Previous studies have demonstrated the effects of environmental metals on the cardiovascular system. However, the relationship of strontium (Sr) to cardiovascular disease (CVD) in the general population has not been established. This cross-sectional study aimed to investigate the association between urinary Sr (U-Sr) and CVD in the US adults using data of 5255 participants from the National Health and Nutrition Examination Survey (NHANES) 2011-2016. Multivariable logistic regression and restricted cubic spline (RCS) regression were performed to assess the association between U-Sr and CVD. After multivariable adjustments, compared to the lowest quartile, the adjusted odds ratios (ORs) of CVD with 95% confidence intervals (CIs) across the quartiles were 0.65 (0.46, 0.92), 0.87 (0.61, 1.25), and 0.78 (0.55, 1.10). RCS plot revealed a nonlinear relationship between U-Sr levels and CVD (P for nonlinearity = 0.004). Threshold effect analysis identified the inflection point of U-Sr for the curve was 90.18 μg/g urinary creatinine (μg/g UCr). Each 1-unit increase in U-Sr was associated with a 1.1% decrease in CVD (OR 0.989; 95% CI 0.980-0.998) on the left side of the inflection point, but no significant association was observed on the right side of the inflection point. This study suggests a nonlinear association of U-Sr with CVD prevalence in the US general adults. These findings may have positive implications for the determination of appropriate Sr levels for public cardiovascular health. Given the cross-sectional study design, further prospective studies are warranted.
Keywords: Cardiovascular disease; NHANES; Risk assessment; Urinary strontium.
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.