Blood lead, cadmium and mercury in relation to homocysteine and C-reactive protein in women of reproductive age: A panel study

Background: To examine the relationship between cadmium, lead, and mercury concentrations with high-sensitivity C-reactive protein (hs-CRP) and homocysteine in women. Methods: Metals were measured at enrollment in whole blood. Homocysteine and hs-CRP were measured in one (N = 9) or two (N = 250) menstrual cycles up to 3 and 8 times per cycle, respectively. Linear mixed models with inverse probability of exposure weights to account for time varying confounding were used and models were stratified by dietary and serum vitamin status (dietary: vitamin B₆, B₁₂, folate; serum: folate). Results: Geometric mean (95% confidence interval (CI)) concentrations for cadmium, lead, and mercury were 0.29 (0.26-0.31) μg/L, 0.91 (0.86-0.96) μg/dL, and 1.05 (0.93-1.18) μg/L, respectively. Lead was associated with increased homocysteine (0.08; 95% CI: 0.01, 0.15) and this persisted among those in the lower three quartiles of consumption of vitamin B₆, B₁₂, folate, and serum folate but was not significant among those in the upper quartile. No associations were observed between metals and hs-CRP. Conclusions: Blood lead was associated with increased homocysteine in a cohort of healthy, premenopausal women but these associations did not persist among those consuming ≥75th percentile of essential micronutrients. Cadmium, lead, and mercury were not associated with hs-CRP concentrations.