prabhu, S. D., Margulies, K. B., Cappola, T. P., Arora, G., Wang, T. J., & Arora, P. (2019). Race, natriuretic peptides, and high-carbohydrate challenge: A clinical trial. Circulation Research, 125(11), 957\u2013968. https:\/\/doi.org\/10.1161\/CIRCRESAHA.119.315026","journal-title":"Circulation Research"},{"issue":"1","key":"9955_CR44","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1007\/s12012-023-09819-0","volume":"24","author":"S Shibeeb","year":"2024","unstructured":"Shibeeb, S., Abdallah, A., & Shi, Z. (2024). Blood homocysteine levels mediate the association between blood lead levels and cardiovascular mortality. Cardiovascular Toxicology, 24(1), 62\u201370. https:\/\/doi.org\/10.1007\/s12012-023-09819-0","journal-title":"Cardiovascular Toxicology"},{"issue":"15","key":"9955_CR45","doi-asserted-by":"publisher","first-page":"22293","DOI":"10.1007\/s11356-021-17484-5","volume":"29","author":"X Wen","year":"2022","unstructured":"Wen, X., Li, T., & Xu, X. (2022). Cadmium exposure in US adults, research based on the national health and nutrition examination survey from 1988 to 2018. Environmental Science and Pollution Research International, 29(15), 22293\u201322305. https:\/\/doi.org\/10.1007\/s11356-021-17484-5","journal-title":"Environmental Science and Pollution Research International"},{"issue":"7","key":"9955_CR46","doi-asserted-by":"publisher","first-page":"1162","DOI":"10.1289\/ehp.0800408","volume":"117","author":"E Gould","year":"2009","unstructured":"Gould, E. (2009). Childhood lead poisoning: Conservative estimates of the social and economic benefits of lead hazard control. Environmental Health Perspectives, 117(7), 1162\u20131167. https:\/\/doi.org\/10.1289\/ehp.0800408","journal-title":"Environmental Health Perspectives"},{"key":"9955_CR47","doi-asserted-by":"publisher","unstructured":"Dignam, T., Kaufmann, R. B., LeStourgeon, L., & Brown, M. J. (2019). Control of lead sources in the United States, 1970\u20132017: Public Health Progress and Current Challenges to Eliminating Lead Exposure. J Public Health Manag Pract, 25 Suppl 1, Lead Poisoning Prevention (Suppl 1 LEAD POISONING PREVENTION), S13-S22. https:\/\/doi.org\/10.1097\/PHH.0000000000000889","DOI":"10.1097\/PHH.0000000000000889"},{"key":"9955_CR48","unstructured":"Hazard Standards and Clearance Levels for Lead in Paint, Dust and Soil (TSCA Sections 402 and 403). https:\/\/www.epa.gov\/lead\/hazard-standards-and-clearance-levels-lead-paint-dust-and-soil-tsca-sections-402-and-403"},{"key":"9955_CR49","doi-asserted-by":"publisher","unstructured":"OECD. Occupational Biomonitoring Guidance Document. OECD Series on Testing and Assessment, no. 370, 2022, OECD Publishing, https:\/\/doi.org\/10.1787\/11bc2c7a-en. In.","DOI":"10.1787\/11bc2c7a-en"},{"issue":"2","key":"9955_CR50","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1017\/S1742058X16000151","volume":"13","author":"RJ Sampson","year":"2016","unstructured":"Sampson, R. J., & Winter, A. S. (2016). The racial ecology of lead poisoning: Toxic inequality in chicago neighborhoods, 1995\u20132013. Du Bois Review: Social Science Research on Race, 13(2), 261\u2013283. https:\/\/doi.org\/10.1017\/S1742058X16000151","journal-title":"Du Bois Review: Social Science Research on Race"}],"container-title":["Cardiovascular Toxicology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12012-024-09955-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12012-024-09955-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12012-024-09955-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T08:54:09Z","timestamp":1739177649000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12012-024-09955-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,28]]},"references-count":50,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["9955"],"URL":"https:\/\/doi.org\/10.1007\/s12012-024-09955-1","relation":{},"ISSN":["1530-7905","1559-0259"],"issn-type":[{"value":"1530-7905","type":"print"},{"value":"1559-0259","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,28]]},"assertion":[{"value":"6 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 December 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The survey protocol was approved by the Research Ethics Review Board of the National Center for Health Statistics (), and NHANES has obtained written informed consent from all participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}}]}}