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Liang D, Liu C, Yang M. The association between the urinary chromium and blood pressure: a population-based study. BMC Cardiovasc Disord 2024; 24:248. [PMID: 38730326 PMCID: PMC11088134 DOI: 10.1186/s12872-024-03918-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 05/02/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND AND AIM The impact of trace elements and heavy metals on human health has attracted widespread attention. However, the correlation between urinary chromium concentrations and blood pressure remains unclear and inadequately reported, and the aim of this study was to investigate the relationship between urinary chromium concentrations and blood pressure in adults in the United States (US). METHODS We utilized data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018 for this study. Multivariate logistic regression and multivariate linear regression were used to explore the association of urinary chromium concentrations with hypertension and blood pressure. Additionally, we also performed subgroup analysis and restricted cubic splines (RCS). RESULTS A total of 2958 participants were enrolled in this study. The overall mean systolic blood pressure and diastolic blood pressure were 123.98 ± 0.60, 72.66 ± 0.57 mmHg, respectively. The prevalence of hypertension was found in 41.31% of the whole participants. In the fully adjusted model, we did not observe a correlation between urinary chromium concentrations and the risk of hypertension and systolic blood pressure. However, we found a negative association between urinary chromium concentrations and diastolic blood pressure. In subgroup analysis, we observed a positive association between urinary chromium and the risk of hypertension among participants older than 60 years of age and those who were Non-Hispanic Black. The interaction term highlighted the influence of age and race on this positive association. We also found a negative association of urinary chromium with diastolic blood pressure in male, participants who were current smokers, overweight, and other races, as well as those without alcohol use and anti-hypertensive drug use. However, the interaction term only revealed the influence of alcohol consumption on the negative association. CONCLUSION Our study suggested that urinary chromium concentrations may show a negative association with diastolic blood pressure and this association was significantly dependent on alcohol consumption. Besides, a positive association between urinary chromium and the risk of hypertension was also found among participants older than 60 years of age and those who were Non-Hispanic Black.
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Affiliation(s)
- Dan Liang
- Department of Endocrine, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Chang Liu
- School of Medicine, Nankai University, Tianjin, China
| | - Mei Yang
- Department of Endocrine, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China.
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Skalny AV, Korobeinikova TV, Zabroda NN, Chang JS, Chao JCJ, Aschner M, Paoliello MMB, Burtseva TI, Tinkov AA. Interactive Effects of Obesity and Hypertension on Patterns of Hair Essential Trace Element and Mineral Content in Adult Women. Biol Trace Elem Res 2023; 201:4677-4687. [PMID: 36648598 DOI: 10.1007/s12011-023-03561-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 01/06/2023] [Indexed: 01/18/2023]
Abstract
The objective of the present study was to evaluate potential similar patterns and interactive effects of obesity and hypertension on hair essential trace element and mineral content in adult women. In this cross-sectional study, a total of 607 adult women divided into controls (n = 101), groups with obesity without hypertension (n = 199), hypertension without obesity (n = 143), and both obesity and hypertension (n = 164) were included in the study. Assessment of hair mineral and trace element levels was performed by inductively-coupled plasma mass-spectrometry. Hair Ca, Mg, Co, and Mn levels in women with obesity, hypertension, and both diseases were significantly lower, compared to controls. Hair Mg levels in women with obesity and hypertension were significantly lower, whereas hair Na and K were found to be higher when compared to other groups. Hair Fe and V content in obese patients was lower than in other groups. Obesity was associated with lower hair Cu levels, whereas patients with hypertension had higher hair Cu content. Hypertension was also associated with higher hair Cr and Se content irrespective of body weight. Hair Zn levels in obese women with and without hypertension were significantly lower than those in healthy controls and normal-weight women with hypertension. In multiple regression models hair Mg was considered as a significant negative predictor of both systolic and diastolic blood pressure values. The observed alterations in hair trace element and mineral content provide an additional link between obesity and hypertension, although further detailed studies are required.
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Affiliation(s)
- Anatoly V Skalny
- Center for Bioelementology and Human Ecology, IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119435, Russia
- Yaroslavl State University, Yaroslavl, 150003, Russia
| | - Tatiana V Korobeinikova
- Center for Bioelementology and Human Ecology, IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119435, Russia
| | - Nadezhda N Zabroda
- Center for Bioelementology and Human Ecology, IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119435, Russia
| | - Jung-Su Chang
- Taipei Medical University, Taipei, 11031, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, 11031, Taiwan
| | - Jane C-J Chao
- Taipei Medical University, Taipei, 11031, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, 11031, Taiwan
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Monica M B Paoliello
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | | | - Alexey A Tinkov
- Center for Bioelementology and Human Ecology, IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119435, Russia.
- Yaroslavl State University, Yaroslavl, 150003, Russia.
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El‐Kersh K, Hopkins CD, Wu X, Rai SN, Cave MC, Smith MR, Go Y, Jones DP, Cai L, Huang J. Metallomics in pulmonary arterial hypertension patients. Pulm Circ 2023; 13:e12202. [PMID: 36824690 PMCID: PMC9941844 DOI: 10.1002/pul2.12202] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/18/2022] [Accepted: 02/06/2023] [Indexed: 02/13/2023] Open
Abstract
Pulmonary arterial hypertension (PAH) prevalence is increasing worldwide, and the prognosis is poor with 5-year survival < 50% in high risk patients. The relationship between metal exposure/essential metal dyshomeostasis and PAH/right ventricular dysfunction is less investigated. The aim of this study is to investigate vegetable consumptions and metal levels between PAH patients and controls. This was a prospective, single center pilot study. Questionnaires were completed by all study subjects (20 PAH patients and 10 healthy controls) on smoking, metal exposure risks, metal supplements, and vegetable consumptions. Blood and urine samples were collected to measure 25 metal levels in blood, plasma, and urine using an X Series II quadrupole inductively coupled plasma mass spectrometry. Statistical analysis was conducted using SAS 9.5 and results with p value < 0.05 were considered significant. Vegetables consumptions (broccoli risk ratio [RR] = 0.4, CI = (0.2, 0.9)], cabbage [RR = 0.2, CI = (0.1, 0.8)], and brussel sprouts [RR = 0.2, CI = (0.1, 0.5)]) are associated with less risks of PAH. In the plasma samples, silver (p < 0.001), and copper (p = 0.002) levels were significantly higher in PAH patients. There was significant positive correlation between cardiac output and cardiac index with plasma levels of silver (r = 0.665, p = 0.001 and r = 0.678 p = 0.001), respectively. There was significant correlation between mixed venous saturation, 6-min walk distance, and last BNP with plasma levels of chromium (r = -0.520, p = 0.022; r = -0.55, p = 0.014; r = 0.463, p = 0.039), respectively. In conclusion, there are significant differences between PAH and control groups in terms of vegetable consumptions and metal concentrations. Silver and chromium levels are correlated with clinical indicators of PAH severities.
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Affiliation(s)
- Karim El‐Kersh
- Division of Pulmonary Critical Care and Sleep Medicine, Department of Internal MedicineUniversity of Nebraska Medical CenterOmahaNebraskaUSA
| | - C. Danielle Hopkins
- Department of Anesthesiology and Perioperative MedicineUniversity of Louisville School of MedicineLouisvilleKentuckyUSA
| | - Xiaoyong Wu
- Department of Environmental HealthUniversity of CincinnatiCincinnatiOhioUSA
| | - Shesh N. Rai
- Department of Environmental HealthUniversity of CincinnatiCincinnatiOhioUSA
| | - Matthew C. Cave
- Division of Gastroenterology, Hepatology, and Nutrition, Department of MedicineUniversity of Louisville School of MedicineLouisvilleKentuckyUSA
- The Center for Integrative Environmental Health SciencesUniversity of LouisvilleLouisvilleKentuckyUSA
- Department of Pharmacology and ToxicologyUniversity of Louisville School of MedicineLouisvilleKentucky
- Department of Biochemistry and Molecular GeneticsUniversity of Louisville School of MedicineLouisvilleKentuckyUSA
- The Transplant Program at UofL Health — Jewish Hospital Trager Transplant CenterLouisvilleKentuckyUSA
| | - M. Ryan Smith
- Division of Pulmonary, Allergy and Critical Care MedicineEmory UniversityAtlantaGeorgiaUSA
| | - Young‐Mi Go
- Division of Pulmonary, Allergy and Critical Care MedicineEmory UniversityAtlantaGeorgiaUSA
| | - Dean P. Jones
- Division of Pulmonary, Allergy and Critical Care MedicineEmory UniversityAtlantaGeorgiaUSA
| | - Lu Cai
- The Center for Integrative Environmental Health SciencesUniversity of LouisvilleLouisvilleKentuckyUSA
- Department of Pharmacology and ToxicologyUniversity of Louisville School of MedicineLouisvilleKentucky
- Department of Pediatrics, Pediatric Research InstituteUniversity of Louisville School of MedicineLouisvilleKentuckyUSA
- Department of Radiation OncologyUniversity of Louisville School of MedicineLouisvilleKentuckyUSA
| | - Jiapeng Huang
- Department of Anesthesiology and Perioperative MedicineUniversity of Louisville School of MedicineLouisvilleKentuckyUSA
- The Center for Integrative Environmental Health SciencesUniversity of LouisvilleLouisvilleKentuckyUSA
- Department of Pharmacology and ToxicologyUniversity of Louisville School of MedicineLouisvilleKentucky
- The Transplant Program at UofL Health — Jewish Hospital Trager Transplant CenterLouisvilleKentuckyUSA
- Department of Cardiovascular and Thoracic Surgery, Cardiovascular Innovation InstituteUniversity of Louisville School of MedicineLouisvilleKentuckyUSA
- Division of Infectious Diseases, Department of Medicine, Center of Excellence for Research in infectious DiseasesUniversity of LouisvilleLouisvilleKentuckyUSA
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Liu Y, Yu L, Zhu M, Lin W, Liu Y, Li M, Zhang Y, Ji H, Wang J. Associations of exposure to multiple metals with blood pressure and hypertension: A cross-sectional study in Chinese preschool children. CHEMOSPHERE 2022; 307:135985. [PMID: 35964715 DOI: 10.1016/j.chemosphere.2022.135985] [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: 03/16/2022] [Revised: 08/01/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
Exposure to metals might be a risk factor for hypertension, which contributes largely to the global burden of disease and mortality. However, relevant epidemiological studies of associations between metals exposure with hypertension among preschoolers are limited. This study aimed to explore the associations of urine metals with blood pressure and hypertension among Chinese preschoolers. A total of 1220 eligible participants who had urine metals measurement, blood pressure measurements, and relevant covariates were included in this cross-sectional study. Urine concentrations of metals were measured by inductively coupled plasma mass spectrometer. The single and multiple metals regression models were used to investigate the associations of urine metal with blood pressure and the risk of hypertension after adjusting for potential confounders. We observed urine concentrations of chromium, iron, and barium were negatively associated with levels of systolic blood pressure, diastolic blood pressure and the risk of hypertension in the single metal model (all P-FDR adjustment <0.05). Significant associations of urine chromium concentrations with systolic blood pressure, diastolic blood pressure and the risk of hypertension were found in the multi-metal model (β or OR (95% confidence interval) was -3.07 (-5.12, -1.02), -2.25 (-4.29, -0.22), and 0.51 (0.26, 0.97) for 3rd quartile, compared with 1st quartile, respectively). The same association was found for barium concentrations in the multi-metal model, while none of the associations among iron quartiles was significant. In addition, urine chromium, iron and barium may have joint effects on systolic blood pressure, diastolic blood pressure and hypertension. Children's age and body mass index could modify the associations of chromium, iron, and barium concentrations with blood pressure. Our findings suggested that exposure to chromium, iron, and barium was inversely associated with blood pressure and hypertension among preschool children. These findings need further validation in prospective studies.
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Affiliation(s)
- Yanli Liu
- Department of Preventive Medicine, School of Public Health and Management, Hubei University of Medicine, Shiyan, Hubei, China; Department of Endocrinology, Renmin Hospital, Hubei University of Medicine, Shiyan, 44200, China
| | - Lili Yu
- Dianjiang Traditional Chinese Medical Hospital, Chongqing, China; Center for Environment and Health in Water Source Area of South-to-North Water Diversion, Hubei University of Medicine, 30 Renmin South Road, Shiyan, 442000, Hubei, China
| | - Meiqin Zhu
- Center for Environment and Health in Water Source Area of South-to-North Water Diversion, Hubei University of Medicine, 30 Renmin South Road, Shiyan, 442000, Hubei, China
| | - Wei Lin
- Center for Environment and Health in Water Source Area of South-to-North Water Diversion, Hubei University of Medicine, 30 Renmin South Road, Shiyan, 442000, Hubei, China
| | - Yang Liu
- Center for Environment and Health in Water Source Area of South-to-North Water Diversion, Hubei University of Medicine, 30 Renmin South Road, Shiyan, 442000, Hubei, China
| | - Mingzhu Li
- Center for Environment and Health in Water Source Area of South-to-North Water Diversion, Hubei University of Medicine, 30 Renmin South Road, Shiyan, 442000, Hubei, China
| | - Yao Zhang
- Department of Preventive Medicine, School of Public Health and Management, Hubei University of Medicine, Shiyan, Hubei, China; Center for Environment and Health in Water Source Area of South-to-North Water Diversion, Hubei University of Medicine, 30 Renmin South Road, Shiyan, 442000, Hubei, China
| | - Hongxian Ji
- Department of Child Health, Shiyan Maternal and Child Health Hospital, Shiyan, 44200, China
| | - Jing Wang
- Department of Endocrinology, Renmin Hospital, Hubei University of Medicine, Shiyan, 44200, China; Center for Environment and Health in Water Source Area of South-to-North Water Diversion, Hubei University of Medicine, 30 Renmin South Road, Shiyan, 442000, Hubei, China.
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Berger MM, Shenkin A, Schweinlin A, Amrein K, Augsburger M, Biesalski HK, Bischoff SC, Casaer MP, Gundogan K, Lepp HL, de Man AME, Muscogiuri G, Pietka M, Pironi L, Rezzi S, Cuerda C. ESPEN micronutrient guideline. Clin Nutr 2022; 41:1357-1424. [PMID: 35365361 DOI: 10.1016/j.clnu.2022.02.015] [Citation(s) in RCA: 168] [Impact Index Per Article: 84.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 02/16/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Trace elements and vitamins, named together micronutrients (MNs), are essential for human metabolism. Recent research has shown the importance of MNs in common pathologies, with significant deficiencies impacting the outcome. OBJECTIVE This guideline aims to provide information for daily clinical nutrition practice regarding assessment of MN status, monitoring, and prescription. It proposes a consensus terminology, since many words are used imprecisely, resulting in confusion. This is particularly true for the words "deficiency", "repletion", "complement", and "supplement". METHODS The expert group attempted to apply the 2015 standard operating procedures (SOP) for ESPEN which focuses on disease. However, this approach could not be applied due to the multiple diseases requiring clinical nutrition resulting in one text for each MN, rather than for diseases. An extensive search of the literature was conducted in the databases Medline, PubMed, Cochrane, Google Scholar, and CINAHL. The search focused on physiological data, historical evidence (published before PubMed release in 1996), and observational and/or randomized trials. For each MN, the main functions, optimal analytical methods, impact of inflammation, potential toxicity, and provision during enteral or parenteral nutrition were addressed. The SOP wording was applied for strength of recommendations. RESULTS There was a limited number of interventional trials, preventing meta-analysis and leading to a low level of evidence. The recommendations underwent a consensus process, which resulted in a percentage of agreement (%): strong consensus required of >90% of votes. Altogether the guideline proposes sets of recommendations for 26 MNs, resulting in 170 single recommendations. Critical MNs were identified with deficiencies being present in numerous acute and chronic diseases. Monitoring and management strategies are proposed. CONCLUSION This guideline should enable addressing suboptimal and deficient status of a bundle of MNs in at-risk diseases. In particular, it offers practical advice on MN provision and monitoring during nutritional support.
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Affiliation(s)
- Mette M Berger
- Department of Adult Intensive Care, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
| | - Alan Shenkin
- Institute of Aging and Chronic Disease, University of Liverpool, Liverpool, UK.
| | - Anna Schweinlin
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany.
| | - Karin Amrein
- Medical University of Graz, Department of Internal Medicine, Division of Endocrinology and Diabetology, Austria.
| | - Marc Augsburger
- University Centre of Legal Medicine Lausanne-Geneva, Lausanne University Hospital and University of Lausanne, Geneva University Hospital and University of Geneva, Lausanne-Geneva, Switzerland.
| | | | - Stephan C Bischoff
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany.
| | - Michael P Casaer
- KU Leuven, Department of Cellular and Molecular Medicine, Laboratory of Intensive Care Medicine, Leuven, Belgium.
| | - Kursat Gundogan
- Division of Intensive Care Medicine, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey.
| | | | - Angélique M E de Man
- Department of Intensive Care Medicine, Research VUmc Intensive Care (REVIVE), Amsterdam Cardiovascular Science (ACS), Amsterdam Infection and Immunity Institute (AI&II), Amsterdam Medical Data Science (AMDS), Amsterdam UMC, Location VUmc, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università di Napoli (Federico II), Naples, Italy; United Nations Educational, Scientific and Cultural Organization (UNESCO) Chair for Health Education and Sustainable Development, Federico II, University, Naples, Italy.
| | - Magdalena Pietka
- Pharmacy Department, Stanley Dudrick's Memorial Hospital, Skawina, Poland.
| | - Loris Pironi
- Alma Mater Studiorum - University of Bologna, Department of Medical and Surgical Sciences, Italy; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Centre for Chronic Intestinal Failure - Clinical Nutrition and Metabolism Unit, Italy.
| | - Serge Rezzi
- Swiss Nutrition and Health Foundation (SNHf), Epalinges, Switzerland.
| | - Cristina Cuerda
- Departamento de Medicina, Universidad Complutense de Madrid, Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
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