The association between urinary aluminum and lung function among an urban adult population: A repeated-measure longitudinal study

Objectives: To investigate the cross-sectional and longitudinal associations between aluminum exposure and lung function and the risk of chronic obstructive pulmonary disease (COPD). Methods: The repeated-measure study was developed with 3917 adults from the Wuhan-Zhuhai cohort and they were followed-up after 3 years and 6 years. Urinary aluminum and lung function were measured at each period. Linear mixed models were used to estimate the exposureeresponse relationship between urinary aluminum and lung function. COX regression models were used to evaluate the association of urinary aluminum with the risk of COPD. Results: A total of 6996 observations including 2251 (32.2%) males with a mean age of 54.8 years were included. In the cross-sectional analyses, each 1-unit increase in log-transformed urinary aluminum was associated with a -33.34 mL (95% confidence interval (CI) -45.71 to -20.96) change in forced vital capacity (FVC) and a -17.89 mL (-27.80 to -7.97) change in forced expiratory volume in 1 s (FEV1). The follow-up analyses detected a negative association between urinary aluminum and the annual change of FVC (-6.73 mL/year, 95% CI e10.92 to -2.54), while the association of annual decline of FEV1 with urinary aluminum was statistically insignificant (-2.26 mL/year, -5.76 to 1.23). In the adjusted COX regression model, each 1-unit increase in log-transformed urinary aluminum was associated with a 29% increase in the incident risk of COPD (hazard ratio 1.29, 95% CI 1.04e1.62). Inclusion: Increased urinary aluminum was associated with lung function reduction and the increased risk of COPD in a general urban population. (C) 2020 Elsevier Ltd. All rights reserved.

Automated summary

The study revealed that aluminum exposure is associated with a decline in lung function and an increased risk of COPD. Higher levels of urinary aluminum were linked to reduced lung function and an elevated risk of developing COPD in the general urban population.