The cross-sectional and longitudinal associations of chromium with dyslipidemia: A prospective cohort study of urban adults in China

Associations between individual and mixed urinary metal exposure and dyslipidemia among Chinese adults: Data from the China Multi-Ethnic Cohort Study

The prevalence of dyslipidemia is increasing, and it has become a significant global public health concern. Some studies have demonstrated contradictory relationships between urinary metals and dyslipidemia, and the combined effects of mixed urinary metal exposure on dyslipidemia remain ambiguous. In this study, we examined how individual and combined urinary metal exposure are associated with the occurrence of dyslipidemia. According to the data from the 2018-2019 baseline survey database of the China Multi-Ethnic Cohort (CMEC) Study, a population of 9348 individuals was studied. Inductively coupled plasmamass spectrometry (ICP-MS) was used to measure 21 urinary metal concentrations in the collected adult urinary samples. The associations between urinary metals and dyslipidemia were analyzed by logistic regression, weighted quantile sum regression (WQS), and quantile-based g-computation (qgcomp), controlled for potential confounders to examine single and combined effects. Dyslipidemia was detected in 3231 individuals, which represented approximately 34.6 % of the total population. According to the single-exposure model, Al and Na were inversely associated with the risk of dyslipidemia (OR = 0.95, 95 % CI: 0.93, 0.98; OR = 0.89, 95 % CI: 0.83, 0.95, respectively), whereas Zn, Ca, and P were positively associated (OR = 1.69, 95 % CI: 1.42, 2.01; OR = 1.12, 95 % CI: 1.06, 1.18; OR = 1.21, 95 % CI: 1.09, 1.34, respectively). Moreover, Zn and P were significantly positively associated even after adjusting for these metals, whereas Al and Cr were negatively associated with the risk of dyslipidemia. The results of the WQS and qgcomp analyses showed that urinary metal mixtures were positively associated with the risk of dyslipidemia (OR = 1.26, 95 % CI: 1.15, 1.38; OR = 1.09, 95 % CI: 1.01, 1.19). This positive association was primarily driven by Zn, P, and Ca. In the sensitivity analyses with collinearity diagnosis, interaction, and stratified analysis, the results remained, confirming the reliability of the study findings. In this study, the individual and combined effects of urinary Zn, P, and Ca on dyslipidemia were determined, which provided novel insights into the link between exposure to metals and dyslipidemia.

Associations of polychlorinated biphenyls exposure, lifestyle, and genetic susceptibility with dyslipidemias: Evidence from a general Chinese population

Polychlorinated biphenyls (PCBs) are endocrine-disrupting chemicals that have been associated with various adverse health conditions. Herein we explored the associations of PCBs with dyslipidemia and further assessed the modification effect of genetic susceptibility and lifestyle factors. Six serum PCBs (PCB-28, 101, 118, 138, 153, 180) were determined in 3845 participants from the Wuhan-Zhuhai cohort. Dyslipidemia, including hyper-total cholesterol (HyperTC), hyper-triglyceride (HyperTG), hyper-low density lipoprotein cholesterol (HyperLDL-C), and hypo-high density lipoprotein cholesterol (HypoHDL-C) were determined, and lipid-specific polygenic risk scores (PRS) and healthy lifestyle score were constructed. We found that all six PCB congeners were positively associated with the prevalence of dyslipidemias, and ΣPCB level was associated with HyperTC, HyperTG, and HyperLDL-C in dose-response manners. Compared with the lowest tertiles of ΣPCB, the odds ratios (95% confidence intervals) in the highest tertiles were 1.490 (1.258, 1.765) for HyperTC, 1.957 (1.623, 2.365) for HyperTG, and 1.569 (1.316, 1.873) for HyperLDL-C, respectively. Compared with those with low ΣPCB, healthy lifestyle, and low genetic risk, participants with high ΣPCB, unfavorable lifestyle, and high genetic risk had the highest odds of HyperTC, HyperTG, and HyperLDL-C. Our study provided evidence that high PCB exposure exacerbated the association of genetic risk and unhealthy lifestyle with dyslipidemia.

Metal mixture exposures and serum lipid levels in childhood: the Rhea mother-child cohort in Greece

BACKGROUND

Growing evidence suggests that cardiovascular disease develops over the lifetime, often beginning in childhood. Metal exposures have been associated with cardiovascular disease and important risk factors, including dyslipidemia, but prior studies have largely focused on adult populations and single metal exposures.

OBJECTIVE

To investigate the individual and joint impacts of multiple metal exposures on lipid levels during childhood.

METHODS

This cross-sectional study included 291 4-year-old children from the Rhea Cohort Study in Heraklion, Greece. Seven metals (manganese, cobalt, selenium, molybdenum, cadmium, mercury, and lead) were measured in whole blood using inductively coupled plasma mass spectrometry. Serum lipid levels included total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, and low-density lipoprotein (LDL) cholesterol. To determine the joint and individual impacts of child metal exposures (log2-transformed) on lipid levels, Bayesian kernel machine regression (BKMR) was employed as the primary multi-pollutant approach. Potential effect modification by child sex and childhood environmental tobacco smoke exposure was also evaluated.

RESULTS

BKMR identified a positive association between the metal mixture and both total and LDL cholesterol. Of the seven metals examined, selenium (median 90.6 [IQR = 83.6, 96.5] µg/L) was assigned the highest posterior inclusion probability for both total and LDL cholesterol. A difference in LDL cholesterol of 8.22 mg/dL (95% CI = 1.85, 14.59) was observed when blood selenium was set to its 75th versus 25th percentile, holding all other metals at their median values. In stratified analyses, the positive association between selenium and LDL cholesterol was only observed among boys or among children exposed to environmental tobacco smoke during childhood.

IMPACT STATEMENT

Growing evidence indicates that cardiovascular events in adulthood are the consequence of the lifelong atherosclerotic process that begins in childhood. Therefore, public health interventions targeting childhood cardiovascular risk factors may have a particularly profound impact on reducing the burden of cardiovascular disease. Although growing evidence supports that both essential and nonessential metals contribute to cardiovascular disease and risk factors, such as dyslipidemia, prior studies have mainly focused on single metal exposures in adult populations. To address this research gap, the current study investigated the joint impacts of multiple metal exposures on lipid concentrations in early childhood.

Human Health Effects of Oral Exposure to Chromium: A Systematic Review of the Epidemiological Evidence

The toxicity and carcinogenicity of hexavalent chromium via the inhalation route is well established. However, a scientific debate has arisen about the potential effects of oral exposure to chromium on human health. Epidemiological studies evaluating the connection between ingested chromium and adverse health effects on the general population are limited. In recent years, a wealth of biomonitoring studies has emerged evaluating the associations between chromium levels in body fluids and tissues and health outcomes. This systematic review brings together epidemiological and biomonitoring evidence published over the past decade on the health effects of the general population related to oral exposure to chromium. In total, 65 studies were reviewed. There appears to be an inverse association between prenatal chromium exposure and normal fetal development. In adults, parameters of oxidative stress and biochemical alterations increase in response to chromium exposure, while effects on normal renal function are conflicting. Risks of urothelial carcinomas cannot be overlooked. However, findings regarding internal chromium concentrations and abnormalities in various tissues and systems are, in most cases, controversial. Environmental monitoring together with large cohort studies and biomonitoring with multiple biomarkers could fill the scientific gap.

Associations of urinary zinc exposure with blood lipid profiles and dyslipidemia: Mediating effect of serum uric acid

The relationship between zinc (Zn) exposure and abnormal blood lipids including dyslipidemia is contentious. Serum uric acid (SUA) has been reported to be correlated to both Zn exposure and dyslipidemia. The underlying mechanisms of Zn exposure associated with blood lipids and the mediating effects of SUA remain unclear. Therefore, this study analyzed the data from Chinese 2110 adults (mean age: 59.0 years old) in rural areas across China to explore the associations of Zn exposure with blood lipid profiles and dyslipidemia, and to further estimate the mediating effects of SUA in these relationships. The study data showed that urinary Zn was associated with increased levels of blood lipid components triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C). Moreover, an increased risk of dyslipidemia was observed in the study participants who had higher urinary Zn levels. Compared with the first quartile, the fourth quartile of urinary Zn concentration corresponded to the increase of TG (β = 0.20, 95 % CI: 0.12, 0.28), LDL-C (β = 0.06, 95 % CI: 0.01, 0.10) and dyslipidemia risk (OR = 2.16, 95 % CI: 1.50, 3.10), respectively. Elevated urinary Zn was also associated with higher levels of SUA and hyperuricemia risk. The SUA levels were positively related to total cholesterol (TC), TG, LDL-C levels and dyslipidemia risk. Mediation analyses revealed that SUA mediated 31.75 %, 46.16 % and 19.25 % of the associations of urinary Zn with TG, LDL-C levels and dyslipidemia risk, respectively. The subgroup and sensitivity analyses confirmed the positive associations between urinary Zn and blood lipid profiles and the mediating effect of SUA. The national population-based study further enhanced our understanding of the associations between Zn exposure and blood lipid profiles and mediating effect of SUA among generally healthy, middle-aged, and elderly individuals.

Associations of mixed urinary metals exposure with metabolic syndrome in the US adult population

BACKGROUND

Metals are harmful to human health in many ways. However, the association between metals and metabolic syndrome (MetS) remains unclear. Aims of this study is to discuss the relationship between urinary metal and MetS.

METHODS

This study included 3419 adult participants from the National Health and Nutrition Examination Survey (NHANES) (2005-2018). Logistic regression analysis, Bayesian kernel machine regression (BKMR), weighted quantile sum (WQS), and restricted cubic spline (RCS) were used to explore the associations of nine urinary metal and MetS.

RESULTS

BKMR and WQS showed the effects of combined nine urinary metal were negatively correlated with MetS. Logistic regression analysis, WQS, and BKMR all suggested that cesium (Cs) and lead (Pb) were negatively correlated with MetS (all PFDCR <0.05). And RCS suggested log2-transformed Cs (χ2 = 20, P < 0.001) and log2-transformed Pb (χ2 = 19.9, P < 0.001) were negatively and linearly associated with MetS.

CONCLUSION

Existing evidence suggests that urine metal content is related to MetS. Cs and Pb are negatively related to MetS. It is still necessary to study and further discuss the causal relationship and mechanism.

Elevated serum lead and cadmium levels associated with increased risk of dyslipidemia in children aged 6 to 9 years in Shenzhen, China

Exposure to heavy metals can influence on metabolism, but studies have not fully evaluated young children. We investigated the association between levels of serum lead (Pb), cadmium (Cd), chromium (Cr), and arsenic (As) and risk of dyslipidemia in children. A total of 4513 children aged 6 to 9 years at 19 primary schools in Shenzhen were enrolled. Overall, 663 children with dyslipidemia were matched 1:1 with control by sex and age, and levels of serum Pb, Cd, Cr, and As were detected by inductively coupled plasma-mass spectrometry. Demographic characteristics and lifestyle were covariates in the logistic regression to determine the association of heavy metal levels with risk of dyslipidemia. Serum Pb and Cd levels were significantly higher in children with dyslipidemia than controls (133.08 vs. 84.19 μg/L; 0.45 vs. 0.29 μg/L; all P < 0.05), but this association was not found in Cr and As. We found significant upward trends for the odds ratios (ORs) of dyslipidemia associated with increasing quartiles of Pb and Cd levels (highest quartile of serum Pb OR 1.86, 95% confidence interval (CI) 1.46-2.38; Cd OR 2.51, 95% CI 1.94-3.24). Elevated serum Pb and Cd levels were associated with increased risk of dyslipidemia among children.

Associations of metals and metals mixture with lipid profiles: A repeated-measures study of older adults in Beijing

Metals inevitably and easily enter into human bodies and can induce a series of pathophysiological changes, such as oxidative stress damage and lipid peroxidation, which then may further induce dyslipidemia. However, the effects of metals and metals mixture on the lipid profiles are still unclear, especially in older adults. A three-visits repeated measurement of 201 older adults in Beijing was conducted from November 2016 to January 2018. Linear Mixed Effects models and Bayesian kernel machine regression models were used to estimate associations of eight blood metals and metals mixture with lipid profiles, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), Castelli risk indexes I (CRI-1), Castelli risk indexes II (CRI-2), atherogenic coefficient (AC), and non-HDL cholesterol (NHC). Cesium (Cs) was positively associated with TG (β_Cs = 0.14; 95% CI: 0.02, 0.26) whereas copper (Cu) was inversely related to TG (β_Cu = -0.65; 95%CI: -1.14, -0.17) in adjusted models. Manganese (Mn) was mainly related to higher HDL-C (β_Mn = 0.14; 95% CI: 0.07, 0.21) whereas molybdenum showed opposite association. Metals mixture was marginally positive associated with HDL-C, among which Mn played a crucial role. Our findings suggest that the effects of single metal on lipid profiles may be counteracted in mixtures in the context of multiple metal exposures; however, future studies with large sample size are still needed to focus on the detrimental effects of single metals on lipid profiles as well as to identify key components.

Independent, combine and interactive effects of heavy metal exposure on dyslipidemia biomarkers: A cross-sectional study in northeastern China

Dyslipidemia is a common disease in the older population and represents a considerable disease burden worldwide. Epidemiological and experimental studies have indicated associations between heavy metal exposure and dyslipidemia; few studies have investigated the effects of heavy metal mixture and interactions between metals on dyslipidemia. We recruited 1121 participants living in heavy metal-contaminated and control areas in northeast China from a cross-sectional survey (2017-2019). Urinary metals including chromium (Cr), cadmium (Cd), lead (Pb), and manganese (Mn) and dyslipidemia biomarkers, namely triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels, were measured. The generalized linear model (GLM) was used to explore the association of a single metal with dyslipidemia biomarkers. Bayesian kernel machine regression (BKMR) and multivariable linear regression were performed to explore the overall effect of metal mixture and the interaction between metals on dyslipidemia. Heavy metal mixture was positively associated with LDL-C, TC, and TG and negatively with HDL-C. In multivariable linear regression, Pb and Cd exhibited a synergistic association with LDL-C in the participants without hyperlipemia. Mn-Cd and Pb-Cr also showed a synergistic association with increasing the level of LDL-C in subjects without hyperlipemia. Cd-Cr showed an antagonistic association with HDL-C, respectively. Cr-Mn exhibited an antagonistic association with decreased HDL-C and TG levels. No significant interaction was noted among the three metals. Our study indicated that exposure to heavy metals is associated with dyslipidemia biomarkers and the presence of potential synergistic or antagonistic interactions between the heavy metals.

Associations of bifenthrin exposure with glucose homeostasis and type 2 diabetes mellitus in a general Chinese population: Roles of protein carbonylation

The adverse health effects of pyrethroids exposure have attracted wide concern. We aimed to assess the associations of bifenthrin, a widely used pyrethroid, with glucose homeostasis and risk of type 2 diabetes mellitus (T2DM) and to explore the underlying mechanism. Serum bifenthrin, fasting plasma glucose (FPG), fasting plasma insulin (FPI), and plasma protein carbonyl (PCO) were determined among 3822 participants from the Wuhan-Zhuhai cohort. Glucose homeostasis was evaluated by FPG, FPI, homeostasis model assessment of insulin resistance (HOMA-IR), impaired fasting glucose (IFG), and abnormal glucose regulation (AGR). The associations of serum bifenthrin with glucose homeostasis and risk of T2DM were assessed by generalized linear models and logistic regression models. The role of PCO in the above associations was evaluated by mediation analyses. After adjusting for covariates, each 2-fold increase in serum bifenthrin was associated with a 0.21 mmol/L increase in FPG and a 5.19%, 10.49%, and 12.18% increase in FPI, HOMA-IR, and PCO levels, respectively. Monotonically elevated ORs of IFG and AGR (all P and P for trend <0.05), but not T2DM (P > 0.05) were detected to be associated with increased bifenthrin. Compared with the participants with low bifenthrin and low PCO, participants with high bifenthrin exposure and high PCO showed a 0.40 mmol/L, 11.07%, and 22.50% increase in FPG, FPI, and HOMA-IR, as well as a 119.97% and 48.88% increase in risks of IFG and AGR, respectively (P for trend <0.05). Moreover, PCO mediated 13.61%-24.98% of the serum bifenthrin-associated glucose dyshomeostasis. The study suggested that bifenthrin exposure was dose-dependently associated with glucose dyshomeostasis in the general Chinese urban adults, and these associations were exacerbated and partly mediated by PCO. Given that other pollutants were not included in this study, the effect of co-exposure of pyrethroids with multiple pollutants is necessary to be considered in future studies.

Metal mixtures with longitudinal changes in lipid profiles: findings from the manganese-exposed workers healthy cohort

The majority of epidemiological investigations on metal exposures and lipid metabolism employed cross-sectional designs and focused on individual metal. We explored the associations between metal mixture exposures and longitudinal changes in lipid profiles and potential sexual heterogeneity. We recruited 250 men and 73 women, aged 40 years at baseline (2012), and followed them up in 2020, from the manganese-exposed workers healthy cohort. We detected metal concentrations of blood cells at baseline with inductively coupled plasma mass spectrometry. Lipid profiles were repeatedly measured over 8 years of follow-up. We performed sparse partial least squares (sPLS) model to evaluate multi-pollutant associations. Bayesian kernel machine regression was utilized for metal mixtures as well as evaluating their joint impacts on lipid changes. In sPLS models, a positive association was found between manganese and change in total cholesterol (TC) (beta = 0.169), while a negative association was observed between cobalt (beta =  - 0.134) and change in low density lipoprotein cholesterol (LDL-C) (beta =  - 0.178) among overall participants, which were consistent in men. Interestingly, rubidium was positively associated with change in LDL-C (beta = 0.273) in women, while copper was negatively associated with change in TC (beta =  - 0.359) and LDL-C (beta =  - 0.267). Magnesium was negatively associated with change in TC (beta =  - 0.327). We did not observe the significantly cumulative effect of metal mixtures on lipid changes. In comparison to other metals, manganese had a more significant influence on lipid change [group PIP (0.579) and conditional PIP (0.556) for TC change in men]. Furthermore, male rats exposed to manganese (20 mg/kg) had higher levels of LDL-C in plasma and more apparent inflammatory infiltration, vacuolation of liver cells, nuclear pyknosis, and fatty change than the controls. These findings highlight the potential role of metal mixtures in lipid metabolism with sex-dependent heterogeneity. More researches are needed to explore the underlying mechanisms.

The association between essential trace element mixture and atherosclerotic cardiovascular disease risk among Chinese community-dwelling older adults

The evidence about the association of the essential trace element (ETE) mixture with atherosclerotic cardiovascular disease (ASCVD) amongst older adults is limited. This study aims to evaluate the associations of single ETEs and the ETE mixture with the 10-year ASCVD risks and its predicting factors in Chinese community-dwelling older adults. A total of 607 community-dwelling older adults were included in this study. Blood levels of vanadium (V), chromium (Cr), manganese (Mn), cobalt (Co), nickel (Ni), and selenium (Se) were assessed by inductively coupled plasma mass spectrometry. The predicted 10-year ASCVD risk was calculated using the Prediction for ASCVD Risk in China (China-PAR) equations. Traditional linear regressions and Bayesian kernel machine regression (BKMR) were used to assess the associations of single ETEs and the ETE mixture with the 10-year ASCVD risks and its predicting factors such as systolic blood pressure (SBP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), diabetes, and waist circumference (WC). In linear regression models, blood Cr levels were negatively associated with the 10-year ASCVD risks after adjustment for covariates (β =  - 0.07, 95% CI =  - 0.11 ~  - 0.03); The 3th quartile (Q3) of Se levels was also associated with a lower 10-year ASCVD risks when compared with the lowest quartile (Q1) of Se levels (β_Q3 vs. _Q1: - 0.12, 95% CI =  - 0.22 ~  - 0.02). In BKMR models, the negative associations of Cr and Se with the 10-year ASCVD risks were observed. Higher blood levels of ETE mixture were associated with decreased 10-year ASCVD risks in a dose-response pattern, with Cr having the highest value of the posterior inclusion probability (PIP) within the mixture. Furthermore, a positive association between Cr and HDL-C and a negative association between Se and SBP were found in both linear regression and BKMR models. Cr and Se were negatively associated with the 10-year ASCVD risks, individually and as a mixture. ETE mixture showed a linear dose-response association with decreased 10-year ASCVD risks, with Cr being the most important component within the mixture. The negative association of the ETE mixture with the 10-year ASCVD risks may be attributed to Cr and Se, mainly mediated by HDL-C and SBP, respectively. Further cohort studies are needed to clarify this association.

Effects of Chromium Supplementation on Lipid Profile: an Umbrella of Systematic Review and Meta-analysis

Dyslipidemia is one of the most well-established modifiable risk factors for cardiovascular disease (CVD) development. Several meta-analyses have revealed the improving effects of chromium on dyslipidemia, while some studies have reported controversial results. This study aimed to summarize meta-analyses of randomized controlled trials (RCTs) that examined the effects of chromium supplementation on lipid profiles in adults. The literature search was conducted using Embase, Scopus, Web of Science, Cochrane Central Library, and PubMed databases with appropriate keywords from the beginning to May 2022. Based on the pooled analysis results, a random-effects model was used to determine the effects of chromium on blood lipid levels. Heterogeneity, publication bias, and sensitivity analysis were also evaluated using standard methods. A total of eight meta-analyses were included in this study. The pooled analysis of eight meta-analyses did not find any significant effect of chromium supplementation on triglycerides (TG) (ES =  - 0.20 mg/dl; 95% CI: - 0.50, 0.10, p = 0.185), total cholesterol (TC) (ES =  - 0.14 mg/dl, 95% CI: - 0.43, 0.16; p = 0.369), low-density lipoprotein cholesterol (LDL-c) (ES =  - 0.08 mg/dl; 95% CI: - 0.19, 0.03; p = 0.142), and high-density lipoprotein cholesterol (HDL-C) levels (ES: 0.05 mg/dl, 95% CI: - 0.05, 0.14, p = 0.312). However, subgroup analysis by the intervention dose suggested that chromium supplementation in doses higher than 500 µg/day could significantly decrease TG. The available evidence proposes no beneficial effects of chromium intervention on blood lipids. As a result, it cannot be used as a single therapy to treat adults with lipid abnormalities.

Association between the nickel exposure and lipid profiles in general population from NHANES

This study is to investigate the association between nickel exposure and serum lipid profiles. We analyzed the population from the National Health and Nutrition Examination Surveys (NHANES) 2017-2018. Urinary nickel exposure was measured using inductively coupled-plasma mass spectrometry. Serum lipid profiles, including triglyceride (TG), total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), and low-density lipoprotein-cholesterol (LDL-C), were measured using the standard biochemistry assays. The association between urinary nickel and lipid profiles was examined using multivariable linear regression models and restricted cubic spine plots. There was a significant negative relationship between nickel level and TC (β, - 9.67; 95% CI, - 13.58 to - 5.76), HDL-C (β, - 1.57; 95% CI, - 2.98 to - 0.16), and LDL-C (β, - 5.88; 95% CI, - 11.04 to - 0.71) after adjusting for potential confounding factors. Furthermore, restricted cubic spines showed that only HDL-C was nonlinearly associated with nickel (p for nonlinearity 0.004). However, nickel exposure was not related to the level of triglyceride. The exposure to nickel was linearly associated with serum total cholesterol and LDL-C while nonlinearly associated with HDL-C in general population.

The association between a combination of healthy lifestyles and the risks of hypertension and dyslipidemia among adults-evidence from the northeast of China

BACKGROUND AND AIMS

There is increasing evidence that lifestyle factors play an important role in the development of hypertension and dyslipidemia. However, existing research usually evaluated these risk factors individually (such as physical activity, smoking, drinking, obesity and so on), rather than joint evaluation. The aim of this study was to quantify the association between a combination of a healthy lifestyle and the risk of hypertension and dyslipidemia.

METHODS AND RESULT

A healthy lifestyle score was created based on 4 factors: never smoking, moderate to high-intensive physical activity, no alcohol drinking, and normal body mass index. We calculated the healthy lifestyle score using the cumulative number of health factors for each individual. Also, a multivariate analysis was used to assess the relationship between healthy lifestyle and hypertension and dyslipidemia. Among 6446 participants, 650 (10.08%) had lowest healthy lifestyle score (0) and 627 (9.72%) had highest healthy lifestyle score (4), respectively. The adjustment model indicated that participants with the highest score (score: 4), which integrated the four lifestyles, had significantly lower ORs for hypertension compared with the lowest score (score: 0) (0.21; (95%CI: 0.10, 0.43 P-trend< 0.001)). In the adjustment models, compared with lowest healthy lifestyle score, the ORs of highest healthy lifestyle score was: 0.17; (95%CI: 0.07, 0.42 P-trend<0.001) for dyslipidemia.

CONCLUSION

Hypertension and dyslipidemia were negatively correlated with healthy lifestyle score. Interventions with healthy lifestyle to reduce hypertension, dyslipidemia and promote population health are warranted.

Combined effects of exposure to polycyclic aromatic hydrocarbons and metals on oxidative stress among healthy adults in Caofeidian, China

Exposure to polycyclic aromatic hydrocarbons (PAHs) and metals is associated with many adverse effects on human health, accompanied by oxidative stress. This study aimed to investigate the effects of co-exposure to PAHs and metals on oxidative stress in healthy adults. A preliminary longitudinal panel study was conducted between 2017 and 2018 in 45 healthy college students in Caofeidian, China. Six urinary monohydroxylated-PAHs (OH-PAHs), ten metals, 8-hydroxydeoxyguanosine (8-OHdG), and 8-iso-prostaglandin-F2α (8-iso-PGF2α) were measured. Linear mixed effects (LME) models and Bayesian kernel machine regression (BKMR) models were used to explore the associations of urinary OH-PAHs and metals with 8-OHdG and 8-iso-PGF2α. LME models showed that most urinary OH-PAHs and metals were positively associated with 8-OHdG and 8-iso-PGF2α. For example, a one-unit increase in the ln-transformed level of 1-hydroxypyrene (1-OHPyr) and vanadium (V) was associated with an increase of 143.8% (95% CI: 105.7 - 188.9%) and 105.8% (95% CI: 79.2-136.4%) in 8-OHdG; 8-iso-PGF2α increased by 118.9% (95% CI: 99.2-140.5%) and 83.9% (95% CI: 67.2-102.2%) with a one-unit increase in the ln-transformed level of 3-hydroxyphenanthrene (3-OHPhe) and aluminum (Al). BKMR models indicated the overall positive associations of the mixture of six OH-PAHs, ten metals, or six OH-PAHs and ten metals with 8-OHdG and 8-iso-PGF2α. Urinary 1-OHPyr and V were identified as the major contributors to the increased urinary 8-OHdG levels, while urinary 3-OHPhe and Al were the most vital contributors to the increased urinary 8-iso-PGF2α levels. The results revealed the longitudinal dose-response relationships of urinary OH-PAHs and metals with oxidative stress among healthy adults in Caofeidian; this finding serves as an evidence regarding the early health hazard caused by exposure to PAHs and metals and has implications for the environmental management of PAH and metal emissions in this area.

Associations of plasma metal concentrations with incident dyslipidemia: Prospective findings from the Dongfeng-Tongji cohort

Metal exposures are ubiquitous around the world, while it is lack of prospective studies to evaluate the associations of exposure to multiple metal/metalloids with incident dyslipidemia. A total of 2947 participants without dyslipidemia at baseline were included in the analyses. We utilized inductively coupled plasma mass spectrometry to measure the baseline plasma metal concentrations. Unconditional logistic regression models were applied to estimate the relations between plasma metals and risk of incident dyslipidemia, and principal component analysis was performed to extract principal components of metals. During 5.01 ± 0.31 years of follow-up, 521 subjects were diagnosed with incident dyslipidemia. After multivariable adjustment, the odds ratios (ORs) of dyslipidemia comparing the highest quartiles to the lowest were 1.58 (95% CI: 1.20, 2.08; P_trend = 0.001) for aluminum, 1.34 (95% CI: 1.03, 1.75; P_trend = 0.03) for arsenic, 1.44 (1.09, 1.91; P_trend = 0.03) for strontium, and 1.47 (95% CI: 1.09, 2.00; P_trend = 0.005) for vanadium. The four metals also showed significant associations with the subtypes of dyslipidemia, including low HDL-C and high LDL-C. The first principal component, which mainly represented aluminum, arsenic, barium, lead, vanadium, and zinc, was associated with increased risk of incident dyslipidemia, and the adjusted OR was 1.40 (95% CI: 1.07, 1.84; P_trend = 0.02) comparing extreme quartiles. The study indicated that elevated plasma aluminum, arsenic, strontium, and vanadium concentrations were associated with a higher incidence of dyslipidemia. These findings highlight the importance of controlling metal exposures for dyslipidemia prevention.

Effects of chromium supplementation on lipid profile in patients with type 2 diabetes: A systematic review and dose-response meta-analysis of randomized controlled trials

BACKGROUND

The purpose of this study was to determine the influence of chromium supplementation on lipid profile in patients with type 2 diabetes mellitus (T2DM).

METHODS

A systematic search was performed in Scopus, Embase, Web of Science, the Cochrane library and PubMed databases to find randomized controlled trials (RCTs) related to the effect of chromium supplementation on lipid profile in patients with T2DM, up to June 2020. Meta-analyses were performed using the random-effects model, and I² index was used to evaluate heterogeneity.

RESULTS

The primary search yielded 725 publications. 24 RCTs (with 28 effect size) were eligible. Our meta-analysis indicated that chromium supplementation resulted in a significant decrease in serum levels of triglyceride (TG) (MD: -6.54 mg/dl, 95 % CI: -13.08 to -0.00, P = 0.050) and total cholesterol (TC) (WMD: -7.77 mg/dl, 95 % CI: -11.35 to -4.18, P < 0.001). Furthermore, chromium significantly increases high-density lipoprotein (HDL) (WMD: 2.23 mg/dl, 95 % CI: 0.07-4.40, P = 0.043) level. However, chromium supplementation did not have significant effects on low-density lipoprotein (LDL) (WMD: -8.54 mg/dl, 95 % CI: -19.58 to 2.49, P = 0.129) level.

CONCLUSION

Chromium supplementation may significantly improve lipid profile in patients with T2DM by decreasing TG and TC and increasing HDL. However, based on our analysis, chromium failed to affect LDL. It should be noted that the lipid-lowering properties of chromium supplementation were small and may not reach clinical importance.

A cohort study on risk factors of high-density lipoprotein cholesterol hypolipidemia among urban Chinese adults

Background

High-density lipoprotein cholesterol (HDL-C) hypolipidemia, a major type of dyslipidemia, has been associated with many kinds of diseases, such as stroke, coronary heart disease, obesity and diabetes, and has displayed an increasing prevalence in China. This study explores the risk factors of HDL-C hypolipidemia and makes recommendations for controlling and preventing HDL-C hypolipidemia and the diseases caused by it.

Methods

Using a retrospective cohort study design, 26,863 urban adults without dyslipidemia, diabetes, cardiovascular and cerebrovascular diseases, hepatosis, renal insufficiency and thyroid diseases were enrolled in the study between 2010 and 2015. Data on each individual were collected at the 2010 baseline year and at a follow-up medical check. A Cox regression model was constructed to evaluate the influence of potential risk factors on the outcome event- HDL-C hypolipidemia.

Results

The incidence of HDL-C hypolipidemia was 5.7% (1531/26863). Sex, age, body mass index (BMI), HDL-C, triglyceride (TG) and urea nitrogen (UN) were significant risk factors of HDL-C hypolipidemia. Men were more likely to develop HDL-C hypolipidemia than women during follow-up medical checks (HR = 1.258, P = 0.014). The incidence of HDL-C hypolipidemia in the over 65 years old group was higher than that of the ≤65 age group (HR = 1.276, P = 0.009). The incidence of HDL-C hypolipidemia increased with increasing BMI (HR = 1.030, P = 0.002), TG (HR = 1.321, P = 0.001) and UN (HR = 1.054, P = 0.019), while falling with increasing HDL-C in the baseline year (HR = 0.002, P < 0.001).

Conclusions

Men, aged over 65, with high BMI were at the highest risk of developing HDL-C hypolipidemia. Measures should be taken to prevent HDL-C hypolipidemia even for healthy urban adults whose blood biochemical indicators were in the normal range when their level of TG, UN and HDL-C are closed to the border of the normal value range.

Association of multiple metals with lipid markers against different exposure profiles: A population-based cross-sectional study in China

We sought to evaluate whether essential and toxic metals are cross-sectionally related to blood lipid levels using data among adults from Shimen (n = 564) and Huayuan (n = 637), two counties with different exposure profiles in Hunan province of China. Traditional and grouped weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) were performed to assess association between exposure to a mixture of 22 metals measured in urine or plasma, and lipid markers. Most of the exposure levels of metals were significantly higher in Shimen area than those in Huayuan area (all P-values < 0.001). Traditional WQS regression analyses revealed that the WQS index were both significantly associated with lipid markers in two areas, except for the HDL-C. Grouped WQS revealed that essential metals group showed significantly positive associations with lipid markers except for HDL-C in Huayuan area, while toxic metals group showed significantly negative associations except for HDL-C and LDL-C in Huayuan area. There were no significant joint effects, but potential non-linear relationships between metals mixture and TC or LDL-C levels were observed in BKMR analyses. Although consistent significantly associations of zinc and titanium with TG levels were found in both areas, the metals closely related to other lipid markers were varied by sites. Additionally, the BKMR analyses revealed an inverse U shaped association of iron with LDL-C levels and interaction effects of zinc and cadmium on LDL-C in Huayuan area. The relationship between metal exposure and blood lipid were not identical against different exposure profiles.

The associations of multiple metals mixture with accelerated DNA methylation aging

Aging is a leading cause of mortality for the elderly and DNA methylation age is reported to be predictive of biological aging. However, few studies have investigated the associations between multiple metals exposure and accelerated aging in the elderly. We performed a pilot study of 288 elderly participants aged 50-115 years and measured genome-wide DNA methylation and 22 blood metals concentrations. Measures of DNA methylation age were estimated using CpGs from Illumina HumanMethylation EPIC BeadChip. Linear mixed regression and Bayesian kernel machine regression (BKMR) models were used to estimate the individual and overall associations between multiple metals and accelerated methylation aging. Single metal models revealed that each 1-standard deviance (SD) increase in log-transformed vanadium, cobalt, nickel, zinc, arsenic, and barium was associated with a -2.256, -1.318, 1.004, -1.926, 1.910 and -1.356 changes in ΔAge, respectively; meanwhile, for aging rate, the change was -0.019, -0.013, 0.010, -0.018, 0.023, and -0.012, respectively (all P < 0.05). The BKMR models showed reverse U-shaped associations of the overall metals mixture with ΔAge and aging rate. Downward trends of ΔAge and aging rate were observed for increasing quantiles of essential metals mixture, but upward trends were observed for non-essential metals mixture. Further individual analysis of the BKMR revealed that the 95% confidence interval of ΔAge and aging rate associated with vanadium, zinc, and arsenic did not cross 0, when other metals concentrations set at 25th, 50th, and 75th percentile. Our findings suggest reverse U-shaped associations of the overall metals mixture with accelerated methylation aging for the first time, and vanadium, zinc, and arsenic may be major contributors driving the associations.