J Korean Med Sci.  2023 Jul;38(26):e203. 10.3346/jkms.2023.38.e203.

The Association Between Blood Lead Levels and Coronary Artery Calcium Score Determined by Using Coronary Computed Tomography Angiography

• Park E
• Kim S
• Cho S
• Kim H
• Jung I
• Moon JD
• Park WJ

• KMID: 2544016
• DOI: http://doi.org/10.3346/jkms.2023.38.e203

Abstract

Background
Lead exposure is a known risk factor for cardiovascular disease (CVD), and coronary artery calcification (CAC) is a biomarker for diagnosing atherosclerotic CVD. This study investigated the association between blood lead level (BLL) and CAC using coronary computed tomography (CT) angiography.
Methods
This study enrolled 2,189 participants from the general population with no history or symptoms of CVD. All participants underwent coronary CT angiography, health examination, and BLL testing. The association between coronary artery calcium score (CACS) and BLL was analyzed.
Results
The arithmetic mean of BLL was 2.71 ± 1.26 μg/dL, and the geometric mean was 2.42 (1.64) μg/dL, ranging from 0.12 to 10.14 μg/dL. There was a statistically significant positive correlation between CACS and BLL (r = 0.073, P < 0.001). Mean BLLs among predefined CACS categories were as follows: absent grade (CACS = 0), 2.67 ± 1.23 μg/dL; minimal grade (> 0, < 10), 2.81 ± 1.25 μg/dL; mild grade (≥ 10, < 100), 2.74 ± 1.29 μg/dL; moderate grade (≥ 100, < 400), 2.88 ± 1.38 μg/dL; severe grade (≥ 400): 3.22 ± 1.68 μg/dL. The odds ratio for severe CAC was 1.242 in association with an 1 μg/dL increase in BLL (P = 0.042).
Conclusion
Using coronary CT angiography, we determined a positive correlation between BLL and CAC among participants without CVD from the general population. To reduce the burden of CVD, efforts and policies should be geared toward minimizing environmental lead exposure.

Keyword

Cardiovascular Diseases; Coronary Artery Disease; Environmental Pollution; Healthy Volunteers; Heavy Metals; Physical Examination

Figure

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  Fig. 1 Selection process of study subjects.

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