Association between urine lead levels and cardiovascular disease risk factors, carotid intima-media thickness and metabolic syndrome in adolescents and young adults

Int J Hyg Environ Health. 2020 Jan;223(1):248-255. doi: 10.1016/j.ijheh.2019.08.005. Epub 2019 Aug 22.


Background: Environmental lead exposure is a known risk factor of cardiovascular disease (CVD) in animal and human epidemiological studies of adults, but limited research has been conducted in young populations. Moreover, the association between lead level and common carotid artery intima-media thickness (CIMT) has never been documented.

Design: and Participants: In this study, 738 subjects were recruited from a cohort of Taiwanese adolescents and young adults to study the relationship between lead levels in urine and CVD risk factors, metabolic syndrome (MS) and CIMT.

Results: The geometric mean of the urine lead level was 1.50 μg/g creatinine. We found a significant positive association between urine lead levels and CVD risk factors, including diastolic blood pressure (DBP), mean arterial pressure (MAP), as well as markers of glucose homeostasis, such as serum glucose, serum insulin, homeostasis model assessment of insulin resistance (HOMA-IR), homeostasis model assessment of β-cell function (HOMA-β), body mass index (BMI) z score, and CIMT. Overall, increased urine lead concentrations were positively correlated with the prevalence of MS, specifically the criteria of waist/BMI and serum HDL-C. The relationship between urine lead levels and CIMT remained unchanged in all subgroups.

Conclusion: In this study, we found that increased urinary levels of lead were positively associated with CVD risk factors, CIMT, and MS in this cohort. Future research to explore the pathogenic basis of exposure to lead and risk of CVDs and their risk factors are warranted.

Keywords: Cardiovascular disease; Carotid intima-media thickness (CIMT); Lead; Metabolic syndrome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Cardiovascular Diseases / epidemiology*
  • Carotid Intima-Media Thickness / statistics & numerical data*
  • Environmental Exposure / statistics & numerical data*
  • Environmental Pollutants / urine*
  • Female
  • Humans
  • Lead / urine*
  • Male
  • Metabolic Syndrome / epidemiology*
  • Risk Factors
  • Young Adult


  • Environmental Pollutants
  • Lead