Investigating the Association Between Trace Element Exposure and Hypertension in the Inner Mongolia Region Trace Element Exposure and its Impact on Hypertension in Inner Mongolia: An In-Depth Analysis
Authors: Xu Danni , Zhao Song , Xu Ziyang , Xu Zihan , Gao Yumin , Zhao Lingyan , Liu Yanchao , Cao Ning , Li Hailing 
Published: July 2024

In this study, the association between exposure levels of trace elements in urine samples collected from residents of a particular region and the prevalence of hypertension was explored with a focus on the interplay between these elements. The study population comprised 183 individuals who met the inclusion criteria and were selected through cluster sampling from villages C and L of the Inner Mongolia Autonomous Region. A questionnaire was used to collect baseline data pertaining to the population, such as age, sex, smoking status, alcohol consumption, and vitamin intake, and to measure blood pressure, serum lipids, and trace element concentrations in the urine. Bivariate logistic linear regression models, interaction models, and WQS models were used to evaluate the associations between trace elements and their interactions, as well as the link between mixed exposures and hypertension in the population. The prevalence of hypertension among study participants was 52.46%. The detection rate was higher in females (60.42%) than in males (43.68%) (χ²=4.505, P = 0.034). Additionally, the detection rate of hypertension was higher among individuals with dyslipidemia (67.78%) than among those with normal lipid levels (37.63%) (χ²=16.664, P < 0.001). The results of the correlation analysis between trace elements in urine samples revealed strong positive correlations between As and Cr, Pb and Cd, Cu and Ca, Zn, K, Cu, Ca, Zn, K, Fe, and K, and moderate positive correlations between Cu and Sr (P < 0.05). Additionally, As, Se, Cr, Sr, Zn, K, Fe, and Cu were found to be statistically significant when the hypertensive and normal blood pressure groups were compared (P < 0.05). Multifactor logistic regression analysis indicated that individuals aged 60 years or older (OR = 1.044), female sex (OR = 3.558), dyslipidemia (OR = 3.486), elevated levels of As (OR = 1.008), Pb (OR = 1.253), and Cd (OR = 5.288) were at a higher risk of developing hypertension (P < 0.05). Conversely, those with lower levels of Se (OR = 0.751), Cr (OR = 0.919), Cu (OR = 0.811), Zn (OR = 0.959), K (OR = 0.820), and Sr (OR = 0.090) were found to be protected against hypertension (P < 0.05). The multiplicative interaction model revealed a synergistic effect between various factors, including age*sex, age*dyslipidemia, sex*dyslipidemia, Se*Cu, Se*Zn, Se*K, Se*Sr, Cr*Cu, Cr*K, Cr*Sr, Cu*Zn, Cu*K, Cu*Sr, Zn*Sr, and K*Sr. This model also revealed an antagonistic effect of As*Se, Se*Pb, Se*Cd, Pb*Cr, Pb*Cu, and Cr*Cd on hypertension risk. The additive interaction model indicated that age, sex, and dyslipidemia synergistically contribute to an increased risk of developing hypertension. According to the mixed exposure model, the trace element with the highest weight was Cd (weighted as 0.52). Ca, K, Pb, Zn, and Fe also carry significant weights in the risk of hypertension, with values of 0.29, 0.13, 0.04, 0.03, and 0.01, respectively. Exposure to trace elements may increase the risk of hypertension in individuals with advanced age or dyslipidemia. The interaction of these factors with the prevalence of hypertension requires further investigation to elucidate the relationship between trace-element exposure and the development of hypertension.
Fund Projects: National Natural Science Foundation of China(81360414、41230749);Inner Mongolia Medical University general project(YKD2023MS024)