Negatively interactive effect of chromium and cadmium on obesity: Evidence from adults living near ferrochromium factory

The association between heavy metal exposure and obesity: A systematic review and meta-analysis

Background

Obesity and metabolic syndrome are global health concerns associated with development of different types of diseases and serious health threats in the long term. Their metabolic imbalance can be attributable to inherited and environmental factors. As a considerable environmental agent, heavy metals exposure can predispose individuals to diseases like obesity. This systematic review and meta-analysis aimed to evaluate the association between heavy metals exposure and the risk of obesity.

Methods

PubMed/MEDLINE, EMBASE and Web of Science were systematically searched until December 17, 2022. Only observational studies that evaluated heavy metals exposure and obesity were included. Studies were excluded if they assessed maternal or prenatal exposure, the mixture of heavy metals and other chemicals, reported the association with overweight or other diseases, and undesirable study designs. The Joanna Briggs Institute checklist was used for quality assessment. The pooled adjusted odds ratio (aOR) and the pooled standardized mean difference (SMD) with their 95% confidence intervals (CIs) were calculated, respectively. The publication bias was evaluated using Egger's and Begg's tests.

Results

Twenty studies (n = 127755), four case-control and sixteen analytical cross-sectional studies, were included. Lead exposure was significantly associated with a lower risk of obesity (aOR: 0.705, 95% CI: 0.498-0.997), while mercury (aOR: 1.458, 95% CI: 1.048-2.031) and barium (aOR: 1.439, 95% CI: 1.142-1.813) exposure increased the risk of obesity. No significant publication bias was found and the studies had a low risk of bias.

Conclusion

Overall, lead exposure reduced obesity risk, while mercury and barium exposure raised it. Further large-scale observational studies are recommended to determine the roles of heavy metals in obesity.Study registration ID: CRD42023394865.

Supplementary information

The online version contains supplementary material available at 10.1007/s40200-023-01307-0.

A case-control study on asthma and obese patients: Influence of lifestyle patterns, serum trace elements, heavy metals, and total antioxidants

Background and aim

Asthma is a chronic airway hyperresponsiveness disorder and Obese people have greater rates of asthma incidence and prevalence. Obesity, a complex condition, can cause nutritional metabolic problems that change trace elements and minerals. Trace element and antioxidant levels affect asthma aetiology. In this study, we aim to determine the serum levels of trace elements Zn, Fe, Cu, Mg, Co, Ni, Pb, Cd, and Cr, total antioxidants (TAS), and lifestyle that determine specific clinical conditions in asthma and obesity patients from Vellore City (Tamil Nadu, India).

Methods

A case-control study to determine the level of the serum trace elements with 838 subjects (n = 242 asthma patients, n = 140 asthmatic obese, n = 185 obese patients, and n = 271 controls) between the ages of 20 and 60 years was carried out. Asthma was diagnosed based on the clinical examination and pulmonary function tests. Trace element levels were determined by atomic absorption spectrophotometry (AAS) in serum, and a DPPH-free radical scavenging assay was used to determine the total antioxidant capacity level in serum.

Result

In asthma male patients, serum levels of Zn, Fe, Cu, Mg, and TAS were significantly lower and Pb, Cd, and Cr significantly higher, whereas in female asthma patients, serum levels of Zn, Fe, Mg, and TAS were significantly lower and Pb significantly higher. In asthmatic obese male patients, Fe, Cu, and TAS were significantly lower, and Pb, Cd, and Co were significantly higher; in asthmatic obese female patients, Zn, Fe, Cu, Mg, and TAS were significantly lower, and Ni was significantly higher. In obese male patients, Zn, Fe, Cu, and TAS were significantly lower and Cd was significantly higher, and in obese female patients, Zn, Fe, Cu, Mg, and TAS were significantly lower.

Conclusion

The influence of the level of trace elements, heavy metal, total antioxidant, and the lifestyle patterns, may increase the risk of asthma and obesity.

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.

Hepatocellular degeneration in mice co-exposed to in-utero aluminium and cadmium: Implication of a disordered antioxidant and energy homeostatic response in the liver

The current study comprised four groups of pregnant animals viz; Control (CTR) received 10 ml/kg of normal saline, Al:10 mg/kg of AlCl3, Cd: 1.5 mg/Kg of CdCl2 Al+Cd; 10 mg/kg of AlCl3 and 1.5 mg/Kg of CdCl2. Treatment was done from pregnancy days (PNT) 7-20. After delivery, male animals were weaned on PSD 21 and sacrificed on PSD 78. From the study significant increases on serum liver enzymes in the group exposed to Cd and that exposed to Al+Cd were observed. The study further showed altered serum and hepatic antioxidant balance for the Cd, Al and Al+Cd groups compared to control. Similarly, lactate dehydrogenase (LDH) and succinate dehydrogenase (SDH) activities in the liver were elevated in Cd and Al+Cd groups while an altered liver histological feature in treated groups were also observed. it was concluded that in utero co-exposure to Al and Cd had the ability to alter hepatic functional indices.

Associations between plasma metal/metalloid mixtures and the risk of central obesity: A prospective cohort study of Chinese adults

Central obesity has increased rapidly over the past decade and posed a substantial disease burden worldwide. Exposure to metals/metalloids has been acknowledged to be involved in the development of central obesity through regulation of cortisol, insulin resistance, and glucocorticoid receptor reduction. Despite the importance, it is lack of prospective study which comprehensively evaluate the relations between multiple metals exposure and central obesity. We explored the prospective associations of plasma metal concentrations with central obesity in a prospective study of the Dongfeng-Tongji cohort. The present study included 2127 participants with a 6.87-year mean follow-up duration. We measured 23 plasma metal/metalloid concentrations at baseline. The associations between metals and incident central obesity were examined utilizing the Cox proportional hazard regression in single and multiple metals models. Additionally, we applied elastic net (ENET), Bayesian kernel machine regression (BKMR), plasma metal score (PMS), and quantile-based g-computation (Qgcomp) models to explore the joint associations of metal mixtures with central obesity. After adjusting potential confounders, we found significant associations of plasma manganese (Mn) and thallium (Tl) concentrations with a higher risk of central obesity, whereas plasma rubidium (Rb) concentration was associated with a lower risk of central obesity both in single and multiple metals models (all FDR <0.05). The ENET and Qqcomp models verified similar metals (Mn, Rb, and Tl) as important predictors for central obesity. The results of both BKMR model and PMS suggested cumulative exposure to metal mixtures was associated with a higher risk of central obesity. Our findings suggested that co-exposure to metals was associated with a higher risk of central obesity. This study expands our knowledge that the management of metals/metalloids exposure may be beneficial for the prevention of new-onset central obesity, which may subsequently alleviate the disease burden of late-life health outcomes.

Why Do People Gain Belly Fat in Rural Areas? A Study of Urinary Metal(loid)s and Abdominal Obesity in China

Obesity is prevalent in rural areas of China, and there are inconsistent findings regarding the association between metal(loid) exposure and the risk of obesity. Abdominal obesity (AOB), which reflects visceral fat abnormity, is a crucial factor in studying obesity-related diseases. We conducted a study measuring 20 urinary metal(loid)s, 13 health indicators, and the waist circumference (WC) in 1849 participants from 10 rural areas of China to investigate their relationships. In the single exposure models, we found that urinary chromium (Cr) was significantly associated with the odds of having AOB [adjusted odds ratio (OR) = 1.81 (95% confidence interval (CI): 1.24, 2.60)]. In the mixture exposure models, urinary Cr consistently emerged as the top contributor to AOB, while the overall effect of mixed metal(loid)s was positive toward the odds of having AOB [adjusted OR: 1.33 (95% CI: 1.00, 1.77)], as revealed from the quantile g-computation model. After adjusting for the effects of other metal(loid)s, we found that the elevation of apolipoprotein B and systolic blood pressure significantly mediated the association between urinary Cr and the odds of having AOB by 9.7 and 19.4%, respectively. Our results suggest that exposure to metal(loid)s is a key factor contributing to the prevalence of AOB and WC gain in rural areas of China.

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.