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Yao J, Du Z, Yang F, Duan R, Feng T. The relationship between heavy metals and metabolic syndrome using machine learning. Front Public Health 2024; 12:1378041. [PMID: 38686033 PMCID: PMC11057329 DOI: 10.3389/fpubh.2024.1378041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/02/2024] [Indexed: 05/02/2024] Open
Abstract
Background Exposure to high levels of heavy metals has been widely recognized as an important risk factor for metabolic syndrome (MetS). The main purpose of this study is to assess the associations between the level of heavy metal exposure and Mets using machine learning (ML) method. Methods The data used in this study are from the national health and nutrition examination survey 2003-2018. According to the demographic information and heavy metal exposure level of participants, a total of 22 variables were included. Lasso was used to screen out the key variables, and 9 commonly used ML models were selected to establish the associations with the 5-fold cross validation method. Finally, we choose the SHapley Additive exPlanations (SHAP) method to explain the prediction results of Adaboost model. Results 11,667 eligible individuals were randomly divided into two groups to train and verify the prediction model. Through lasso, characteristic variables were selected from 24 variables as predictors. The AUC (area under curve) of the models selected in this study were all greater than 0.7, and AdaBoost was the best model. The AUC value of AdaBoost was 0.807, the accuracy was 0.720, and the sensitivity was 0.792. It is noteworthy that higher levels of cadmium, body mass index, cesium, being female, and increasing age were associated with an increased probability of MetS. Conversely, lower levels of cobalt and molybdenum were linked to a decrease in the estimated probability of MetS. Conclusion Our study highlights the AdaBoost model proved to be highly effective, precise, and resilient in detecting a correlation between exposure to heavy metals and MetS. Through the use of interpretable methods, we identified cadmium, molybdenum, cobalt, cesium, uranium, and barium as prominent contributors within the predictive model.
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Affiliation(s)
- Jun Yao
- Department of Respiratory and Critical Care, Guangyuan Central Hospital, Guangyuan, Sichuan, China
| | - Zhilin Du
- Department of Oncology, Chengdu Seventh People’s Hospital (Affliated Cancer Hospital of Chengdu Medical College), Chengdu, Sichuan, China
| | - Fuyue Yang
- Department of Rheumatology and Immunology, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Ran Duan
- Department of Oncology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Tong Feng
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
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Arruebarrena MA, Hawe CT, Lee YM, Branco RC. Mechanisms of Cadmium Neurotoxicity. Int J Mol Sci 2023; 24:16558. [PMID: 38068881 PMCID: PMC10706630 DOI: 10.3390/ijms242316558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/17/2023] [Accepted: 11/18/2023] [Indexed: 12/18/2023] Open
Abstract
Cadmium is a heavy metal that increasingly contaminates food and drink products. Once ingested, cadmium exerts toxic effects that pose a significant threat to human health. The nervous system is particularly vulnerable to prolonged, low-dose cadmium exposure. This review article provides an overview of cadmium's primary mechanisms of neurotoxicity. Cadmium gains entry into the nervous system via zinc and calcium transporters, altering the homeostasis for these metal ions. Once within the nervous system, cadmium disrupts mitochondrial respiration by decreasing ATP synthesis and increasing the production of reactive oxygen species. Cadmium also impairs normal neurotransmission by increasing neurotransmitter release asynchronicity and disrupting neurotransmitter signaling proteins. Cadmium furthermore impairs the blood-brain barrier and alters the regulation of glycogen metabolism. Together, these mechanisms represent multiple sites of biochemical perturbation that result in cumulative nervous system damage which can increase the risk for neurological and neurodegenerative disorders. Understanding the way by which cadmium exerts its effects is critical for developing effective treatment and prevention strategies against cadmium-induced neurotoxic insult.
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Affiliation(s)
- Madelyn A. Arruebarrena
- Neuroscience and Behavior Program, University of Notre Dame, Notre Dame, IN 46556, USA; (M.A.A.); (Y.M.L.)
| | - Calvin T. Hawe
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN 46556, USA;
| | - Young Min Lee
- Neuroscience and Behavior Program, University of Notre Dame, Notre Dame, IN 46556, USA; (M.A.A.); (Y.M.L.)
| | - Rachel C. Branco
- Neuroscience and Behavior Program, University of Notre Dame, Notre Dame, IN 46556, USA; (M.A.A.); (Y.M.L.)
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN 46556, USA;
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Lu L, Li Y, Chen C, Zhang Y, Guo W, Zhang S, Kahe K. Associations of cadmium exposure with risk of metabolic syndrome and its individual components: a meta-analysis. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023; 33:846-854. [PMID: 35585250 DOI: 10.1038/s41370-022-00444-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 04/17/2022] [Accepted: 04/25/2022] [Indexed: 06/15/2023]
Abstract
Data directly associating cadmium (Cd) with metabolic syndrome (MetS) are sparse and inconsistent. We aimed to quantitatively assess the association of Cd exposure with risk of MetS and its individual components. Literature searching was performed in PubMed, EMBASE, and MEDLINE-OVID through September, 2021. Weighted odds ratios (ORs) for MetS and its components were pooled by comparing the highest to the lowest category of Cd exposure using random-effects models. Eleven (10 from Asia and 1 from the US) cross-sectional studies (33,887 participants and 7176 cases) were identified. Overall, Cd exposure was not associated with risk of MetS [OR: 1.08, 95% confidence interval (CI): 0.92, 1.28]. However, the association became significant when pooling Asian studies (OR: 1.18, 95% CI: 1.02, 1.35), and it was more pronounced with Cd measured in blood (OR: 1.24, 95% CI: 1.05, 1.45). Additionally, Cd exposure was significantly associated with reduced HDL-cholesterol (OR: 1.27, 95% CI: 1.05, 1.54) and elevated triglyceride (OR: 1.17, 95% CI: 1.05, 1.30), but not other components. This meta-analysis indicates that Cd exposure is associated with risk of MetS among Asian populations, which is mainly explained by Cd's association with dyslipidemia. Further studies are needed to better understand the mechanism of action.
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Affiliation(s)
- Liping Lu
- Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Yuexia Li
- Department of Intensive Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
- Key Laboratory of Hepatobiliary and Pancreatic Surgery and Digestive Organ Transplantation of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
| | - Cheng Chen
- Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Yijia Zhang
- Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Wenzhi Guo
- Key Laboratory of Hepatobiliary and Pancreatic Surgery and Digestive Organ Transplantation of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
| | - Shuijun Zhang
- Key Laboratory of Hepatobiliary and Pancreatic Surgery and Digestive Organ Transplantation of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
| | - Ka Kahe
- Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA.
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA.
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4
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Xing W, Wang L, Gu W, Liang M, Wang Z, Fan D, Zhang B. Association of blood cadmium and metabolic syndrome: a cross-sectional analysis of National Health and Nutrition Examination Survey 2017-2020. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:27150-27162. [PMID: 36378388 DOI: 10.1007/s11356-022-24177-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/09/2022] [Indexed: 06/16/2023]
Abstract
Previous findings have reported the role of different types of heavy metals in cardiometabolic diseases. In the present research, we aim to evaluate the association between blood cadmium levels and Metabolic Syndrome (MetS) based on the large-sample NHANES data. Public availably data from NHANES 2017-2020 cycle was obtained. Participants were divided into MetS and non-MetS groups according to waist circumference (WC), triglyceride (TG), high-density lipoprotein (HDL), blood pressure (BP) and fasting plasma glucose (FPG) levels based on the National Cholesterol Education Program (NCEP) criteria. Student's t test, Mann-Whitney U test, and Chi-square test were performed for univariate analysis. Multivariate logistic analysis was performed to explore the relationship between blood cadmium and MetS and research findings were presented in forest plot. We also investigated the association of blood cadmium and MetS in subgroups stratified by age, gender and race. Population with MetS had significantly higher levels of blood [0.30 (0.18-0.54) vs. 0.24 (0.15-0.46) ug/L, p < 0.001] and urinary cadmium levels [0.29 (0.17-0.52) vs. 0.20 (0.09-0.42) ug/L, p < 0.001] compared with those without MetS. Higher blood cadmium concentrations were also observed in participants with elevated WC (0.28 vs. 023 ug/L, p < 0.001], TG (0.28 vs. 0.26 ug/L, p = 0.029), BP (0.33 vs. 0.23 ug/L, p < 0.001) and FPG (0.29 vs. 0.24 ug/L, p < 0.001) compared with those with normal metabolic parameters. Multivariate logistic regression showed that one-unit increasement of blood cadmium was associated with 1.25 times higher prevalence ratios for MetS after adjusting potential confounders (95% CI: 1.06-1.48, p = 0.0083). The associations between serum cadmium concentrations and MetS components were then evaluated, and the results showed higher blood cadmium levels were associated with higher risk for elevated TG, low HDL and elevated BP when treated as continuous variable. When treated as categorical variable, only BP was found positively associated with blood cadmium. Stratified multiple logistic regression analysis indicated that the positive association between blood cadmium and MetS remained significant in subjects less than 60 years old and female subgroup. In conclusion, the cross-sectional survey suggested the positive association between blood cadmium levels and risk for MetS, prospective research need to be conducted for further evaluation of the causal relationship between blood cadmium and MetS.
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Affiliation(s)
- Weilong Xing
- Ministry of Ecology and Environment (MEE), Nanjing Institute of Environmental Sciences, Nanjing, 210042, People's Republic of China.
- Nanjing Institute of Environmental Science, Key Laboratory of Pesticide Environmental Assessment and Pollution Control Ministry of Ecology and Environment, Nanjing, 210042, People's Republic of China.
| | - Lei Wang
- Ministry of Ecology and Environment (MEE), Nanjing Institute of Environmental Sciences, Nanjing, 210042, People's Republic of China
| | - Wen Gu
- Ministry of Ecology and Environment (MEE), Nanjing Institute of Environmental Sciences, Nanjing, 210042, People's Republic of China
| | - Mengyuan Liang
- Ministry of Ecology and Environment (MEE), Nanjing Institute of Environmental Sciences, Nanjing, 210042, People's Republic of China
| | - Zhen Wang
- Ministry of Ecology and Environment (MEE), Nanjing Institute of Environmental Sciences, Nanjing, 210042, People's Republic of China
| | - Deling Fan
- Ministry of Ecology and Environment (MEE), Nanjing Institute of Environmental Sciences, Nanjing, 210042, People's Republic of China
| | - Bing Zhang
- Ministry of Ecology and Environment (MEE), Nanjing Institute of Environmental Sciences, Nanjing, 210042, People's Republic of China
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Hernández-Mendoza H, Álvarez-Loredo HE, Romero-Guzmán ET, Gaytán-Hernández D, Chang-Rueda C, Martínez-Navarro I, Juárez-Flores BI, Rios-Lugo MJ. Relationship Between Serum Levels of Arsenic, Cadmium, and Mercury and Body Mass Index and Fasting Plasma Glucose in a Mexican Adult Population. Biol Trace Elem Res 2022; 200:4916-4923. [PMID: 35098445 PMCID: PMC8801291 DOI: 10.1007/s12011-021-03081-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/20/2021] [Indexed: 01/22/2023]
Abstract
In Mexico, few studies have analyzed the associations between toxic elements and metabolic diseases. In the present study, we analyzed the associations between serum arsenic (As), cadmium (Cd), and mercury (Hg) levels and body mass index (BMI) and fasting plasma glucose (FPG) in a Mexican adult population. Anthropometric data corresponding to 86 Mexican healthy adults (59 females and 27 men) were analyzed. FPG was analyzed by an enzymatic colorimetric method, and serum As, Cd, and Hg levels were analyzed by inductively coupled plasma-mass spectrometry (ICP-MS). The data show that the median serum As, Cd, and Hg levels were relatively higher in females (As = 1.78 ng mL-1, Cd = 1.00 ng mL-1, Hg = 0.96 ng mL-1) than those in males (As = 1.22 ng mL-1, Cd = 0.91 ng mL-1, Hg = 0.95 ng mL-1). However, these differences were not statistically significant (p ≥ 0.097). We also found that the median level of As significantly increased with an increase in the body weight categories (normal weight = 1.08; overweight = 1.50; obesity = 2.75; p < 0.001). In addition, a positive association between serum As levels and FPG before and after adjustment for BMI was demonstrated (RhoUnadjusted = 0.012; (RhoAdjusted = 0.243, p = 0.032). Serum As levels are positively associated with BMI and FPG in the adult population of Mexico. Nevertheless, these results need to be replicated and confirmed with a larger sample size.
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Affiliation(s)
- Héctor Hernández-Mendoza
- Instituto de Investigación de Zonas Desérticas, Universidad Autónoma de San Luis Potosí, Altair 200, C.P: 78377, San Luis Potosí, S.L.P., México.
- Universidad del Centro de México, Capitán Caldera 75, C.P: 78250, San Luis Potosí, S.L.P., México.
| | - Héctor Edmundo Álvarez-Loredo
- Centro de Investigación en Ciencias de Salud y Biomedicina, Sección de Medicina Molecular y Traslacional, Universidad Autónoma de San Luis Potosí, Avda Sierra Leona 550, C.P: 78210, San Luis Potosí, S.L.P., México
| | - Elizabeth Teresita Romero-Guzmán
- Departamento de Química, Gerencia de Ciencias Básicas, Dirección de Investigación Científica, Carretera México-Toluca S/N, C.P: 52750, La Marquesa Ocoyoacác, México
| | - Darío Gaytán-Hernández
- Facultad de Enfermería Y Nutrición, Unidad de Posgrado, Universidad Autónoma de San Luis Potosí, Avda. Niño Artillero 130, C.P: 78210, San Luis Potosí, S.L.P., México
| | - Consuelo Chang-Rueda
- Facultad de Ciencias Químicas, Universidad Autónoma de Chiapas, Campus IV Carretera a Puerto Madero Km 1.5, C.P: 30580, Tapachula, Chiapas, México
| | - Israel Martínez-Navarro
- Centro de Investigación en Ciencias de Salud y Biomedicina, Sección de Medicina Molecular y Traslacional, Universidad Autónoma de San Luis Potosí, Avda Sierra Leona 550, C.P: 78210, San Luis Potosí, S.L.P., México
| | - Bertha Irene Juárez-Flores
- Instituto de Investigación de Zonas Desérticas, Universidad Autónoma de San Luis Potosí, Altair 200, C.P: 78377, San Luis Potosí, S.L.P., México
| | - María Judith Rios-Lugo
- Centro de Investigación en Ciencias de Salud y Biomedicina, Sección de Medicina Molecular y Traslacional, Universidad Autónoma de San Luis Potosí, Avda Sierra Leona 550, C.P: 78210, San Luis Potosí, S.L.P., México.
- Facultad de Enfermería Y Nutrición, Unidad de Posgrado, Universidad Autónoma de San Luis Potosí, Avda. Niño Artillero 130, C.P: 78210, San Luis Potosí, S.L.P., México.
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Qu Z, Zhou J, Guo P, Wang J, Wang P, Liu L, Wu M, Wang P, Liu N. Association between environmental lead/cadmium co-exposure in drinking water and soil and type 2 diabetes mellitus/obesity in Southern China. Front Public Health 2022; 10:941922. [PMID: 36159247 PMCID: PMC9489910 DOI: 10.3389/fpubh.2022.941922] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 08/19/2022] [Indexed: 01/25/2023] Open
Abstract
Lead (Pb) and cadmium (Cd) in environment can be directly absorbed by drinking water and soil. However, data on human Pb and Cd exposure by drinking water and soil and its long-term consequence for type 2 diabetes mellitus (T2DM) and obesity are lacking. Our study aims to explore the association of typical heavy metals co-exposure in drinking water and soil to the community residents with T2DM and obesity indices in two cities of southern China. A cross-sectional study enrolling total 1,274 participants was performed and the local water and soil samples were collected in two communities in southern China. The average daily dose (ADD) of heavy metals was calculated to assess the exposure. The obesity indices comprise body mass index (BMI), waist-to-hip ratio (WHR) and waist circumference (WC). Binary, multiple logistic and linear regressions were employed for assessing the associations of Pb and Cd exposure with T2DM and obesity. The results showed that there weren't any significant correlations between ADDs of Pb/Cd and T2DM in community residents (all Ps>0.05). Compared with those with 18.5 ≤ BMI <24, with 1 μg/kg bw/d ADD of Pb increase in exposure are associated with 49.2-56.1% lower likelihood of overweight. Besides, with ADDs of Pb exposure was increased by 1 μg/kg bw/d and WHR decreasing by 0.01-0.02, and WC decreasing by 2.22-4.67 cm. We speculate that Pb causes weight loss because it damages the absorption function of the gastrointestinal tract as an initial injury. 1μg/kg bw/d ADD of Cd increase is associated with 100.9% upper likelihood of low weight in Model 1. It suggests that Pb/Cd pollution in the local environment was serious and harmful to residents' health. Government should introduce relevant oversight and accountability systems to improve the prevention and management of lifestyle-related chronic diseases in the future.
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Affiliation(s)
- Zhi Qu
- School of Nursing, Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China,Health Science Center, Institute of Environment and Health, South China Hospital, Shenzhen University, Shenzhen, China
| | - Jianli Zhou
- School of Nursing, Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China,Health Science Center, Institute of Environment and Health, South China Hospital, Shenzhen University, Shenzhen, China
| | - Peisen Guo
- Health Science Center, Institute of Environment and Health, South China Hospital, Shenzhen University, Shenzhen, China,College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Jingrui Wang
- School of Nursing, Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China
| | - Panpan Wang
- Health Science Center, Institute of Environment and Health, South China Hospital, Shenzhen University, Shenzhen, China,College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Limin Liu
- Health Science Center, Institute of Environment and Health, South China Hospital, Shenzhen University, Shenzhen, China,College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Mengdi Wu
- Health Science Center, Institute of Environment and Health, South China Hospital, Shenzhen University, Shenzhen, China,College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Peixi Wang
- School of Nursing, Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China,*Correspondence: Peixi Wang
| | - Nan Liu
- School of Nursing, Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China,Health Science Center, Institute of Environment and Health, South China Hospital, Shenzhen University, Shenzhen, China,College of Public Health, Zhengzhou University, Zhengzhou, China,Nan Liu
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Association between Heavy Metal Exposure and Dyslipidemia among Korean Adults: From the Korean National Environmental Health Survey, 2015-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063181. [PMID: 35328872 PMCID: PMC8951064 DOI: 10.3390/ijerph19063181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 12/22/2022]
Abstract
Cardiovascular disease (CVD) is a leading cause of death in Korea. Dyslipidemia, characterized by the presence of abnormal lipid levels, has been suggested as an early diagnostic and preventable factor for CVD. Recent studies have shown that exposure to lead (Pb), cadmium (Cd), and mercury (Hg) affects lipid metabolism. This study aimed to verify the association between heavy metal concentrations and serum lipid profiles in the general population. A representative sample of 2591 Korean adults from the Korean National Environmental Health Survey (2015−2017) was analyzed. The associations between heavy metals [Blood Pb (BPb), blood Hg (BHg), urinary Hg (UHg), urinary Cd (UCd)] and serum lipid profiles [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), non-low level of high-density lipoprotein cholesterol (Non-HDL-C)] were assessed using regression analysis. After adjusting for demographic and socioeconomic factors, the proportional changes in serum lipid levels were significantly associated with increases in BPb, BHg, and UHg levels (p for trend < 0.05). Overall, BPb, BHg, and Uhg levels positively correlated with dyslipidemia, whereas UCd levels did not show a significant association. Our results suggest that heavy metal exposure, at low levels, may contribute to an increased prevalence of dyslipidemia in Korean adults.
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Moon MK, Lee I, Lee A, Park H, Kim MJ, Kim S, Cho YH, Hong S, Yoo J, Cheon GJ, Choi K, Park YJ, Park J. Lead, mercury, and cadmium exposures are associated with obesity but not with diabetes mellitus: Korean National Environmental Health Survey (KoNEHS) 2015-2017. ENVIRONMENTAL RESEARCH 2022; 204:111888. [PMID: 34403664 DOI: 10.1016/j.envres.2021.111888] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/27/2021] [Accepted: 08/12/2021] [Indexed: 05/24/2023]
Abstract
BACKGROUND Associations of heavy metal exposures with obesity and obesity-related traits have been suggested, while those with nonalcoholic fatty liver disease (NAFLD) and diabetes mellitus (DM) are often inconsistent. METHODS This study included 3787 adults aged ≥19 years who participated in the Korean National Environmental Health Survey 2015-2017, and investigated the association of toxic heavy metals with metabolic diseases. Lead (Pb), mercury (Hg), and cadmium (Cd) were measured either in urine (uHg, uCd) or total blood (bPb, bHg). Body mass index (BMI) was calculated, and DM cases were identified through a self-answered medication history. Hepatic Steatosis Index (HSI) as a surrogating index of NAFLD, was calculated using hepatic enzyme measurements, including aspartate aminotransferase (AST) and alanine aminotransferase (ALT). RESULTS Adults in the highest quartile of bPb, bHg, and uHg showed significantly elevated odds of obesity (BMI ≥25 kg/m2), compared to the lowest quartile (OR 1.58 for bPb, 1.92 for bHg, and 1.81 for uHg). HSI was positively correlated with bHg, uHg, and uCd concentrations. The odds of NAFLD (HSI ≥36) were also increased with increasing quartile of bHg, uHg, and uCd concentrations. For DM, bPb showed a significant negative association, while bHg and uCd exhibited non-monotonic and inconclusive associations. CONCLUSIONS Among the general adult population of Korea, both Pb and Hg exposures were associated with an increased risk of obesity. In addition, both Hg and Cd exposures were associated with increased odds of NAFLD. These metals, however, were not associated with an increased risk of DM.
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Affiliation(s)
- Min Kyong Moon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Endocrinology, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Inae Lee
- School of Public Health, Seoul National University, Seoul, South Korea
| | - Aram Lee
- Department of Environmental Health Sciences, Soonchunhyang University, Asan, South Korea
| | - Hyunwoong Park
- Department of Laboratory Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Min Joo Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Sunmi Kim
- School of Public Health, Seoul National University, Seoul, South Korea; Chemical Safety Research Center, Korea Research Institute of Chemical Technology, Daejeon, South Korea
| | - Yoon Hee Cho
- Center for Environmental Health Sciences, Department of Biomedical and Pharmaceutical Sciences, University of Montana, Missoula, MT, USA
| | - Sooyeon Hong
- Environmental Health Research Division, National Institute of Environmental Research, Ministry of Environment, Incheon, Republic of Korea
| | - Jiyoung Yoo
- Environmental Health Research Division, National Institute of Environmental Research, Ministry of Environment, Incheon, Republic of Korea
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Kyungho Choi
- School of Public Health, Seoul National University, Seoul, South Korea
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
| | - Jeongim Park
- Department of Environmental Health Sciences, Soonchunhyang University, Asan, South Korea.
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Zhou J, Meng X, Deng L, Liu N. Non-linear associations between metabolic syndrome and four typical heavy metals: Data from NHANES 2011-2018. CHEMOSPHERE 2022; 291:132953. [PMID: 34800500 DOI: 10.1016/j.chemosphere.2021.132953] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 11/14/2021] [Accepted: 11/15/2021] [Indexed: 06/13/2023]
Abstract
Previous studies have found that heavy metals are associated with metabolic syndrome (MetS), although findings are inconsistent. Further, investigations into potential associations that consider age- or gender-specific effects and dose-response associations for metal exposure and MetS are rare. In this study, we explore the associations between blood levels of typical heavy metals [lead (Pb), cadmium (Cd), mercury (Hg) and manganese (Mn)] and MetS among adults using logistic regression analysis and restricted cubic splines (RCS) logistic analysis using data from the US National Health and Nutrition Examination Survey 2011-2018. After adjusting for covariates, higher levels of blood Pb, Cd and Hg were associated with lower risks of MetS in participants overall, and in all subgroup analyses, by logistic regression analysis (all P-values <0.05); in contrast, higher levels of blood Mn had a higher risk of MetS only in the age group of 30-49 years (P-values <0.05). We also found non-linear associations of heavy metal levels in blood with risk of MetS in participants overall, in specific age groups and in both genders, using RCS logistic regressions (all P-values <0.05). In addition, the non-linear associations of Pb and Hg we observed in different subgroups differed. In conclusion, blood levels of four heavy metals were associated with the risk of MetS through a variety of non-linear patterns.
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Affiliation(s)
- Jianli Zhou
- Department of Occupational Health and Occupational Medicine, School of Public Health, Southern Medical University, Guangzhou, 510515, PR China
| | - Xiaojing Meng
- Department of Occupational Health and Occupational Medicine, School of Public Health, Southern Medical University, Guangzhou, 510515, PR China.
| | - Lugang Deng
- Institute of Environment and Health, South China Hospital, Health Science Center, Shenzhen University, Shenzhen, 518116, PR China
| | - Nan Liu
- Department of Occupational Health and Occupational Medicine, School of Public Health, Southern Medical University, Guangzhou, 510515, PR China; Institute of Environment and Health, South China Hospital, Health Science Center, Shenzhen University, Shenzhen, 518116, PR China; Institute of Chronic Disease Risks Assessment, School of Nursing and Health, Henan University, Kaifeng, 475004, PR China; College of Public Health, Zhengzhou University, Zhengzhou, 540001, PR China.
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Cadmium Exposure in Young Adulthood Is Associated with Risk of Nonalcoholic Fatty Liver Disease in Midlife. Dig Dis Sci 2022; 67:689-696. [PMID: 33630217 PMCID: PMC8843233 DOI: 10.1007/s10620-021-06869-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 01/20/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Studies have suggested that cadmium (Cd) may be involved in the etiology of nonalcoholic fatty liver disease (NAFLD), but available data in human is sparse. AIMS We aimed to examine Cd exposure in young adulthood in relation to prevalent NAFLD in midlife among American adults. METHODS This study included 2446 participants from the Coronary Artery Risk Development in Young Adults study with toenail Cd measurement at exam year 2 (baseline) and computed tomography quantification of liver fat at exam year 25. Toenail Cd concentrations were considered as a reliable marker of long-term exposure. NAFLD was defined if liver attenuation < 51 Hounsfield units after excluding other possible causes of liver fat. Multivariable-adjusted logistic regression models were used to estimate the odds ratio of NAFLD by Cd exposure. RESULTS Median toenail Cd concentration was 8.2 ppb (inter-quartile range 4.3-18.6 ppb). After 23 years from baseline, 580 participants with prevalent NAFLD (24% prevalence) in midlife were identified. Compared with individuals in the lowest quartile, those in the highest quartile of toenail Cd had a significantly higher odds of NAFLD (OR: 1.43, 95% CI: 1.02, 1.99, P for trend: 0.04) after adjustment for demographics, socioeconomics, major lifestyle factors, and baseline levels of body mass index, lipids, and fasting insulin. The association was not significantly modified by race, sex, BMI, or smoking status at baseline. CONCLUSIONS Toenail Cd concentration was associated with a higher odds of prevalent NAFLD23 years later in life in this cohort of US general population.
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Effects of heavy metals on hypertension during menopause: a Korean community-based cross-sectional study. ACTA ACUST UNITED AC 2021; 28:1400-1409. [PMID: 34581292 DOI: 10.1097/gme.0000000000001865] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the associations between serum cadmium, lead, and mercury and hypertension in pre- and postmenopausal women. METHODS Serum heavy metal (cadmium, lead, and mercury) levels were analyzed in 7,226 randomly selected women who participated in Korean National Health and Nutrition Examination Surveys from 2009 to 2017. Odds ratios (ORs) for hypertension were calculated for log2-transformed serum heavy metal levels, median tertile levels of serum cadmium, mercury, and lead, and for interactions between heavy metal levels and tertiles, after covariate adjustment. RESULTS A doubling of serum cadmium was associated with hypertension in premenopausal (OR 2.47; 95% CI, 1.01-6.10, P = 0.049) and postmenopausal women (OR 1.70; 95% CI, 1.02-2.84, P = 0.043), and significant trends were observed for cadmium tertiles (P < 0.01). In premenopausal women, a two-fold increase in serum mercury increased the OR of hypertension by 3.08 (95% CI, 1.12-8.43, P = 0.029), and significant trends were also observed for serum mercury tertiles (P < 0.01). Interactions between serum cadmium, lead, and mercury levels in pre- and postmenopausal women were found to impact the prevalence of hypertension. CONCLUSION Given increasing exposure to heavy metals in Korea, further prospective study is needed to identify associations between heavy metal exposures, both separately and in combination, with the prevalence of cardiovascular disease risk factors in well-characterized cohorts of different populations and to determine means of preventing heavy metal exposure.
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Nguyen HD, Kim MS. Effects of heavy metal, vitamin, and curry consumption on metabolic syndrome during menopause: a Korean community-based cross-sectional study. Menopause 2021; 28:949-959. [PMID: 34284432 DOI: 10.1097/gme.0000000000001825] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To determine the associations between metabolic syndrome (MetS) during menopause and serum heavy metal levels and vitamin and curry consumption. METHODS A data set of 7,131 pre- and postmenopausal women aged ≥ 20 years collected between 2009 and 2017 was used to obtain information on sociodemographic, lifestyles, family histories, food intakes, and serum heavy metal levels and MetS. Logistic regression was used to identify associations between the presence of MetS and risk factors and to predict risks of MetS based on marginal effects. RESULTS Our results show that postmenopausal women had a higher risk of MetS than premenopausal women. During postmenopause elevations in the levels of serum cadmium by one unit increased the risk of MetS by 33% (OR 1.33; 95% CI, 1.03-1.72, P = 0.028). Risks of MetS in pre- and postmenopausal women, when serum Hb levels increased by 1 unit increased 21% (OR 1.21; 95% CI, 1.09-1.33, P < 0.001) and 26% (OR 1.26; 95% CI, 1.16-1.38, P < 0.001), respectively. Furthermore, the risk of MetS risk in pre- and postmenopausal women was increased 2.49-fold and 2.79-fold by a 1% increase in HbA1c level (OR 2.49; 95% CI, 1.97-3.16, P < 0.001) and (OR 2.79; 95% CI, 2.30-3.38, P < 0.001), respectively. High curry consumption reduced the risk of MetS significantly more than low curry consumption (OR 0.60; 95% CI, 0.39-0.91, P = 0.017) in premenopausal women. Furthermore, an increase in daily vitamin B2 intake by 1 mg reduced the risk of MetS by 45% (OR 0.55; 95% CI, 0.32-0.94, P = 0.028) in postmenopausal women. CONCLUSION Vitamin B2 and curry supplementation may protect against MetS. Further work is needed to reduce risk factors associated with heavy metals and determine the effects of vitamins and curry consumption on MetS during menopause.
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Affiliation(s)
- Hai Duc Nguyen
- Department of Pharmacy, College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Sunchon, Jeonnam, Republic of Korea
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Association between heavy metals, high-sensitivity C-reaction protein and 10-year risk of cardiovascular diseases among adult Korean population. Sci Rep 2021; 11:14664. [PMID: 34282223 PMCID: PMC8289831 DOI: 10.1038/s41598-021-94158-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 06/30/2021] [Indexed: 02/06/2023] Open
Abstract
The prevalence of cardiovascular diseases (CVDs) in Korea tends to be increasing. It has worsened during the COVID-19 pandemic. Increasing evidence shows heavy metals are associated with increased CVD risk. We aimed to determine the association between the serum heavy metal levels and 10-year risk of CVDs and to predict risks of CVDs based on marginal effects. Heavy metals were measured by a graphite furnace atomic absorption spectrometry and direct mercury analyzer. The results show a significant relationship between the increase in cadmium, lead, mercury, hs-CRP levels and the 10-year risk of CVD after adjustment for serum cotinine, age group, sex, body mass index, a family history of CVDs, diabetes or hyperlipidemia, high-risk drinking, physical activity, and diabetes. A doubling of serum cadmium, lead, mercury, and hs-CRP was associated with the increase in the 10-year risk of CVD by 0.14%, 0.10%, 0.11% and 0.22%, respectively. Therefore, a special concern should be given to the harmful impacts of heavy metals on the 10-year risk of CVD. It is important to develop a prevention strategy targeting the high-risk population to slow down this progression to risk factors related to heavy metals and reduce prevalence. Remarkedly, hs-CRP is the most validated and widely used inflammatory marker, and could be a potential clinical value in predicting and monitoring CVDs.
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Zhao H, Pan Y, Wang C, Guo Y, Yao N, Wang H, Li B. The Effects of Metal Exposures on Charlson Comorbidity Index Using Zero-Inflated Negative Binomial Regression Model: NHANES 2011-2016. Biol Trace Elem Res 2021; 199:2104-2111. [PMID: 32816137 DOI: 10.1007/s12011-020-02331-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/05/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND With the rising incidence of chronic diseases, and the increase of aging population has led to multimorbidity a serious public health problem. The aim of this study was to explore the association between metal exposures and Charlson comorbidity index (CCI), which will provide valuable information for improving quality of life and reducing mortality. METHODS The study sample consists of three continuous cycles (2011-2016) of the National Health and Nutrition Examination Survey (NHANES), and 4901 eligible subjects were included in the study. Zero-inflated negative binomial (ZINB) model was utilized to investigate the effects in metal exposures on CCI, which includes spot urine (arsenic, mercury, and cadmium), whole blood (manganese, selenium, and lead), and serum (copper and zinc). RESULTS In count part (CCI ≥ 0), holding other variables constant, the expected change in CCI for a one-unit increase in blood selenium is 0.997 (RR = 0.997, p = 0.017). In logit part (CCI = 0), the log odds of having CCI equals zero would increase by 0.659, 1.073, and 0.963 for every additional urinary cadmium (OR = 0.659, p = 0.007), blood lead (OR = 1.073, p = 0.023), blood manganese (OR = 0.963, p = 0.025), respectively. CONCLUSIONS Our findings indicated that cadmium and manganese were likely to increase mortality. Inversely, selenium and lead might be positive on people's health. The findings may be extremely essential for preventing diseases and improving life quality.
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Affiliation(s)
- Hantong Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Yingan Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Changcong Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Yinpei Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Nan Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Han Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China.
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Park BH, Lee BK, Ahn J, Kim NS, Park J, Kim Y. Association of Participation in Health Check-ups with Risk Factors for Cardiovascular Diseases. J Korean Med Sci 2021; 36:e19. [PMID: 33463093 PMCID: PMC7813587 DOI: 10.3346/jkms.2021.36.e19] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 10/27/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND We compared the risk factors for cardiovascular diseases (CVDs) among Koreans who did and did not participate in national periodic health check-ups, after adjustment for demographic factors, socioeconomic status, and lifestyle factors. METHODS This cross-sectional study used data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2018. Study subjects were classified as participants or non-participants in health check-ups, based on attendance at national periodic health check-ups during the previous two years. RESULTS Comparison of participants and non-participants in health check-ups indicated statistically significant differences in age, gender, region, education level, monthly income, employment status, obesity, smoking, alcohol consumption, exercise, and marital status. After adjustment for demographic, socioeconomic factors, and health-related behaviors, woman non-participants were more likely to have metabolic syndrome, pre-hypertension, hypertension, prediabetes, and diabetes, and man non-participants were more likely to have pre-diabetes and diabetes. CONCLUSION Subjects who participated in periodic health check-ups had fewer CVD-related risk factors than non-participants. Thus, health care providers should encourage non-participants to attend periodic health check-ups so that appropriate interventions can be implemented and decrease the risk for CVDs in these individuals.
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Affiliation(s)
- Bok Hyun Park
- Department of Environmental Health, Daejeon Health Institute of Technology, Daejeon, Korea
| | - Byung Kook Lee
- Department of Preventive Medicine, Soonchunhyang University, Asan, Korea
| | - Jaeouk Ahn
- Department of Medical IT Engineering, College of Medical Sciences, Soonchunhyang University, Asan, Korea
| | - Nam Soo Kim
- Institute of Occupational and Environmental Medicine, Soonchunhyang University, Asan, Korea
| | - Jungsun Park
- Department of Occupational Health, Daegu Catholic University, Gyeongsan, Korea.
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
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Xu P, Liu A, Li F, Tinkov AA, Liu L, Zhou JC. Associations between metabolic syndrome and four heavy metals: A systematic review and meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 273:116480. [PMID: 33486246 DOI: 10.1016/j.envpol.2021.116480] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 12/19/2020] [Accepted: 01/07/2021] [Indexed: 06/12/2023]
Abstract
Four most concerned heavy metal pollutants, arsenic, cadmium, lead, and mercury may share common mechanisms to induce metabolic syndrome (MetS). However, recent studies exploring the relationships between MetS and metal exposure presented inconsistent findings. We aimed to clarify the relationship between heavy metal exposure biomarkers and MetS using a meta-analysis and systematic review approach. Literature search was conducted in international and the Chinese national databases up to June 2020. Of selected studies, we extracted the relevant data and evaluated the quality of each study's methodology. We then calculated the pooled effect sizes (ESs), standardized mean differences (SMDs), and their 95% confidence intervals (CIs) using a random-effect meta-analysis approach followed by stratification analyses for control of potential confounders. Involving 55,536 participants, the included 22 articles covered 52 observational studies reporting ESs and/or metal concentrations on specific metal and gender. Our results show that participants with MetS had significantly higher levels of heavy metal exposure [pooled ES = 1.16, 95% CI: 1.09, 1.23; n = 42, heterogeneity I2 = 75.6%; and SMD = 0.22, 95% CI: 0.15, 0.29; n = 32, I2 = 94.2%] than those without MetS. Pooled ESs in the subgroups stratified by arsenic, cadmium, lead, and mercury were 1.04 (95% CI: 0.97, 1.10; n = 8, I2 = 61.0%), 1.10 (0.95, 1.27; 11, 45.0%), 1.21 (1.00, 1.48; 12, 82.9%), and 1.26 (1.06, 1.48; 11, 67.7%), respectively. Pooled ESs in the subgroups stratified by blood, urine, and the other specimen were 1.22 (95% CI: 1.08, 1.38; n = 26, I2 = 75.8%), 1.06 (1.00, 1.13; 14, 58.1%), and 2.41 (1.30, 4.43; 2, 0.0%), respectively. In conclusion, heavy metal exposure was positively associated with MetS. Further studies are warranted to examine the effects of individual metals and their interaction on the relationship between MetS and heavy metals.
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Affiliation(s)
- Ping Xu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, 518100, China
| | - Aiping Liu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, 518100, China
| | - Fengna Li
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, 518100, China
| | - Alexey A Tinkov
- Yaroslavl State University, 150003, Yaroslavl, Russia; IM Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia
| | - Longjian Liu
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
| | - Ji-Chang Zhou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, 518100, China; Guangdong Province Engineering Laboratory for Nutrition Translation, Guangzhou, 510080, China.
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Huang M, Chen J, Yan G, Yang Y, Luo D, Chen X, He M, Yuan H, Huang Z, Lu Y. Plasma titanium level is positively associated with metabolic syndrome: A survey in China's heavy metal polluted regions. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 208:111435. [PMID: 33038727 DOI: 10.1016/j.ecoenv.2020.111435] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/20/2020] [Accepted: 09/28/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Several heavy metals have been reported to be associated with metabolic syndrome(MetS) in general population, while effects of multiple metals exposure on MetS in residents living in heavy metal polluted regions have not been investigated. We aimed to assess the association of 23 metal levels and MetS among population living in China's heavy metal polluted regions. METHODS From August 2016 to July 2017, a total of 2109 eligible participants were consecutively enrolled in our study in Hunan province, China. The levels of plasma and urine metals were measured by inductively coupled plasma mass spectrometer (ICP-MS). MetS was defined by the criteria of the International Diabetes Federation. Multivariable regression models were applied to analysis the potential relationship. RESULTS In the overall population, crude model showed positive relationship of plasma titanium (Ti) with MetS and negative association of urine vanadium, iron, and selenium with MetS. After adjusted for potential confounders, only plasma Ti was positive associated with MetS (adjusted OR for Q4 versus Q1: 1.46; 95% CI: 1.06-1.99), and this positive correlation was explained by abdominal obesity (OR = 1.84, 95% CI: 1.41-2.39) and high triglycerides (OR = 2.23, 95% CI: 1.68-2.96). Further linear regression analysis revealed significant association of plasma Ti levels with waist circumference (β = 0.0056, 95% CI: 0.0004-0.0109, P = 0.036) and triglycerides (β = 0.0012, 95% CI: 0.0006-0.0019, P < 0.001), respectively. CONCLUSION High plasma Ti level was associated with increased risk of MetS via increasing waist circumference and triglycerides in people under high metal exposure.
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Affiliation(s)
- Miao Huang
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Jingyuan Chen
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Guangyu Yan
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Yiping Yang
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Dan Luo
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha 410078, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Meian He
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Hong Yuan
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha 410013, China; National-Local Joint Engineering Laboratory of Drug Clinical Evaluation Technology, Changsha 410000, China
| | - Zhijun Huang
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha 410013, China.
| | - Yao Lu
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha 410013, China; National-Local Joint Engineering Laboratory of Drug Clinical Evaluation Technology, Changsha 410000, China.
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Park J, Kim Y. Associations of Blood Heavy Metals with Uric Acid in the Korean General Population: Analysis of Data from the 2016-2017 Korean National Health and Nutrition Examination Survey. Biol Trace Elem Res 2021; 199:102-112. [PMID: 32342340 DOI: 10.1007/s12011-020-02152-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 04/07/2020] [Indexed: 12/24/2022]
Abstract
We hypothesized that blood heavy metal levels such as lead, cadmium, and mercury were associated with uric acid level and hyperuricemia, and that this association remains significant after adjustment for other metals. We tested this hypothesis using the Korean National Health and Nutrition Examination Survey data. Beta coefficients and 95% confidence intervals (95% CIs) were calculated using multiple linear regression, and odds ratios (ORs) and 95% CIs were calculated using logistic regression in the cross-sectional study design. Relative to women, men had a higher geometric mean (GM) of lead (1.95 vs. 1.50 μg/dL) and mercury (3.94 vs. 2.77 μg/L), a lower GM of cadmium (0.80 vs. 1.04 μg/L), and a higher arithmetic mean (AM) of uric acid (5.84 vs. 4.40 mg/dL). Women had significant positive associations of log uric acid level with doubling of lead and mercury, and negative association with cadmium. Logistic regression analysis indicated the inverse association of serum hyperuricemia with doubling of blood metals was only significant for cadmium in women (OR = 0.641, 95% CI = 0.463 to 0.886) and the associations of serum hyperuricemia in the highest versus lowest quartiles of heavy metals were only significant for cadmium in women (OR = 0.495, 95% CI = 0.246 to 0.998). For both genders, age and estimated glomerular filtration rate (e-GFR) had negative associations with uric acid, but hypertension and triglycerides had positive associations with uric acid. In conclusion, blood lead and mercury levels were positively associated with uric acid level, but blood cadmium level was inversely associated with uric acid level and hyperuricemia in women.
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Affiliation(s)
- Jungsun Park
- Department of Occupational Health, Catholic University of Daegu, Gyeongsan, South Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, # 290-3 Cheonha-dong, Dong-gu, Ulsan, 44033, South Korea.
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Martins AC, Urbano MR, Almeida Lopes ACB, Carvalho MDFH, Buzzo ML, Docea AO, Mesas AE, Aschner M, Silva AMR, Silbergeld EK, Paoliello MMB. Blood cadmium levels and sources of exposure in an adult urban population in southern Brazil. ENVIRONMENTAL RESEARCH 2020; 187:109618. [PMID: 32447086 DOI: 10.1016/j.envres.2020.109618] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/24/2020] [Accepted: 04/29/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Cadmium (Cd) is a toxic metal that is widely present in the environment due to geologic and anthropogenic sources. Exposures to high Cd levels may cause nephrotoxicity, carcinogenicity, pulmonary and cardiovascular disease, among others. The goal of this study was to investigate in an adult urban population whether an association exists between sources and levels of Cd exposure and blood Cd concentrations. METHODS Using a census-based design, a total of 959 adults, aged 40 years or older, were randomly selected. Information on socio-demographics, dietary, and lifestyle background was obtained by household interviews. Blood Cd levels were measured by inductively coupled-plasma mass spectrometry. Geometric means (GM) (95% CI) and the 50th percentile were determined, stratified by sex, age, race, education, income class, smoking status, consumption of vegetables, red meat and milk, occupation and blood pressure. To assess the association between Cd exposure and the aforementioned variables, we estimated the geometric mean ratio (GMR) (95%CI) of blood Cd concentrations. RESULTS AND CONCLUSION The geometric mean (95%CI) of blood Cd levels in the total population was 0.25 (0.22, 0.27) ug/dL. In a univariate analysis, significantly higher blood Cd levels were found in men (p < 0.001), current and former smokers (p < 0.001), alcohol drinkers (p < 0.001), those who never or almost never consumed milk (p < 0.001), and in subjects with higher diastolic blood pressure (p = 0.03). Significant correlations were found between the number of cigarettes consumed daily and blood Cd levels. Multivariate analysis confirmed higher blood Cd concentrations were associated with alcohol consumption (GMR 95%CI = 1.28, 1.04-1.59) and in former and current smokers (GMR 95% IC = 1.33, 1.06-1.67 and 4.23, 3.24-5.52, respectively). Our results shed novel information on variables associated with blood Cd levels in an urban Brazilian population, and should encourage additional research to prevent environmental Cd exposure, both in Brazil and globally.
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Affiliation(s)
- Airton C Martins
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, 10461, Bronx, NY, USA
| | - Mariana R Urbano
- Department of Statistics, State University of Londrina, Rodovia Celso Garcia Cid, Km 380, S/no, Campus Universitário, 86057-970, Londrina, PR, Brazil
| | - Ana Carolina B Almeida Lopes
- Graduate Program in Public Health, Center of Health Sciences, State University of Londrina, 60 Robert Koch Avenue, 86038-350, Londrina, PR, Brazil
| | - Maria de Fatima H Carvalho
- Inorganic Contaminants Department, Adolfo Lutz Institute, Sao Paulo, Avenida Doutor Arnaldo, 355, 01246-000, São Paulo, SP, Brazil
| | - Marcia L Buzzo
- Inorganic Contaminants Department, Adolfo Lutz Institute, Sao Paulo, Avenida Doutor Arnaldo, 355, 01246-000, São Paulo, SP, Brazil
| | - Anca O Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania
| | - Arthur E Mesas
- Universidad de Castilla-La Mancha, Facultad de Enfermería, Edificio Melchor Cano, Campus Universitario de Cuenca, Camino de Pozuelo, S/n 16071, Cuenca, Spain
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, 10461, Bronx, NY, USA; I. M. Sechenov First Moscow Medical University (Sechenov University), Bolshaya Pirogovskaya St., 19-1, 119146, Moscow, Russia
| | - Ana Maria R Silva
- Graduate Program in Public Health, Center of Health Sciences, State University of Londrina, 60 Robert Koch Avenue, 86038-350, Londrina, PR, Brazil
| | - Ellen K Silbergeld
- Emerita Professor, Johns Hopkins University, Bloomberg School of Public Health, 615 N Wolfe St, 21205, Baltimore, MD, USA
| | - Monica M B Paoliello
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, 10461, Bronx, NY, USA; Graduate Program in Public Health, Center of Health Sciences, State University of Londrina, 60 Robert Koch Avenue, 86038-350, Londrina, PR, Brazil.
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20
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The Effect of Whole Blood Lead (Pb-B) Levels on Changes in Peripheral Blood Morphology and Selected Biochemical Parameters, and the Severity of Depression in Peri-Menopausal Women at Risk of Metabolic Syndrome or with Metabolic Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145033. [PMID: 32668760 PMCID: PMC7400500 DOI: 10.3390/ijerph17145033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/06/2020] [Accepted: 07/10/2020] [Indexed: 01/01/2023]
Abstract
The aim of our study was to assess the impact of whole blood lead (Pb-B) levels on changes in peripheral blood morphology and selected biochemical parameters, and the severity of depression in peri-menopausal women at risk of metabolic syndrome (pre-MetS) or with metabolic syndrome (MetS). The study involved 233 women from the general population of the West Pomeranian Province (Poland) aged 44–65 years. The intensity of menopausal symptoms and the severity of depression was examined using the Blatt–Kupperman Index (KI) and the Beck Depression Inventory (BDI). C-reactive protein (CRP), insulin, glucose, glycated hemoglobin (HbA1C), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, triglyceride levels (TG), cortisol, morphology of blood cells and homeostasis model assessment for insulin resistance (HOMA-IR) and Pb-B was measured. Women with MetS had higher levels of glucose, HbA1C, HDL, LDL, TG, cortisol, insulin and higher HOMA-IR. No significant differences in Pb-B were observed between pre-MetS and the control group, and between pre-MetS and the MetS group. A significant correlation was noticed between Pb-B vs. the percentage of monocytes in blood, and blood cortisol levels in women with MetS; Pb-B vs. lymphocyte count and HbA1C in the pre-MetS group, as well as in the BDI scores between the MetS and pre-MetS group. We cannot clearly state that exposure to Pb is an environmental factor that can be considered as a risk factor for MetS in this studied group.
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Ahn J, Kim NS, Lee BK, Oh I, Kim Y. Changes of Atmospheric and Blood Concentrations of Lead and Cadmium in the General Population of South Korea from 2008 to 2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2096. [PMID: 31200504 PMCID: PMC6617041 DOI: 10.3390/ijerph16122096] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 06/08/2019] [Accepted: 06/11/2019] [Indexed: 01/10/2023]
Abstract
We measured changes in atmospheric and blood levels of lead and cadmium in the South Korean general population during the past decade. Blood data of 16,873 adults were taken from the Korean National Health and Nutrition Examination Survey (KNHANES, 2008-2017). Atmospheric data were taken from 66 air quality monitoring sites in 16 different regions in South Korea. From 2008 to 2017, the geometric mean (GM) blood lead level decreased from 2.37 to 1.46 μg/dL (38.4% decrease), and the atmospheric lead concentration decreased by 61.0% in the overall population. During this time, the GM blood cadmium level decreased from 0.88 to 0.72 μg/L (18.2% decrease), and the atmospheric cadmium concentration decreased by 63.6%. Multiple linear regression analysis indicated that a half reduction in air lead was associated with a 0.09 μg/dL decrease in blood lead (95% CI: 0.03 to 0.15) in a subgroup of the metropolitan city population. However, a half reduction in air cadmium had no significant effect on blood cadmium. Multiple linear regression analyses indicated that the decrease in blood lead level over 10 years in Korea was related to the decrease in atmospheric lead concentration. However, the decrease in blood cadmium level during this time was not significantly associated with the decrease in atmospheric cadmium concentration. Our findings suggest that inhalation is a major source of lead exposure, but not of cadmium exposure. Ingestion of dietary cadmium presumably has a stronger impact on blood cadmium levels.
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Affiliation(s)
- Jaeouk Ahn
- Department of Medical IT Engineering, Soonchunhyang University, 22 Suncheonhyang-ro, Asan 31538, Korea.
| | - Nam-Soo Kim
- Institute of Occupational and Environmental Medicine, Soonchunhyang University, 22 Soonchunhyang-ro, Asan 31538, Korea.
| | - Byung-Kook Lee
- Department of Preventive Medicine, Soonchunhyang University, 22 Suncheonhyang-ro, Asan 31538, Korea.
| | - Inbo Oh
- Environmental Health Center, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan 44033, Korea.
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan 44033, Korea.
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22
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Chandler JD, Hu X, Ko EJ, Park S, Fernandes J, Lee YT, Orr ML, Hao L, Smith MR, Neujahr DC, Uppal K, Kang SM, Jones DP, Go YM. Low-dose cadmium potentiates lung inflammatory response to 2009 pandemic H1N1 influenza virus in mice. ENVIRONMENT INTERNATIONAL 2019; 127:720-729. [PMID: 30999129 PMCID: PMC6536378 DOI: 10.1016/j.envint.2019.03.054] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/08/2019] [Accepted: 03/24/2019] [Indexed: 05/04/2023]
Abstract
Cadmium (Cd) is a toxic, pro-inflammatory metal ubiquitous in the diet that accumulates in body organs due to inefficient elimination. Responses to influenza virus infection are variable, particularly severity of pneumonia. We used a murine model of chronic low-dose oral exposure to Cd to test if increased lung tissue Cd worsened inflammation in response to sub-lethal H1N1 infection. The results show that Cd-treated mice had increased lung tissue inflammatory cells, including neutrophils, monocytes, T lymphocytes and dendritic cells, following H1N1 infection. Lung genetic responses to infection (increasing TNF-α, interferon and complement, and decreasing myogenesis) were also exacerbated. To reveal the organization of a network structure, pinpointing molecules critical to Cd-altered lung function, global correlations were made for immune cell counts, leading edge gene transcripts and metabolites. This revealed that Cd increased correlation of myeloid immune cells with pro-inflammatory genes, particularly interferon-γ and metabolites. Together, the results show that Cd burden in mice increased inflammation in response to sub-lethal H1N1 challenge, which was coordinated by genetic and metabolic responses, and could provide new targets for intervention against lethal inflammatory pathology of clinical H1N1 infection.
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Affiliation(s)
- Joshua D Chandler
- Division of Pulmonary, Allergy and Critical Care Medicine, Emory University School of Medicine, Atlanta, GA 30322, United States of America
| | - Xin Hu
- Division of Pulmonary, Allergy and Critical Care Medicine, Emory University School of Medicine, Atlanta, GA 30322, United States of America
| | - Eun-Ju Ko
- Center for Inflammation, Immunity and Infection, Georgia State University, Atlanta, GA 30303, United States of America
| | - Soojin Park
- Center for Inflammation, Immunity and Infection, Georgia State University, Atlanta, GA 30303, United States of America
| | - Jolyn Fernandes
- Division of Pulmonary, Allergy and Critical Care Medicine, Emory University School of Medicine, Atlanta, GA 30322, United States of America
| | - Young-Tae Lee
- Center for Inflammation, Immunity and Infection, Georgia State University, Atlanta, GA 30303, United States of America
| | - Michael L Orr
- Division of Pulmonary, Allergy and Critical Care Medicine, Emory University School of Medicine, Atlanta, GA 30322, United States of America
| | - Li Hao
- Division of Pulmonary, Allergy and Critical Care Medicine, Emory University School of Medicine, Atlanta, GA 30322, United States of America
| | - M Ryan Smith
- Division of Pulmonary, Allergy and Critical Care Medicine, Emory University School of Medicine, Atlanta, GA 30322, United States of America
| | - David C Neujahr
- Division of Pulmonary, Allergy and Critical Care Medicine, Emory University School of Medicine, Atlanta, GA 30322, United States of America
| | - Karan Uppal
- Division of Pulmonary, Allergy and Critical Care Medicine, Emory University School of Medicine, Atlanta, GA 30322, United States of America
| | - Sang-Moo Kang
- Center for Inflammation, Immunity and Infection, Georgia State University, Atlanta, GA 30303, United States of America
| | - Dean P Jones
- Division of Pulmonary, Allergy and Critical Care Medicine, Emory University School of Medicine, Atlanta, GA 30322, United States of America.
| | - Young-Mi Go
- Division of Pulmonary, Allergy and Critical Care Medicine, Emory University School of Medicine, Atlanta, GA 30322, United States of America.
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Guo X, Yang Q, Zhang W, Chen Y, Ren J, Gao A. Associations of blood levels of trace elements and heavy metals with metabolic syndrome in Chinese male adults with microRNA as mediators involved. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 248:66-73. [PMID: 30771749 DOI: 10.1016/j.envpol.2019.02.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 02/01/2019] [Accepted: 02/04/2019] [Indexed: 06/09/2023]
Abstract
Metabolic syndrome (MetS) is a global health problem with an increasing prevalence. However, effects of trace elements and heavy metals on MetS and the mechanism underlying this effect are poorly understood. A preliminary cross-sectional study was conducted in 2015. Significantly higher blood concentrations of lead (Pb), cadmium (Cd), copper (Cu), and selenium (Se) were observed in the MetS group. With a priori adjustment for age, the concentration of Cu and Se in the blood was associated with a 2.56 - fold [95% confidence interval (CI), 1.11, 5.92] and 3.31 - fold (95% CI, 1.4, 7.82) increased risk of MetS, respectively. Moreover, increased blood Se concentrations were associated with body mass index (BMI) [odds ratio (OR): 2.56; 95% CI, 1.11, 5.93], high blood pressure [for both systolic and diastolic blood pressures (SBP and DBP); OR: 3.82; 95% CI, 1.47, 7.31 for SBP and OR: 2.56; 95% CI, 1.18, 5.59 for DBP], and hypertriglyceridemia (OR: 3.3; 95% CI, 1.51, 7.2). In addition, the expression of miR-21-5p, miR-122-5p, and miR-146a-5p was significantly higher in subjects with MetS than those without MetS. Increased expression of miR-21-5p was significantly associated with increased SBP (β = 5.28; 95% CI, 0.63, 9.94) and DBP (β = 4.17; 95% CI, 0.68, 7.66). Moreover, Cu was positively associated with miR-21-5p (β = 3.02; 95% CI, 0.07, 5.95), whereas Se was positively associated with miR-122-5p (β = 2.7; 95% CI, 0.64, 4.76). The bootstrapping mediation models indicated that miR-21-5p partially mediated the relationships between Cu level and SBP/DBP. This study suggested that Cu and Se were both associated with MetS, and miR-21-5p participated in the development of MetS associated with Cu.
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Affiliation(s)
- Xiaoli Guo
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Qiaoyun Yang
- Department of Occupational Health and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, 300070, PR China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin, 300070, PR China; National Demonstration Center for Experimental Preventive Medicine Education (Tianjin Medical University), Tianjin, 300070, PR China
| | - Wei Zhang
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Yujiao Chen
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Jing Ren
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Ai Gao
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China.
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Planchart A, Green A, Hoyo C, Mattingly CJ. Heavy Metal Exposure and Metabolic Syndrome: Evidence from Human and Model System Studies. Curr Environ Health Rep 2019; 5:110-124. [PMID: 29460222 DOI: 10.1007/s40572-018-0182-3] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW Metabolic syndrome (MS) describes the co-occurrence of conditions that increase one's risk for heart disease and other disorders such as diabetes and stroke. The worldwide increase in the prevalence of MS cannot be fully explained by lifestyle factors such as sedentary behavior and caloric intake alone. Environmental exposures, such as heavy metals, have been implicated, but results are conflicting and possible mechanisms remain unclear. To assess recent progress in determining a possible role between heavy metal exposure and MS, we reviewed epidemiological and model system data for cadmium (Cd), lead (Pb), and mercury (Hg) from the last decade. RECENT FINDINGS Data from 36 epidemiological studies involving 17 unique countries/regions and 13 studies leveraging model systems are included in this review. Epidemiological and model system studies support a possible association between heavy metal exposure and MS or comorbid conditions; however, results remain conflicting. Epidemiological studies were predominantly cross-sectional and collectively, they highlight a global interest in this question and reveal evidence of differential susceptibility by sex and age to heavy metal exposures. In vivo studies in rats and mice and in vitro cell-based assays provide insights into potential mechanisms of action relevant to MS including altered regulation of lipid and glucose homeostasis, adipogenesis, and oxidative stress. Heavy metal exposure may contribute to MS or comorbid conditions; however, available data are conflicting. Causal inference remains challenging as epidemiological data are largely cross-sectional; and variation in study design, including samples used for heavy metal measurements, age of subjects at which MS outcomes are measured; the scope and treatment of confounding factors; and the population demographics vary widely. Prospective studies, standardization or increased consistency across study designs and reporting, and consideration of molecular mechanisms informed by model system studies are needed to better assess potential causal links between heavy metal exposure and MS.
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Affiliation(s)
- Antonio Planchart
- Department of Biological Sciences, NC State University, Toxicology building, 850 Main Campus Dr, Raleigh, NC, 27606, USA.,Center for Human Health and the Environment, NC State University, Toxicology building, 850 Main Campus Dr, Raleigh, NC, 27606, USA
| | - Adrian Green
- Department of Biological Sciences, NC State University, Toxicology building, 850 Main Campus Dr, Raleigh, NC, 27606, USA
| | - Cathrine Hoyo
- Department of Biological Sciences, NC State University, Toxicology building, 850 Main Campus Dr, Raleigh, NC, 27606, USA.,Center for Human Health and the Environment, NC State University, Toxicology building, 850 Main Campus Dr, Raleigh, NC, 27606, USA
| | - Carolyn J Mattingly
- Department of Biological Sciences, NC State University, Toxicology building, 850 Main Campus Dr, Raleigh, NC, 27606, USA. .,Center for Human Health and the Environment, NC State University, Toxicology building, 850 Main Campus Dr, Raleigh, NC, 27606, USA.
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Noor N, Zong G, Seely EW, Weisskopf M, James-Todd T. Urinary cadmium concentrations and metabolic syndrome in U.S. adults: The National Health and Nutrition Examination Survey 2001-2014. ENVIRONMENT INTERNATIONAL 2018; 121:349-356. [PMID: 30243183 PMCID: PMC6786759 DOI: 10.1016/j.envint.2018.08.029] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 08/08/2018] [Accepted: 08/11/2018] [Indexed: 05/16/2023]
Abstract
BACKGROUND Low to moderate acute cadmium exposure has been associated with increased risk of chronic diseases, such as cardiovascular and kidney disease. Little is known about the association between urinary cadmium levels-an indicator of longer-term exposure-and metabolic syndrome (MetS). METHODS We analysed data from 3982 participants aged 20-<80 years of the National Health and Nutrition Examination Survey 2001-2014. Urinary cadmium levels were measured and adjusted for creatinine using spot urine samples. Cadmium levels were evaluated in quintiles (Q). MetS was defined by National Cholesterol Education Program's Adult Treatment Panel III report criteria. Prevalence odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariable logistic regression accounting for complex survey design, while adjusting for potential confounders and stratifying by sex and smoking status. RESULTS In the overall study population, there was a marginal inverse association between urinary cadmium and MetS (adj. OR for Q5 versus Q1: 0.7; 95% CI: 0.5-1.0). Sex stratified models were similar. When examining individual components of MetS, participants with higher levels of urinary cadmium had decreased odds of abdominal obesity (adj. OR for Q5 versus Q1 0.4; 95% CI: 0.3-0.6), but increased odds for low HDL (adj. OR for Q5 versus Q1 2.1; 95% CI: 1.4-3.1). Among current smokers, higher urinary cadmium was associated with increased odds of MetS, hypertension, and low HDL even after accounting for serum cotinine-a marker of smoking intensity. CONCLUSIONS Higher levels of urinary cadmium, a marker of long term exposure, were not associated with an increased risk of MetS in the overall study population. However, higher urine cadmium was associated with altered MetS components. Current smokers were the most vulnerable group, with higher long-term cadmium exposure being associated with increased risk of MetS, low HDL, and hypertension.
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Affiliation(s)
- Nudrat Noor
- Department of Environmental Health, Harvard School of Public Health, Boston, MA 02115, United States of America
| | - Geng Zong
- Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, United States of America
| | - Ellen W Seely
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave., 3rd Floor, Boston, MA 02115, United States of America
| | - Marc Weisskopf
- Department of Environmental Health, Harvard School of Public Health, Boston, MA 02115, United States of America; Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, United States of America
| | - Tamarra James-Todd
- Department of Environmental Health, Harvard School of Public Health, Boston, MA 02115, United States of America; Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, United States of America; Division of Women's Health, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02120, United States of America.
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26
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Wang X, Mukherjee B, Park SK. Associations of cumulative exposure to heavy metal mixtures with obesity and its comorbidities among U.S. adults in NHANES 2003-2014. ENVIRONMENT INTERNATIONAL 2018; 121:683-694. [PMID: 30316184 PMCID: PMC6268112 DOI: 10.1016/j.envint.2018.09.035] [Citation(s) in RCA: 180] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 08/27/2018] [Accepted: 09/22/2018] [Indexed: 05/18/2023]
Abstract
BACKGROUND Some heavy metals (e.g., arsenic, cadmium, lead, mercury) have been associated with obesity and obesity comorbidities. The analytical approach for those associations has typically focused on individual metals. There is a growing interest in evaluating the health effects of cumulative exposure to metal mixtures. OBJECTIVES We utilized our Environmental Risk Score (ERS), a summary measure to examine the risk of exposure to multi-pollutants in epidemiologic research, to evaluate the associations of cumulative exposure to a mixture of correlated heavy metals with obesity and its comorbidities including hypertension, and type-2 diabetes mellitus (T2DM) while accounting for high degree correlations and interactions among metal mixtures components. METHODS We examined blood and urinary markers of 18 heavy metals among 9537 adults in NHANES 2003-2014. We randomly split data into a training set for the construction of ERS (n = 6675) and a testing set for the evaluation of its statistical performance (n = 2862). ERS of heavy metal mixtures was computed for waist circumference using adaptive elastic-net (AENET) with 189 predictors including 18 main effects, 18 squared terms, and 153 pairwise interactions of heavy metals. Regression analyses with complex survey designs were performed to assess the associations of ERS with other obesity measures, hypertension and T2DM. RESULTS 7 main effects (blood lead, blood cadmium, blood mercury, and urinary markers of monomethylarsonic acid (MMA), barium, mercury and thallium), 4 squared terms (blood cadmium, urinary cadmium, urinary antimony and urinary tungsten), and 7 pairwise interactions (blood lead & urinary cadmium, blood lead & urinary MMA, blood lead & urinary uranium, urinary cadmium & urinary MMA, urinary dimethylarsinic acid (DMA) & urinary tungsten, urinary MMA & urinary cobalt, and urinary lead & urinary antimony) were selected by AENET for construction of ERS of waist circumference-related metal mixtures. An increase in ERS from 10th percentile to 90th percentile in the overall study population was significantly associated with 4.50 kg/m2 (95% CI: 4.06, 4.94) higher BMI, 4.16 mm (95% CI: 3.56, 4.76) higher skinfold thickness, and 4.11 kg (95% CI: 0.83, 7.40) higher total body fat, independent of age, sex, race/ethnicity, education, smoking status, physical activity and NHANES cycle (Ps < 0.05). Significant associations of ERS with both hypertension and T2DM were also observed (Ps < 0.05). CONCLUSIONS Our study suggests that cumulative exposure to heavy metals as mixtures is associated with obesity and its related chronic conditions such as hypertension and T2DM. Additional research is needed to confirm these findings in longitudinal settings.
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Affiliation(s)
- Xin Wang
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States of America
| | - Bhramar Mukherjee
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, United States of America
| | - Sung Kyun Park
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States of America; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States of America.
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27
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Skalnaya MG, Skalny AV, Grabeklis AR, Serebryansky EP, Demidov VA, Tinkov AA. Hair Trace Elements in Overweight and Obese Adults in Association with Metabolic Parameters. Biol Trace Elem Res 2018; 186:12-20. [PMID: 29497998 DOI: 10.1007/s12011-018-1282-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 02/21/2018] [Indexed: 11/26/2022]
Abstract
The objective of the present study was to investigate the level of toxic and essential trace elements in hair of adult overweight and obese persons as well as its association with metabolic parameters. Hair trace element levels were assessed using inductively coupled plasma mass-spectrometry in 112 overweight and obese patients and 106 lean controls. Serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), glucose, uric acid (UA) levels, and cholinesterase (CE) and gamma-glutamyltransferase (GGT) activity were also assessed. Excessive body weight significantly affected hair trace element levels. In particular, hair Co (33%), Cu (13%), I (30%), Mg (2-fold), Mn (25%), Zn (17%), and Ni (21%) levels were lower, whereas Al (14%) and As levels were higher in comparison to those in the control group. Correlation analysis demonstrated the most significant correlations for hair Mg with body weight, BMI, systolic and diastolic blood pressure, and UA, and for hair Al with body weight, BMI, TC, glucose, TG, CE, GGT, and UA. Multiple regression analysis demonstrated that trace elements were not associated with TC and LDL-C levels neither in crude nor in adjusted models. In turn, crude and adjusted models accounted for 25 and 43% of serum TG variance. The most significant associations were observed for hair Al, Fe, Si, and V in adjusted model. The obtained data demonstrate that obesity-related metabolic disorders may be at least partially mediated by altered trace element and mineral levels.
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Affiliation(s)
- Margarita G Skalnaya
- Peoples' Friendship University of Russia (RUDN University), Miklukho-Maklay St., 10/2, Moscow, 117198, Russia
| | - Anatoly V Skalny
- Peoples' Friendship University of Russia (RUDN University), Miklukho-Maklay St., 10/2, Moscow, 117198, Russia
- Yaroslavl State University, Sovetskaya St., 14, Yaroslavl, 150000, Russia
- Institute of Bioelementology, Orenburg State University, Pobedy Ave., 13, Orenburg, 460018, Russia
| | - Andrey R Grabeklis
- Peoples' Friendship University of Russia (RUDN University), Miklukho-Maklay St., 10/2, Moscow, 117198, Russia
- Yaroslavl State University, Sovetskaya St., 14, Yaroslavl, 150000, Russia
| | - Eugeny P Serebryansky
- Russian Society for Trace Elements in Medicine, Zemlyanoi Val, 46, Moscow, 105064, Russia
| | - Vasily A Demidov
- Russian Society for Trace Elements in Medicine, Zemlyanoi Val, 46, Moscow, 105064, Russia
| | - Alexey A Tinkov
- Peoples' Friendship University of Russia (RUDN University), Miklukho-Maklay St., 10/2, Moscow, 117198, Russia.
- Yaroslavl State University, Sovetskaya St., 14, Yaroslavl, 150000, Russia.
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28
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Sung JH, Oh I, Kim A, Lee J, Sim CS, Yoo C, Park SJ, Kim GB, Kim Y. Environmental and Body Concentrations of Heavy Metals at Sites Near and Distant from Industrial Complexes in Ulsan, Korea. J Korean Med Sci 2018; 33:e33. [PMID: 29349943 PMCID: PMC5773847 DOI: 10.3346/jkms.2018.33.e33] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 10/28/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Industrial pollution may affect the heavy metal body burden of people living near industrial complexes. We determined the average concentrations of atmospheric heavy metals in areas close to and distant from industrial complexes in Korea, and the body concentrations of these heavy metals in residents living near and distant from these facilities. METHODS The atmospheric data of heavy metals (lead and cadmium) were from the Regional Air Monitoring Network in Ulsan. We recruited 1,148 participants, 872 who lived near an industrial complex ("exposed" group) and 276 who lived distant from industrial complexes ("non-exposed" group), and measured their concentrations of blood lead, urinary cadmium, and urinary total mercury. RESULTS The results showed that atmospheric and human concentrations of heavy metals were higher in areas near industrial complexes. In addition, residents living near industrial complexes had higher individual and combined concentrations (cadmium + lead + mercury) of heavy metals. CONCLUSION We conclude that residents living near industrial complexes are exposed to high concentrations of heavy metals, and should be carefully monitored.
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Affiliation(s)
- Joo Hyun Sung
- Department of Occupational and Environmental Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Inbo Oh
- Environmental Health Center, University of Ulsan College of Medicine, Ulsan, Korea
| | - Ahra Kim
- Environmental Health Center, University of Ulsan College of Medicine, Ulsan, Korea
| | - Jiho Lee
- Environmental Health Center, University of Ulsan College of Medicine, Ulsan, Korea
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Chang Sun Sim
- Environmental Health Center, University of Ulsan College of Medicine, Ulsan, Korea
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Cheolin Yoo
- Environmental Health Center, University of Ulsan College of Medicine, Ulsan, Korea
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Sang Jin Park
- Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Geun Bae Kim
- Environmental Health Research Division, National Institute of Environmental Research, Incheon, Korea
| | - Yangho Kim
- Environmental Health Center, University of Ulsan College of Medicine, Ulsan, Korea
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
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Jeong KS, Ha E, Shin JY, Park H, Hong YC, Ha M, Kim S, Lee SJ, Lee KY, Kim JH, Kim Y. Blood heavy metal concentrations in pregnant Korean women and their children up to age 5years: Mothers' and Children's Environmental Health (MOCEH) birth cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 605-606:784-791. [PMID: 28679122 DOI: 10.1016/j.scitotenv.2017.06.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 05/26/2017] [Accepted: 06/02/2017] [Indexed: 06/07/2023]
Abstract
The present study assessed the associations of heavy metal concentrations in pregnant women with the concentrations in their children during early childhood. This study is a part of the Mothers' and Children's Environmental Health (MOCEH) study, a Korean multi-center prospective birth cohort study of 1751 pregnant women who were recruited from 2006 to 2010. We completed the follow-up of children who were 5years-old in 2016. Lead, total mercury, and cadmium were measured in women during early and late pregnancy, in cord blood, and in children who were 2, 3, and 5years-old. Lead concentration was lowest in cord blood, highest in 24month-old children, and then decreased with child age. Total mercury concentration was highest in cord blood, and gradually decreased with child age. Cadmium concentration was lowest in cord blood, and increased with child age. After adjusting for child sex, maternal age, and maternal education level, we found strong correlations between the levels of lead and total mercury in women during late pregnancy with the levels in cord blood; however, there were weak correlations between the levels of these metals in women during late pregnancy and cord blood with the levels in their children. In conclusion, maternal lead and mercury concentrations correlated with the levels in cord blood and in children up to age 60months. This correlation may be due to high trans-placental transmission of these metals and shared living environment such as environmental exposure, food consumption, and lifestyle.
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Affiliation(s)
- Kyoung Sook Jeong
- Department of Occupational and Environmental Medicine, Dongguk University College of Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Eunhee Ha
- Department of Occupational and Environmental Medicine, Ewha Medical Research Center, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Ji Young Shin
- Department of Occupational and Environmental Medicine, Ewha Medical Research Center, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Medical Research Center, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Yun-Chul Hong
- Institute of Environmental Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Mina Ha
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Suejin Kim
- Environmental Health Research Division, National Institute of Environmental Research, Incheon, Republic of Korea
| | - Soo-Jeong Lee
- Department of Obstetrics and Gynecology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Kyung Yeon Lee
- Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Ja Hyeong Kim
- Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
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An HC, Sung JH, Lee J, Sim CS, Kim SH, Kim Y. The association between cadmium and lead exposure and blood pressure among workers of a smelting industry: a cross-sectional study. Ann Occup Environ Med 2017; 29:47. [PMID: 29034097 PMCID: PMC5628470 DOI: 10.1186/s40557-017-0202-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 09/21/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Lead and cadmium are harmful heavy metals that are used for a variety of occupational purposes. Considering their potentially hazardous effects on health, studies on the association between exposure to these two heavy metals and health disorders have been actively conducted. This study aimed to determine the association between blood lead and cadmium levels and blood pressure in workers exposed to lead and cadmium in a smelter. METHODS Nine hundred and sixty-three male workers who worked in a smelter, and underwent medical examinations at the Ulsan University Hospital between January 1 and December 31, 2014, were selected as participants. Among them, 310 subjects whose data on height, weight, blood pressure, fasting blood glucose, lipid profile, and blood lead and cadmium levels were available and who answered the questionnaire were selected as the final participants. We investigated the drinking habit, smoking status, exercise adequacy, and family history of hypertension of these workers using formal questionnaires. A statistical analysis was conducted using Student's t-test, analysis of variance, and linear or logistic regression. RESULTS The association between blood lead and cadmium levels and blood pressure was analyzed through statistical adjustment of the risk factors of hypertension. Results showed an association between blood cadmium level and blood pressure elevation. However, blood lead level was found to be not correlated with blood pressure elevation. CONCLUSIONS This study shows the association between blood cadmium level and systolic blood pressure (SBP) and diastolic blood pressure (DBP) elevation. TRIAL REGISTRATION IRB No. 2017-03-037. Retrospectively Registered 30 March 2017.
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Affiliation(s)
- Hyun Chan An
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033 Republic of Korea
| | - Joo Hyun Sung
- Department of Occupational and Environmental Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Ulsan, Republic of Korea
| | - Jiho Lee
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033 Republic of Korea
| | - Chang Sun Sim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033 Republic of Korea
| | - Sang Hoon Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033 Republic of Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033 Republic of Korea
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Kim NS, Ahn J, Lee BK, Park J, Kim Y. Environmental exposures to lead, mercury, and cadmium among South Korean teenagers (KNHANES 2010-2013): Body burden and risk factors. ENVIRONMENTAL RESEARCH 2017; 156:468-476. [PMID: 28415041 DOI: 10.1016/j.envres.2017.04.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 02/22/2017] [Accepted: 04/07/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Limited information is available on the association of age and sex with blood concentrations of heavy metals in teenagers. In addition, factors such as a shared family environment may have an association. We analyzed data from the Korean National Health and Nutrition Examination Survey (KNHANES, 2010-2013) to determine whether blood levels of heavy metals differ by risk factors such as age, sex, and shared family environment in a representative sample of teenagers. METHODS This study used data obtained in the KNHANES 2010-2013, which had a rolling sampling design that involved a complex, stratified, multistage, probability-cluster survey of a representative sample of the non-institutionalized civilian population in South Korea. Our cross-sectional analysis was restricted to teenagers and their parents who completed the health examination survey, and for whom blood measurements of cadmium, lead, and mercury were available. The final analytical sample consisted of 1585 teenagers, and 376 fathers and 399 mothers who provided measurements of blood heavy metal concentrations. RESULTS Male teenagers had greater blood levels of lead and mercury, but sex had no association with blood cadmium level. There were age-related increases in blood cadmium, but blood lead decreased with age, and age had little association with blood mercury. The concentrations of cadmium and mercury declined from 2010 to 2013. The blood concentrations of lead, cadmium, and mercury in teenagers were positively associated with the levels in their parents after adjustment for covariates. CONCLUSION Our results show that blood heavy metal concentrations differ by risk factors such as age, sex, and shared family environment in teenagers.
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Affiliation(s)
- Nam-Soo Kim
- Institute of Occupational and Environmental Medicine, Soonchunhyang University, Asan, South Korea
| | - Jaeouk Ahn
- Department of Medical IT Engineering, Soonchunhyang University, Asan, South Korea
| | - Byung-Kook Lee
- Department of Preventive Medicine, Soonchunhyang University, Asan, South Korea
| | - Jungsun Park
- Department of Occupational Health, Catholic University of Daegu, Gyeongsan, South Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.
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Roy C, Tremblay PY, Ayotte P. Is mercury exposure causing diabetes, metabolic syndrome and insulin resistance? A systematic review of the literature. ENVIRONMENTAL RESEARCH 2017; 156:747-760. [PMID: 28482296 DOI: 10.1016/j.envres.2017.04.038] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 04/25/2017] [Accepted: 04/28/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Several populations are exposed to mercury (Hg) via their environment, occupation or diet. It is hypothesized that Hg exposure can lead to the development of diabetes mellitus (DM). Metabolic syndrome (MS) is also a possible outcome as its symptoms are closely linked to those of DM. METHOD We conducted a systematic review of the literature by screening Web of Science, MEDLINE, SciFinder and Embase and we included original studies pertaining to the relationship of total Hg exposure (elemental, inorganic or organic) to DM, MS or insulin resistance. The studies were selected based on the PICOS (patients, intervention, comparator, outcomes and study design) criteria and their quality assessed using a nine-point scale. Study characteristics and results were extracted and presented in structured tables. We also extracted covariates entered as confounding factors to evaluate possible biases in selected studies. Finally, a weight of evidence approach was used to assess the causality of the relationship. RESULTS A total of 34 studies were included in the present review. Epidemiological data assessment suggests a possible association between total Hg concentrations in different biological matrices and incidence of DM or MS, but the relationship is not consistent. In vivo and in vitro studies support the biological plausibility of the relation between Hg exposure and DM or MS. Five out of nine of Bradford Hill's criteria were fulfilled: strength, temporality, plausibility, coherence and analogy. CONCLUSION Increased total Hg exposure may augment the risk of DM and MS, but the lack of consistency of the epidemiological evidence prevents inference of a causal relationship. Additional prospective cohort studies and careful consideration of confounding variables and interactions are required to conclude on the causal relationship of total Hg exposure on the development of DM or MS.
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Affiliation(s)
- Cynthia Roy
- Centre de Toxicologie du Québec, Institut national de santé publique du Québec (INSPQ), 945 Wolfe, Québec, QC, Canada G1V 5B3; Axe santé publique et pratiques optimales en santé, Centre de recherche du CHU de Québec, 2875 boul. Laurier, Édifice Delta 2, Bureau 600, Québec, QC, Canada G1V 2M2.
| | - Pierre-Yves Tremblay
- Centre de Toxicologie du Québec, Institut national de santé publique du Québec (INSPQ), 945 Wolfe, Québec, QC, Canada G1V 5B3; Axe santé publique et pratiques optimales en santé, Centre de recherche du CHU de Québec, 2875 boul. Laurier, Édifice Delta 2, Bureau 600, Québec, QC, Canada G1V 2M2
| | - Pierre Ayotte
- Centre de Toxicologie du Québec, Institut national de santé publique du Québec (INSPQ), 945 Wolfe, Québec, QC, Canada G1V 5B3; Axe santé publique et pratiques optimales en santé, Centre de recherche du CHU de Québec, 2875 boul. Laurier, Édifice Delta 2, Bureau 600, Québec, QC, Canada G1V 2M2; Département de médecine préventive et sociale, Université Laval, Pavillon Ferdinand-Vandry, Québec, QC, Canada G1V 0A6
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Sun H, Wang N, Chen C, Nie X, Han B, Li Q, Zhu C, Chen Y, Xia F, Chen Y, Zhai H, Jiang B, Hu B, Lu Y. Cadmium exposure and its association with serum uric acid and hyperuricemia. Sci Rep 2017; 7:550. [PMID: 28373703 PMCID: PMC5428845 DOI: 10.1038/s41598-017-00661-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 03/07/2017] [Indexed: 12/12/2022] Open
Abstract
Few studies have investigated the association between serum uric acid (UA) and cadmium exposure. Our previous study revealed a significantly higher blood cadmium (CdB) level in the Chinese population compared to populations in other countries. To determine whether CdB in Chinese adults is associated with serum UA and hyperuricemia, 2996 participants from the cross-sectional SPECT-China study were recruited. CdB was measured by atomic absorption spectrometry. Hyperuricemia was defined as a serum UA concentration ≥416.4 μmol/L for men and ≥356.9 μmol/L for women. Regression analyses were used to analyze the association of CdB with serum UA and hyperuricemia. We found that the median CdB level was higher in men with hyperuricemia (2.40 μg/L) than in men without hyperuricemia (1.98 μg/L, P < 0.05). A positive relationship between serum UA and CdB was found in Chinese men after adjusting for the estimated glomerular filtration rate (eGFR), current smoking status, diabetes, dyslipidemia, hypertension and body mass index and in participants with eGFR > 60 mL/min per 1.73 m2. Further, the odds ratio of hyperuricemia increased with increasing CdB quartiles (P for trend < 0.05) in men. In conclusion, CdB was positively related to the serum UA level and to hyperuricemia in Chinese men but not in Chinese women.
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Affiliation(s)
- Honglin Sun
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Chi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Xiaomin Nie
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Bing Han
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Qin Li
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Chunfang Zhu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Fangzhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yingchao Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Hualing Zhai
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Boren Jiang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Bin Hu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
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Nie X, Wang N, Chen Y, Chen C, Han B, Zhu C, Chen Y, Xia F, Cang Z, Lu M, Meng Y, Jiang B, D Jensen M, Lu Y. Blood cadmium in Chinese adults and its relationships with diabetes and obesity. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:18714-23. [PMID: 27312901 DOI: 10.1007/s11356-016-7078-2] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 06/13/2016] [Indexed: 05/18/2023]
Abstract
The aim of this study is to evaluate blood cadmium levels (BCLs) in Chinese adults and explore whether blood cadmium is associated with diabetes or obesity. This study included 5544 adults from a cross-sectional SPECT-China study. BCL and blood lead level (BLL) was measured by atomic absorption spectrometry. Fasting plasma glucose (FPG) was used to define prediabetes and diabetes. Overweight and obesity were defined by body mass index (BMI). The associations of BCL with prediabetes, diabetes, overweight, and obesity were analyzed by multinomial logistic regression analyses. Medians (interquartile range) of BCL were 1.97 μg/L (0.60-3.82) in men and 1.59 μg/L (0.54-3.51) in women. Subjects in low-economic-status areas and urban areas had significantly higher BCL. BCL in current smokers was significantly higher than in current non-smokers. In the adjusted model, a mild positive relationship between BCL and FPG was found. Meanwhile, the prevalence of prediabetes was increased according to the increase in BCL tertiles. Surprisingly, BCL had a negative relationship with prevalence of overweight. In conclusion, BCL in Chinese adults was much higher than in other developed countries and was influenced by gender, smoking, and residential area. BCL was positively related to prediabetes while negatively related to overweight.
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Affiliation(s)
- Xiaomin Nie
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Chi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Bing Han
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Chunfang Zhu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yingchao Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Fangzhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Zhen Cang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Meng Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Ying Meng
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Boren Jiang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
| | - Michael D Jensen
- Endocrine Research Unit, Mayo Clinic, 5-194 Joseph, Rochester, MN55905, USA.
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
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Chandler JD, Wongtrakool C, Banton SA, Li S, Orr ML, Barr DB, Neujahr DC, Sutliff RL, Go YM, Jones DP. Low-dose oral cadmium increases airway reactivity and lung neuronal gene expression in mice. Physiol Rep 2016; 4:e12821. [PMID: 27401458 PMCID: PMC4945833 DOI: 10.14814/phy2.12821] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 05/15/2016] [Indexed: 01/05/2023] Open
Abstract
Inhalation of cadmium (Cd) is associated with lung diseases, but less is known concerning pulmonary effects of Cd found in the diet. Cd has a decades-long half-life in humans and significant bioaccumulation occurs with chronic dietary intake. We exposed mice to low-dose CdCl2 (10 mg/L in drinking water) for 20 weeks, which increased lung Cd to a level similar to that of nonoccupationally exposed adult humans. Cd-treated mice had increased airway hyperresponsiveness to methacholine challenge, and gene expression array showed that Cd altered the abundance of 443 mRNA transcripts in mouse lung. In contrast to higher doses, low-dose Cd did not elicit increased metallothionein transcripts in lung. To identify pathways most affected by Cd, gene set enrichment of transcripts was analyzed. Results showed that major inducible targets of low-dose Cd were neuronal receptors represented by enriched olfactory, glutamatergic, cholinergic, and serotonergic gene sets. Olfactory receptors regulate chemosensory function and airway hypersensitivity, and these gene sets were the most enriched. Targeted metabolomics analysis showed that Cd treatment also increased metabolites in pathways of glutamatergic (glutamate), serotonergic (tryptophan), cholinergic (choline), and catecholaminergic (tyrosine) receptors in the lung tissue. Protein abundance measurements showed that the glutamate receptor GRIN2A was increased in mouse lung tissue. Together, these results show that in mice, oral low-dose Cd increased lung Cd to levels comparable to humans, increased airway hyperresponsiveness and disrupted neuronal pathways regulating bronchial tone. Therefore, dietary Cd may promote or worsen airway hyperresponsiveness in multiple lung diseases including asthma.
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Affiliation(s)
- Joshua D Chandler
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Emory University, Atlanta, Georgia
| | - Cherry Wongtrakool
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Emory University, Atlanta, Georgia Atlanta VA Medical Center, Decatur, Georgia
| | - Sophia A Banton
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Emory University, Atlanta, Georgia
| | - Shuzhao Li
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Emory University, Atlanta, Georgia
| | - Michael L Orr
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Emory University, Atlanta, Georgia
| | - Dana Boyd Barr
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - David C Neujahr
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Emory University, Atlanta, Georgia
| | - Roy L Sutliff
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Emory University, Atlanta, Georgia Atlanta VA Medical Center, Decatur, Georgia
| | - Young-Mi Go
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Emory University, Atlanta, Georgia
| | - Dean P Jones
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Emory University, Atlanta, Georgia
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