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oai:figshare.com:article/34028077 2026-09-29T22:07:49Z category_7 category_272 category_734 category_811 category_64 portal_63 item_type_6 month_year_09_2026

Strontium and Lead Accelerate, Calcium Protects: Arterial Stiffness Progression in an 11-Year Prospective Cohort Study Sencai Lin (23176112) Ying Yang (24175) Junxiu He (23176109) Yu Bao (1588321) Hong Cheng (112057) Weifan Kong (25139383) Xiuming Feng (25139386) Xiaolin Liang (230778) Xiaoting Ge (820955) Xiaobo Yang (123393) Medicine Environmental Sciences not elsewhere classified Biological Sciences not elsewhere classified Mathematical Sciences not elsewhere classified Cancer year prospective study decreasing pb trajectory 28 – 13 14 – 2 pb ), magnesium arterial stiffness progression sr ), calcium ca ), lead cei_ca inversely associated term metal exposure high epwv trajectory high epwv trajectories epwv progression 31 ), metal exposure lead accelerate distinct trajectories calcium protects metal mixture metal biomonitoring time assessments risk populations quantile increase provided insights primary prevention positive drivers overlooking heterogeneity longitudinal links higher odds established predictor critical role ceis ). cardiovascular disease 26 ). Arterial stiffness measured by estimated pulse wave velocity (ePWV) is an established predictor of cardiovascular disease. Long-term metal exposure may drive arterial stiffness progression, but prior studies largely relied on single-time assessments of exposure or outcome, overlooking heterogeneity in ePWV progression and its longitudinal links to long-term metal exposure. In an 11-year prospective study of 707 participants from the Manganese-Exposed Workers Healthy Cohort, we repeatedly quantified blood cell metals and computed cumulative exposure indices (CEIs). Latent class mixed models identified low and high ePWV trajectories. A one-quantile increase in CEI of a five-metal mixture [strontium (Sr), calcium (Ca), lead (Pb), magnesium, and manganese] was associated with belonging to the high ePWV trajectory (OR = 1.62; 95% CI: 1.14–2.31), with CEI_Sr and CEI_Pb as positive drivers and CEI_Ca inversely associated. The stronger CEI_Sr and CEI_Pb effects were observed in participants with high body mass index or smokers. The distinct trajectories of metal exposure were further identified; we found that the high-decreasing Pb trajectory was associated with higher odds of the high ePWV trajectory compared with the low-decreasing Pb trajectory (OR = 3.98; 95% CI: 1.28–13.26). We provided insights into the longitudinal links between long-term metal exposure and arterial stiffness progression, emphasizing the critical role of metal biomonitoring and primary prevention of arteriosclerosis in high-risk populations. 2026-09-29T00:00:00Z Text Journal contribution 10.1021/acs.est.6c07147.s001 https://figshare.com/articles/journal_contribution/Strontium_and_Lead_Accelerate_Calcium_Protects_Arterial_Stiffness_Progression_in_an_11-Year_Prospective_Cohort_Study/34028077 CC BY-NC 4.0