Background Atherosclerotic cardiovascular disease (ASCVD) is one of the primary causes of death in Chinese residents. Research has shown that arsenic exposure could increase the incidence of ASCVD. However, the association between arsenic exposure and ASCVD 10-year risk and the possible mechanisms involved are still unclear.
Objective This study is conducted to evaluate the associations of arsenic exposure on mean platelet volume (MPV) and 10-year risk of ASCVD, and to investigate the potential role of MPV in the association between arsenic exposure and 10-year risk of ASCVD.
Methods The study participants were originated from the baseline survey of the Wuhan-Zhuhai Cohort, which was consisted of residents aged 18-80 years from two communities from each city in 2011 and 2012 respectively. Detailed socio-demographic characteristics and anthropometric indices were obtained from face-to-face questionnaire interviews and physical examinations, respectively. All participants were requested to provide fasting blood and urine samples. After excluding those not aged 35-74 years, those lacking biological samples and anthropometric indices, and those with nephritis, a total of 3 081 subjects were included. Urinary arsenic was detected by inductively coupled plasma mass spectrometry. MPV was detected with automatic biochemical analyzer. ASCVD 10-year risk scores were calculated using the China-PAR (Prediction for ASCVD Risk in China) equations improved by China Cardiovascular Disease Project. According to the scores, the participants were divided into two categories:high-risk (≥ 0.05) and low-risk (< 0.05). Logistic regression model was used to evaluate the association between urinary arsenic and 10-year risk of ASCVD. Restricted cubic spline regression was used to evaluate the associations between urinary arsenic and MPV and between MPV and 10-year risk of ASCVD. Furthermore, mediating model was used to assess the mediating effect of MPV on the association of urinary arsenic with 10-year risk of ASCVD.
Results The mean age of the study population was 54.05 years. The medians of urinary arsenic and MPV were 2.69 μg/mmol (corrected for creatinine) and 8.80fL respectively. After adjusting for potential confounders, there was a positive dose-response relationship between urinary arsenic and 10-year risk of ASCVD, and each 1-unit increase in ln-transformed value of urinary arsenic was associated with a 16.3% (95% CI:0.8%-34.2%) increase of being high-risk ASCVD. The results of restricted cubic spline regression analysis showed that urinary arsenic was positively linearly correlated with MPV, as well as MPV with 10-year risk of ASCVD. Besides, the results of mediation analysis indicated that MPV mediated 20.9% of the association between urinary arsenic and 10-year risk of ASCVD.
Conclusion Exposure to arsenic may be associated with increased MPV and increased 10-year risk of ASCVD. MPV might mediate the association of urinary arsenic with 10-year risk of ASCVD.
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