Associations of multiple plasma metals with atherosclerosis risk in mid-aged and elderly population from routine physical examination in a hospital of Shenzhen

[Background] Metal exposure is associated with the risk of atherosclerosis (AS), but current conclusions about the associations between exposure to multiple metals and AS remain controversial. [Objective] This study aims to investigate the associations of multiple metal exposure levels with the risk of AS among a mid-aged and elderly population from routine physical examination in Shenzhen, China. [Methods] A total of 664 mid-aged and elderly participants were recruited from population who ordered routine physical examination in the Eighth Affiliated Hospital, Sun Yat-Sen University of Shenzhen, China from 2012 to 2017. Information including demographic characteristics, lifestyles, physiological and biochemical indexes of the participants were collected through questionnaires and physical examinations. The concentrations of 13 metals in plasma were measured by inductively coupled plasma mass spectrometry (ICP-MS). Carotid intima-media thickness was measured by color Doppler ultrasound to evaluate AS. Logistic