Abstract
Introduction: Environmental metal exposure has been linked with multi-system toxicity and elevated stress hormones, and high metal concentrations have been observed among Asian Americans. Metal exposure may also increase Allostatic Load (AL), or physiologic “wear-and-tear” on the body. Hypothesis: Metal biomarker concentration is associated with high AL among non-Hispanic Asian (NHA) and non-Hispanic White (NHW) adults. Methods: AL scores were calculated based on 9 biomarkers representing cardiovascular, metabolic, and immune system function using data from the National Health and Nutrition Examination Survey (2015-2020). High AL was defined as having ≥3 high-risk biomarkers based on empirically defined thresholds. Lead, cadmium, and mercury were quantified in blood while arsenic, monomethylarsonic acid (MMA), and dimethylarsinic acid (DMA) were measured in urine. Metal concentrations were categorized into empirically-defined sample tertiles. Survey-weighted logistic regression analyses controlled for demographic, socioeconomic, and health behavior variables. Analyses were also stratified by NHA and NHW. Results: The study sample consisted of 5,012 adults [mean age: 50.4, SE: 0.5] (21.6% foreign-born NHA, 2.7% US-born NHA, and 75.7% NHW). Prevalence of high AL was 38.2% among NHW, 32.4% among foreign-born NHA, and 19.3% among US-born NHA. Metal exposure demonstrated heterogenous relationships with AL ( Table ). Individuals in the highest tertile of cadmium exposure had 38% greater odds of having high AL than those in the lowest tertile, however this association was attenuated after controlling for socioeconomic status and health behaviors. Lead, mercury, arsenic, DMA, and MMA were associated with lower odds of high AL. Relationships were similar when stratified by NHW and NHA. Conclusion: The association between metals and AL differs by metal type in our study population. Future studies should explore the mechanistic pathways between high metal exposure and AL.
Published Version
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