Association between trace metal element levels and ideal cardiovascular health in adolescents

Adolescence is a critical stage in the development of cardiovascular disease. The American Heart Association has introduced a state-of-the-art algorithm called "Life Essential 8" (LE8) designed to quantify cardiovascular health (CVH). Research on the association of trace metal elements with cardiovascular disease in adolescents is inconsistent. This study aims to examine the association between trace metal elements and ideal CVH in adolescents.

This cross-sectional study included 5724 adolescents who participated in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. CVH was assessed using Life's Essential 8 (LE8) developed by the American Heart Association (AHA). Exposure factors were trace metal elements (iron, iodine, cadmium, lead, mercury, selenium, and manganese).

More than half of the adolescents had non-ideal CVH and only 40.8% achieved ideal CVH scores. Of the CVH measures, high blood glucose (96.1%), body mass index (81.3%), blood pressure (77.4%), and physical activity (65.0%) had high proportions of "ideal" values. However, diet, lipids and nicotine intake had lower rates of achieving the ideal CVH criteria (26.9%, 42.6% and 47.6%, respectively). The results of regression logistic showed that iron and mercury were negatively associated with the occurrence of non-ideal CVH (adjusted ORs of 0.997 [95% CI 0.995,0.999] and 0.913 [95% CI 0.840,0.991], and that urinary iodine, blood cadmium, lead, and selenium were positively associated with the occurrence of non-ideal CVH (adjusted ORs of 1.432 [95% CI 1.054,1.945], 3.845 [95% CI 2.278,6.491], and 1.010 [95% CI 1.003,1.017], respectively). No correlation between manganese and CVH was observed.

There is an urgent need to intervene in the CVH of children and adolescents. It is important to emphasize the need to maintain adequate iron intake while reducing iodine, cadmium, lead, and selenium intake.