Prospective association among metals and metalloids with chronic diseases and all-cause and cardiovascular mortality: Results form the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

• Grant number: 25/01496-7
• Support Opportunities: Research Projects - Thematic Grants
• Start date: December 01, 2025
• End date: November 30, 2030
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Isabela Judith Martins Bensenor
• Grantee: Isabela Judith Martins Bensenor
• Host Institution: Hospital Universitário (HU). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Pesquisadores principais: Paulo Andrade Lotufo
• Associated researchers: Airlane Pereira Alencar ; Alessandra Carvalho Goulart ; Andre Russowsky Brunoni ; Carolina Castro Porto Silva Janovsky ; Fernando Barbosa Júnior ; Itamar de Souza Santos ; José Augusto Sgarbi ; Patricia de Fatima dos Santos Teixeira ; Raul Dias dos Santos Filho

Abstract

Background: The environmental RF, weather changes and global warming highlight the importance of environmental RF as new non-classical risk factors associated to chronic diseases. In older studies, metals/metalloids were evaluated in high-risk areas or in natural disaster regions. However, recently, the literature about metal/metalloids studied them as risk factors for chronic diseases in studies in urban areas. There is scarce information about metal/metalloids levels as causal risk factors for chronic diseases in adults living in large metropolitan areas in which the risk of being exposed to these risk factors is not so clear with the exception of high-risk groups.Objective: The objective of this study is to evaluate levels of metal/metalloids including heavy metals and micronutrients and their relationship with chronic diseases such as thyroid disorders, inflammatory diseases, cardiovascular diseases (CDV) and diabetes. Methods: The ELSA-Brasil is a prospective multicentric cohort study that recruited civil servants 35-74 years living in 6 metropolitan areas in the country. The study began in 2008 and invite all participants every 4 to 5 years to a visit in the Investigation Centers to answer questionnaires, collect blood samples and underwent other exams. Every year we use media strategies to ask questions about their health including the study outcomes (morbidity and mortality). The study has 13 to 15 years of follow-up now. As part of data collection, the study stores biological samples of plasma and urine in all 4 waves of the study: 2008-2010; 2012-2014; 2017-2019 e 2022-2024. These biological samples will be used to test the levels of metals/metalloids in plasma and urine (exposures variables) and the incidence and mortality associated to these diseases (study outcomes). Several strategies of statistical analyses will be used to evaluate the data: binary regression and Poisson regressions models, Cox Proportional hazards penalize or not survival analysis using Kaplan Meier curves compared by the log-rank test and also linear regressions as part of the metallome-wide association studies and also machine learning approaches to evaluate the effect of the exposure to several metal/metalloids in the same analysis including heavy metals and micronutrients to study the possible effect of these elements together. Key words: metalloma, metal, metalloids, thyroid diseases, inflammatory diseases, cardiovascular diseases, diabetes. (AU)