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Choe Y, Kim KN, Lee YJ, Kim JI, Kim BN, Lim YH, Hong YC, Shin CH, Lee YA. Prenatal and childhood exposure to endocrine-disrupting chemicals and early thelarche in 8-year-old girls: A prospective study using Bayesian kernel regression. ENVIRONMENTAL RESEARCH 2024; 263:120056. [PMID: 39343343 DOI: 10.1016/j.envres.2024.120056] [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: 05/22/2024] [Revised: 09/20/2024] [Accepted: 09/22/2024] [Indexed: 10/01/2024]
Abstract
BACKGROUND Studies on the combined effects of persistent and non-persistent endocrine-disrupting chemicals (EDCs) on puberty are insufficient. To date, no studies have analyzed breast development at age 8 years, a key criterion for determining precocious puberty. We investigated the relationship between prenatal or childhood exposure to EDC mixtures and early thelarche, defined as breast development before age 8 years in girls. METHODS This prospective study included 211 girls with data on prenatal and 8-year-old exposure of cadmium (Cd), lead, mercury, bisphenol-A (BPA), 3-phenoxybenzoic acid, and three phthalate metabolites from the Environment and Development of Children cohort. Prenatal exposure was assessed through samples from pregnant women at 14-27th weeks of gestation. Tanner staging was assessed by a pediatric endocrinologist. The relationship between single and mixed chemical exposures and outcomes was assessed using logistic regression, generalized additive models (GAM), and Bayesian kernel machine regression (BKMR) models. RESULTS Early thelarche was observed in 42 (19.9%) girls at age 8 years. In the logistic regression models, the risk of early thelarche increased with increased exposure to Cd in their mothers (adjusted odds ratio [aOR] per interquartile range [IQR] = 1.80, 95% confidence interval [CI] 1.23-2.65) but decreased with prenatal BPA exposure (aOR per IQR = 0.57, 95% CI 0.35-0.92). None of the 8-year-old chemical exposures was associated with early thelarche. In the GAM, early thelarche was positively correlated with prenatal Cd and inversely associated with prenatal BPA exposure (p = 0.004 for Cd and p = 0.036 for BPA). In the BKMR models, an increase in log-transformed prenatal Cd concentrations from the 25th to 75th percentile was associated with an increase in the estimated probability of early thelarche at age 8 years (risk difference: 0.46 [95% credible interval: 0.04-0.88]) when other chemicals were set at their median values. CONCLUSIONS Considering the combined effects of persistent and non-persistent chemical mixtures, maternal Cd exposure during the second trimester may be associated with early thelarche in 8-year-old girls.
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Affiliation(s)
- Yunsoo Choe
- Department of Pediatrics, Hanyang University Guri Hospital, Guri, South Korea; Department of Pediatrics, Hanyang University College of Medicine, Seoul, South Korea
| | - Kyoung-Nam Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Yun Jeong Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Johanna Inhyang Kim
- Department of Psychiatry, Hanyang University College of Medicine, Seoul, South Korea
| | - Bung-Nyun Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Youn-Hee Lim
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea; Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea; Department of Human Systems Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Choong Ho Shin
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Young Ah Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea.
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Jian X, Baeyens W, De Waele E, Guo W, Jia YW, Leemans L, Leermakers M, Van Larebeke N, Gao Y. Intake rates of methylmercury in the Belgian population: Evolution over 40 years. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 954:176695. [PMID: 39366585 DOI: 10.1016/j.scitotenv.2024.176695] [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: 09/05/2024] [Revised: 09/30/2024] [Accepted: 10/01/2024] [Indexed: 10/06/2024]
Abstract
Methylmercury (MeHg) is one of the most toxic compounds, it bioaccumulates and biomagnifies along the food chain and finally damages human's nervous system. Knowing that the main intake route for MeHg in humans is through fish consumption, intake rates were studied in various countries, but not in Belgium. Based on Hg and MeHg measurements in various fishes, mainly from North Sea catches, in combination with the national food consumption surveys, we could calculate daily Hg and MeHg intake rates for the Belgian population in 1975, 1997 and 2014-2021. These values are then compared with daily intake values reported by other countries and with the acceptable daily intake (ADI) values recommended by international organizations. Daily Hg and MeHg intake rates decreased strongly between 1975 and the 2 later periods: while average intake rates are all below the ADI norms, this is not the case for the 95th percentile rates because they exceed or are very close to the ADI values. Since daily MeHg intake rates correlate well with hair and blood concentrations, these were used as a good proxy of MeHg intoxication and were related to health effects observed in children, adolescents, adults and elderly persons living in Belgium via biomonitoring.
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Affiliation(s)
- Xiao Jian
- Department of Clinical Nutrition, The Second Affiliated Hospital of Dalian Medical University, 467 Zhongshan Road, Shahekou District, 116023 Dalian, Liaoning Province, China; Archaeology, Environmental Changes and Geo-Chemistry (AMGC), Vrije Universiteit Brussel (VUB), Pleinlaan 2, 1050 Brussels, Belgium
| | - Willy Baeyens
- Archaeology, Environmental Changes and Geo-Chemistry (AMGC), Vrije Universiteit Brussel (VUB), Pleinlaan 2, 1050 Brussels, Belgium
| | - Elisabeth De Waele
- Vitality Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090, Brussels, Belgium.; Metabolism and Nutrition, Department of Clinical Nutrition, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Wei Guo
- Faculty of Architecture, Civil and Transportation Engineering, Beijing University of Technology (BJUT), Pingle Park 100, Chaoyang District, 100124 Beijing, PR China
| | - Yu-Wei Jia
- Archaeology, Environmental Changes and Geo-Chemistry (AMGC), Vrije Universiteit Brussel (VUB), Pleinlaan 2, 1050 Brussels, Belgium
| | - Lynn Leemans
- Vitality Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090, Brussels, Belgium
| | - Martine Leermakers
- Archaeology, Environmental Changes and Geo-Chemistry (AMGC), Vrije Universiteit Brussel (VUB), Pleinlaan 2, 1050 Brussels, Belgium
| | - Nik Van Larebeke
- Archaeology, Environmental Changes and Geo-Chemistry (AMGC), Vrije Universiteit Brussel (VUB), Pleinlaan 2, 1050 Brussels, Belgium
| | - Yue Gao
- Archaeology, Environmental Changes and Geo-Chemistry (AMGC), Vrije Universiteit Brussel (VUB), Pleinlaan 2, 1050 Brussels, Belgium.
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Liu H, Li Z, Xie L, Jing G, Liang W, He J, Dang Y. The Relationship Between Heavy Metals and Missed Abortion: Using Mediation of Serum Hormones. Biol Trace Elem Res 2024; 202:3401-3412. [PMID: 37982984 DOI: 10.1007/s12011-023-03931-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 10/23/2023] [Indexed: 11/21/2023]
Abstract
Accumulating evidence suggests that heavy metal exposure may have adverse effects on the fetal development. Furthermore, disruption of serum hormone homeostasis can result in the adverse pregnancy outcomes. Therefore, this study aimed to investigate the potential association between heavy metals and missed abortion, with a focus on whether serum hormones mediate this relationship. The concentrations of heavy metals and hormones in serum were measured in this case-control study. Statistical models including, logistic regression model, principal component analysis (PCA), and weighted quantile sum (WQS) regression model were employed to examine the relationship between heavy metals, serum hormones, and missed abortion. Furthermore, the mediation analysis was performed to assess the role of serum hormones as potential mediators in this relationship. This study revealed significant associations between heavy metal exposure and missed abortion. Notable, the WQS index weight, which was mainly influenced by copper (Cu) and zine (Zn), is associated with missed abortion. Moreover, heavy metals including manganese (Mn), nickel (Ni), Zn, arsenic (As), Cu, cadmium (Cd), and lead (Pb) were found to be associated with serum levels of β-human chorionic gonadotropin (β-hCG), progesterone (P), estradiol (E2), and lactogen (HPL). In addition, the mediation analysis indicated that β-hCG explained a portion of the association (ranging from 18.77 to 43.51%) of between Mn, Ni, Zn, and As exposure and missed abortion. Serum P levels explained 17.93 to 51.70% of the association between Ni, Cu, and As exposure and missed abortion. Serum E2 levels played a significant mediating role, explaining a portion of the association (ranging from 22.14 to 73.60%) between Mn, Ni, Cu, As, Cd, and Pb exposure and missed abortion. Our results suggested that β-hCG, P, and E2 are one of the potential mediators in the complex relationship between heavy metals exposure and missed abortion. These results highlight the importance of considering both heavy metal exposure and serum hormone levels in understanding the etiology of missed abortion.
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Affiliation(s)
- Haixia Liu
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Chengguan District, No. 199, Donggang West Road, LanzhouGansu Province, 730000, China
| | - Zhilan Li
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Chengguan District, No. 199, Donggang West Road, LanzhouGansu Province, 730000, China
| | - Li'ao Xie
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Chengguan District, No. 199, Donggang West Road, LanzhouGansu Province, 730000, China
| | - Guangzhuang Jing
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Chengguan District, No. 199, Donggang West Road, LanzhouGansu Province, 730000, China
| | - Weitao Liang
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Chengguan District, No. 199, Donggang West Road, LanzhouGansu Province, 730000, China
| | - Jie He
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Chengguan District, No. 199, Donggang West Road, LanzhouGansu Province, 730000, China
| | - Yuhui Dang
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Chengguan District, No. 199, Donggang West Road, LanzhouGansu Province, 730000, China.
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Oleko A, Saoudi A, Zeghnoun A, Pecheux M, Cirimele V, Mihai Cirtiu C, Berail G, Szego E, Denys S, Fillol C. Exposure of the general French population to metals and metalloids in 2014-2016: Results from the Esteban study. ENVIRONMENTAL RESEARCH 2024; 252:118744. [PMID: 38579993 DOI: 10.1016/j.envres.2024.118744] [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: 11/24/2023] [Revised: 03/13/2024] [Accepted: 03/16/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND The purpose of the Esteban study was to describe levels of various biomarkers of exposure to several environmental pollutants, including metals and metalloids, among the French population. This paper describes the distribution of concentrations of 28 metals and metalloids in two different populations, and estimates the main determinants of exposure to total arsenic, the sum of inorganic arsenic (iAs) and its two metabolites monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA), cadmium, chromium, copper, mercury and nickel. METHODS Esteban is a cross-sectional study conducted between 2014 and 2016 on a random sample of 2503 adults (18-74 years old) and 1104 children (6-17 years old) from the general population. The data collected included biological samples (blood, hair, and urines), socio-demographic characteristics, environmental and occupational exposure, and information on dietary factors and lifestyle. The geometric mean and percentiles of the distribution were estimated for each metal. Multivariate analyses were performed to identify the determinants of exposure using a generalized linear model. RESULTS Only four metals had a quantification rate below 90% in adults (beryllium, iridium, palladium, and platinum), and three metals in children (beryllium, iridium, and platinum). The concentrations of total arsenic, cadmium, chromium and mercury were higher than those found in most international studies. The determinants significantly associated with exposure were mainly diet and smoking. CONCLUSIONS Esteban provided a nationwide description of 28 metal and metalloid exposure levels for adults (some never measured before) and for the first time in children. The study results highlighted widespread exposure to several metals and metalloids. These results could be used to advocate public health decisions for continued efforts to reduce harmful exposure to toxic metals. The Reference values (RV95) built from Esteban could also be used to support future government strategies.
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Affiliation(s)
- Amivi Oleko
- Santé Publique France, French Public Health Agency, 12 Rue Du Val D'Osne, 94415, Saint Maurice Cedex, France.
| | - Abdessattar Saoudi
- Santé Publique France, French Public Health Agency, 12 Rue Du Val D'Osne, 94415, Saint Maurice Cedex, France
| | - Abdelkrim Zeghnoun
- Santé Publique France, French Public Health Agency, 12 Rue Du Val D'Osne, 94415, Saint Maurice Cedex, France
| | - Marie Pecheux
- Santé Publique France, French Public Health Agency, 12 Rue Du Val D'Osne, 94415, Saint Maurice Cedex, France
| | - Vincent Cirimele
- ChemTox 3 Rue Grüninger, Parc D'Innovation F, Illkirch Graffenstaden, 67400, France
| | - Ciprian Mihai Cirtiu
- Centre de Toxicologie Du Québec (CTQ), Institut National de Santé Publique Du Québec (INSPQ), 945 Av., Wolfe, Québec, G1V 5B3, Canada
| | - Géraldine Berail
- Laboratoire de l'Environnement et de l'Alimentation de la Vendée (LEA Vendée), La Roche sur Yon, France
| | - Emmanuelle Szego
- Santé Publique France, French Public Health Agency, 12 Rue Du Val D'Osne, 94415, Saint Maurice Cedex, France
| | - Sébastien Denys
- Santé Publique France, French Public Health Agency, 12 Rue Du Val D'Osne, 94415, Saint Maurice Cedex, France
| | - Clémence Fillol
- Santé Publique France, French Public Health Agency, 12 Rue Du Val D'Osne, 94415, Saint Maurice Cedex, France
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Yuan Y, Peng TY, Yu GY, Zou Z, Wu MZ, Zhu R, Wu S, Lv Z, Luo SX. Association between serum copper level and reproductive health of Women in the United States: a cross-sectional study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:2441-2450. [PMID: 37725958 DOI: 10.1080/09603123.2023.2253753] [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: 03/23/2023] [Accepted: 08/26/2023] [Indexed: 09/21/2023]
Abstract
Copper is an indispensable trace element in metabolism. This study aimed to investigate the relationship between copper and reproductive health, and possibly provide new insights for diagnosis and treatment. This study was based on data extracted from the NHANES database (2013-2014 and 2015-2016). The t-test, ANOVA, Chi-square test, multiple linear regression, and restricted cubic spline analysis were used. Serum copper levels were significantly higher in women with gestational diabetes than in those without gestational diabetes (P = 0.0150). Women with higher copper levels and smoking habits tended to deliver overweight babies (P = 0.028). Women with diabetes had higher serum copper and were prone to deliver overweight babies (P = 0.024). Serum copper levels showed a positive relationship with sex hormone-binding globulin (SHBG) levels (P < 0.0001). In this study, serum copper levels were found to be associated with reproductive health in women. Further studies are required to draw causal inferences.
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Affiliation(s)
- Yi Yuan
- Pediatrics College, Guangzhou Medical University, Guangzhou, China
| | - Tong-Yu Peng
- The First Clinical College, Chongqing Medical University, Chongqing, China
| | - Guang-Yuan Yu
- Department of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Zhao Zou
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Meng-Ze Wu
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ruofei Zhu
- Department of Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Gynecology, Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University, Guangzhou, China
| | - Shuang Wu
- Pediatrics College, Guangzhou Medical University, Guangzhou, China
| | - Zi Lv
- Department of obstetrics and gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Obstetrics, Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University, Guangzhou, China
| | - Su-Xin Luo
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Rodriguez-Carrillo A, Remy S, D'Cruz SC, Salamanca-Fernandez E, Gil F, Olmedo P, Mustieles V, Vela-Soria F, Baken K, Olea N, Smagulova F, Fernandez MF, Freire C. Kisspeptin as potential biomarker of environmental chemical mixture effect on reproductive hormone profile: A pilot study in adolescent males. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 868:161668. [PMID: 36657687 DOI: 10.1016/j.scitotenv.2023.161668] [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: 11/04/2022] [Revised: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Kisspeptin has been proposed as an effect biomarker to understand the mechanisms by which some environmental chemicals adversely affect the human reproductive system. OBJECTIVE To ascertain whether kisspeptin serum protein and DNA methylation levels are associated with exposure to several environmental chemicals (individually and as a mixture) and serum reproductive hormone levels in adolescent males. METHODS Three phenols (bisphenol A [BPA], methyl-paraben [MPB], and benzophenone-3 [BP3]); two toxic metals (arsenic and cadmium); and four metabolites of non-persistent pesticides, including insecticides (2-isopropyl-6-methyl-4-pyrimidinol [IMPy], malathion diacid [MDA], and dimethylcyclopropane carboxylic acid [DCCA]) and fungicides (ethylene thiourea [ETU]) were measured in first-morning urine samples of 133 adolescent males aged 15-17 years from the INMA-Granada cohort. In blood samples collected on the same day, KISS1 gene DNA methylation was measured at four CpGs from the Exon IV, as well as serum levels of kiss54 protein, total testosterone (T), estradiol (E2), sex hormone binding-globulin, dehydroepiandrosterone sulfate, luteinizing hormone (LH), and follicle-stimulating hormone (FSH). Multiple linear regression and mixture (quantile g-computation) models were fit. RESULTS Urinary MDA and DCCA concentrations were associated with higher kiss54 levels [% change (95%CI) for each log-unit increase in concentration = 2.90 (0.32;5.56), and 1.93 (0.45,3.43), respectively]; IMPy with lower DNA methylation percentage at CpG1 and total CpGs [% change (95%CI) = -1.15 (-1.96;-0.33): -0.89 (-1.73;-0.01), respectively]; and BP3 and DCCA with lower total CpGs methylation [-0.53 (-1.04;-0.01) and - 0.69 (-1.37;-0.01), respectively]. The pesticide mixture and the whole chemical mixture were associated with higher kiss54 [% change (95%CI) = 9.09 (3.29;15.21) and 11.61 (3.96;19.82), respectively] and lower methylation levels at several CpGs. Additionally, serum kiss54 in the third tertile was associated with higher LH levels [% change (95%CI) = 28.69 (3.75-59.63)], and third-tertile CpG1, CpG2, and total CpG methylation percentages were associated with lower FSH and E2. CONCLUSION The findings of the present study and the negative correlation between serum kiss54 levels and KISS1 DNA methylation percentages suggested that kisspeptin may be a promising effect biomarker.
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Affiliation(s)
- Andrea Rodriguez-Carrillo
- Biomedical Research Center (CIBM), University of Granada, 18016 Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain; Department of Radiology and Physical Medicine, School of Medicine, University of Granada, 18016 Granada, Spain.
| | - Sylvie Remy
- Department of Radiology and Physical Medicine, School of Medicine, University of Granada, 18016 Granada, Spain
| | - Shereen Cynthia D'Cruz
- Univ Rennes, EHESP, Inserm, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Elena Salamanca-Fernandez
- Biomedical Research Center (CIBM), University of Granada, 18016 Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain; Department of Radiology and Physical Medicine, School of Medicine, University of Granada, 18016 Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain
| | - Fernando Gil
- Department of Legal Medicine and Toxicology, School of Medicine, University of Granada, 18016 Granada, Spain
| | - Pablo Olmedo
- Department of Legal Medicine and Toxicology, School of Medicine, University of Granada, 18016 Granada, Spain
| | - Vicente Mustieles
- Biomedical Research Center (CIBM), University of Granada, 18016 Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain; Department of Radiology and Physical Medicine, School of Medicine, University of Granada, 18016 Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain
| | - Fernando Vela-Soria
- Biomedical Research Center (CIBM), University of Granada, 18016 Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain
| | - Kirsten Baken
- Unit Health, VITO, Flemish Institute for Technological Research, 2400 Mol, Belgium
| | - Nicolás Olea
- Biomedical Research Center (CIBM), University of Granada, 18016 Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain; Department of Radiology and Physical Medicine, School of Medicine, University of Granada, 18016 Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain
| | - Fátima Smagulova
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain
| | - Mariana F Fernandez
- Biomedical Research Center (CIBM), University of Granada, 18016 Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain; Department of Radiology and Physical Medicine, School of Medicine, University of Granada, 18016 Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain.
| | - Carmen Freire
- Biomedical Research Center (CIBM), University of Granada, 18016 Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain
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Bertram J, Ramolla C, Esser A, Schettgen T, Fohn N, Steib J, Kraus T. Blood lead monitoring in a former mining area in Euskirchen, Germany: results of a representative random sample in 3- to 17-year-old children and minors. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:20995-21009. [PMID: 36264474 PMCID: PMC9584279 DOI: 10.1007/s11356-022-23632-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
Heavy metal residues in former mining areas can pose a burden to the local environment and population even decades after closure of the mining sites. In the North Rhine-Westphalian (Germany) communities of Mechernich and Kall, both parts of the district of Euskirchen, lead residues are a source of health concerns for local residents. A statistically representative collective of both communities depending on sex, age, and area of residence was created, mirroring the local underage population. The blood lead levels (BLL) of 182 children and minors in the two adjacent communities were assessed via ICP-MSMS. The results were compared to German lead reference values, valid for the general underage population. In total, 32 (17.6%) of the subjects investigated exceeded the according reference values of 15 µg/L and 20 µg/L, respectively, depending on sex and age, thus pointing out an additional lead burden affecting children in the area. Potential lead sources contributing to the BLL were evaluated using a questionnaire. Factors that showed significant impact on the BLL were, other than age, sex, height, and weight, the factors occupancy, time spend in the garden, garden hand-to-mouth contact, consumption frequency of homegrown products, and lifestyle factors. The data presented enable both residents and the local authorities to further reduce lead exposure and to take appropriate personal and public action.
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Affiliation(s)
- Jens Bertram
- Institute for Occupational, Social and Environmental Medicine, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Aachen, Germany.
| | - Christian Ramolla
- Public Health Department Euskirchen, District of Euskirchen, Germany
| | - André Esser
- Institute for Occupational, Social and Environmental Medicine, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Aachen, Germany
| | - Thomas Schettgen
- Institute for Occupational, Social and Environmental Medicine, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Aachen, Germany
| | - Nina Fohn
- Institute for Occupational, Social and Environmental Medicine, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Aachen, Germany
| | - Jasmina Steib
- Institute for Occupational, Social and Environmental Medicine, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Aachen, Germany
| | - Thomas Kraus
- Institute for Occupational, Social and Environmental Medicine, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Aachen, Germany
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Malin Igra A, Rahman A, Johansson AL, Pervin J, Svefors P, Arifeen SE, Vahter M, Persson LÅ, Kippler M. Early Life Environmental Exposure to Cadmium, Lead, and Arsenic and Age at Menarche: A Longitudinal Mother-Child Cohort Study in Bangladesh. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:27003. [PMID: 36729392 PMCID: PMC9894154 DOI: 10.1289/ehp11121] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 12/07/2022] [Accepted: 01/03/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Several metals act as endocrine disruptors, but there are few large longitudinal studies about associations with puberty onset. OBJECTIVES We evaluated whether early life cadmium, lead, and arsenic exposure was associated with timing of menarche. METHODS In a mother-child cohort in rural Bangladesh (n=935), the exposure was assessed by concentrations in maternal erythrocytes in early pregnancy and in girls' urine at 5 and 10 years of age using inductively coupled plasma mass spectrometry. The girls were interviewed twice, at average ages 13.3 [standard deviation (SD)=0.43] and 13.8 (SD=0.43) y, and the date of menarche, if present, was recorded. Associations were assessed using Kaplan-Meier analysis and multivariable-adjusted Cox regression. RESULTS In total, 77% of the girls (n=717) had reached menarche by the second follow-up. The median age of menarche among all girls was 13.0 y (25th-75th percentiles: 12.4-13.7 y). At 10 years of age, median urinary cadmium was 0.25μg/L (5th-95th percentiles: 0.087-0.72μg/L), lead 1.6μg/L (0.70-4.2μg/L), and arsenic 54μg/L (19-395μg/L). Given the same age, girls in the highest quartile of urinary cadmium at 5 and 10 years of age had a lower rate of menarche than girls in the lowest quartile, with an adjusted hazard ratio of (HR) 0.80 (95% CI: 0.62, 1.01) at 5 years of age, and 0.77 (95% CI: 0.60, 0.98) at 10 years of age. This implies that girls in the highest cadmium exposure quartile during childhood had a higher age at menarche. Comparing girls in the highest to the lowest quartile of urinary lead at 10 years of age, the former had a higher rate of menarche [adjusted HR = 1.23 (95% CI: 0.97, 1.56)], implying lower age at menarche, whereas there was no association with urinary lead at 5 years of age. Girls born to mothers in the highest quartile of erythrocyte arsenic during pregnancy were less likely to have attained menarche than girls born to mothers in the lowest quartile [adjusted HR= 0.79 (95% CI: 0.62, 0.99)]. No association was found with girls' urinary arsenic exposure. DISCUSSION Long-term childhood cadmium exposure was associated with later menarche, whereas the associations with child lead exposure were inconclusive. Maternal exposure to arsenic, but not cadmium or lead, was associated with later menarche. https://doi.org/10.1289/EHP11121.
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Affiliation(s)
| | - Anisur Rahman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Anna L.V. Johansson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jesmin Pervin
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Pernilla Svefors
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Shams El Arifeen
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Marie Vahter
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lars-Åke Persson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- London School of Hygiene and Tropical Medicine, London, UK
| | - Maria Kippler
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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9
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Li X, Yu X, Luo K, Liu H, Fan X, Yin X, Zhao Q, Liu X, Yang Y. Exposure to metals and the disruption of sex hormones in 6-19 years old children: An exploration of mixture effects. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 250:114477. [PMID: 36586165 DOI: 10.1016/j.ecoenv.2022.114477] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 12/04/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Individual metals have been linked to sex hormones disruption, but the associations of metals mixture are rarely examined among children. METHODS A total of 1060 participants of 6-19-year-old who participated in the National Health and Nutrition Examination Survey (2013-2016) were included. Eighteen metals were quantified in the whole blood and urine. Sex hormones were measured in serum, including total testosterone (TT), estradiol (E2), and sex hormone binding globulin (SHBG). In addition, free androgen index (FAI) and the ratio of TT to E2 were calculated. Bayesian kernel machine regression and latent class analysis were performed to assess the associations of metals mixture and exposure patterns of metals at varied levels with sex hormones while adjusting for selected covariates. All analyses were conducted by sex-age and sex-puberty groups to explore the potential sex-dimorphic effects. RESULTS Exposure to metals mixture was associated with elevated levels of FAI and E2 among 12-19 years old girls. Moreover, the exposure pattern of metals that was characterized by high levels of blood and urinary cadmium, blood manganese, and urinary cobalt was associated with elevated E2 and reduced TT/E2 levels among girls of 12-19 years old. However, the associations of metals mixture with sex hormones were overall nonsignificant among boys. Nevertheless, metals exposure pattern that was characterized by high levels of blood lead, urinary barium, strontium, and lead but comparatively low levels of the other metals was consistently associated with reduced levels of FAI and E2 but elevated levels of TT/E2 and SHBG among boys of 12-19 years old. CONCLUSION Metals mixture and exposure patterns that were dominated by high levels of certain metals were associated with sex hormones imbalance among 12-19 years old children in a sex-dimorphic pattern, with the identified individual metals that drove the associations of metals mixture varied by sex.
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Affiliation(s)
- Xueyan Li
- Department of Pediatric Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Xiaohan Yu
- Department of Pediatric Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Kai Luo
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Huajian Liu
- Department of Pediatric Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Xu Fan
- Department of Pediatric Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Xiaoming Yin
- Department of Pediatric Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Qi Zhao
- Department of Pediatric Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Xin Liu
- Department of Pediatric Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Yi Yang
- Department of Pediatric Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China.
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Kim C, Zimmerman E, Huerta-Montañez G, Rosario-Pabón ZY, Vélez-Vega CM, Alshawabkeh AN, Cordero JF, Meeker JD, Watkins DJ. Associations between biomarkers of prenatal metals exposure and non-nutritive suck among infants from the PROTECT birth cohort in Puerto Rico. FRONTIERS IN EPIDEMIOLOGY 2022; 2:1057515. [PMID: 38455310 PMCID: PMC10911005 DOI: 10.3389/fepid.2022.1057515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/15/2022] [Indexed: 03/09/2024]
Abstract
Background/Aim Infant non-nutritive suck (NNS) has been used as an early marker of neonatal brain function. Although there is an established relationship between prenatal exposure to certain metals and brain development, the association between metal exposure and NNS has not been explored. Therefore, in this study we assessed associations between maternal urinary metal(loid) concentrations and NNS measurements among infants from the Puerto Rico PROTECT birth cohort. We hypothesized that maternal urinary metal(loid) concentrations are significantly associated with infant NNS measures in a sex-dependent manner. Methods We measured urinary concentrations of 14 metal(loid)s in pregnant women at up to three time points in pregnancy. The geometric mean of each metal(loid) for each pregnant woman was calculated and used as an exposure measurement across gestation. NNS measurements (duration, frequency, amplitude, bursts/min, cycles/burst, cycles/min) were collected from infants between 4 and 6 (±2 weeks) weeks of age using our custom research pacifier. Linear regression was used to estimate associations between urinary metal(loid) concentrations across pregnancy and continuous NNS variables. Sex-specific effects were estimated using interaction terms between NNS variables and infant sex. Results We observed significant positive associations between mercury, manganese, and tin with NNS duration (mercury: %Δ = 1.08, 95% CI: 0.42, 1.74; manganese: %Δ = 0.67, 95% CI: 0.15, 1.20; tin: %Δ = 0.83, 95% CI: 0.17, 1.49) and NNS cycles/burst (mercury: %Δ = 1.85, 95% CI: 0.58, 3.11; manganese: (%Δ = 1.37, 95% CI: 0.40, 2.34; tin: %Δ = 1.68, 95% CI: 0.46, 2.91). Furthermore, the association between NNS cycles/min with cadmium (%Δ = 8.06, 95% CI: 3.33, 12.78), manganese (%Δ = 4.44, 95% CI: 1.40, 7.47), and tin (%Δ = 4.50, 95% CI: 0.81, 8.18) were in the opposite direction from its association with zinc (%Δ = -9.30, 95% CI: -14.71, -3.89), as well as with copper (%Δ = -6.58, 95% CI: -12.06, -1.10). For the sex-stratified analysis, the negative associations between metal(loid)s and NNS duration were predominantly driven by male infants; however, the negative associations between metal(loid)s and NNS bursts/min were mainly driven by female infants. Conclusion We observed significant associations between prenatal metal(loid) exposure and NNS measurements among infants from the ongoing Puerto Rico PROTECT cohort. Similar to previous studies that have demonstrated associations between NNS and subsequent neurodevelopment, this study highlights the potential of NNS as a quantitative index to measure altered neurodevelopment from prenatal metal(loid) exposures. We believe this study will inform future efforts aimed at reducing health risks related to early life metal exposures, such as developing early identification of metal-induced adverse outcomes in child neurodevelopment.
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Affiliation(s)
- Christine Kim
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Emily Zimmerman
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA, United States
| | - Gredia Huerta-Montañez
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, United States
| | - Zaira Y. Rosario-Pabón
- UPR Medical Sciences Campus, University of Puerto Rico Graduate School of Public Health, San Juan, Puerto Rico
| | - Carmen M. Vélez-Vega
- UPR Medical Sciences Campus, University of Puerto Rico Graduate School of Public Health, San Juan, Puerto Rico
| | | | - José F. Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, United States
| | - John D. Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Deborah J. Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
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11
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Rami Y, Ebrahimpour K, Maghami M, Shoshtari-Yeganeh B, Kelishadi R. The Association Between Heavy Metals Exposure and Sex Hormones: a Systematic Review on Current Evidence. Biol Trace Elem Res 2022; 200:3491-3510. [PMID: 34668113 DOI: 10.1007/s12011-021-02947-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
The general population is voluntarily or unintentionally exposed to heavy metals through ingestion of food, polluted water, or contact with soil, dust, or polluted air. A number of metals are considered as endocrine disruptors and can alter the level of reproductive hormones. This study aims to systematically review the epidemiological studies on the association between heavy metals exposure and sex hormones level. We conducted a systematic search from available databases, including PubMed, Clarivate Web of Science, Scopus, Google Scholar, and Cochrane Collaboration, until April 2021. The relevant studies were selected, and two reviewers conducted the quality assessment. Then, data were extracted based on the inclusion criteria. We identified nine articles related to the association between heavy metals exposure and sex hormones level. We summarized the relevant information. Due to the diversity of metals and the variety of sex hormones, the effect of exposure on hormones level was not clear; however in most studies, at least for one metal, a significant association (inverse or positive) was observed between metals exposure and hormones level. Heavy metals exposure may potentially alter sex hormone levels; however, further research is needed to evaluate the impact of this association.
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Affiliation(s)
- Yasaman Rami
- Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Karim Ebrahimpour
- Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahboobeh Maghami
- Department of Bio-Statistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahareh Shoshtari-Yeganeh
- Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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12
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Chai Z, Zhang G, Ling X, Dong T, Wang J, Zhang Y, Zou P, Yang H, Zhou N, Chen Q, Zheng Y, Liu J, Cao J, Ao L. Low-level and combined exposure to environmental metal elements affects male reproductive outcomes: Prospective MARHCS study in population of college students in Chongqing, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 828:154395. [PMID: 35276165 DOI: 10.1016/j.scitotenv.2022.154395] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Male fertility has shown a continuously declining tendency for decades. Over exposure to metal/metalloid elements has been proposed as associated with reproductive impairment. However, the hazard profile remained unclear in general public experiencing low-level and combined metal exposure. METHODS Based on the MARHCS cohort in Chongqing, China, 796 college students were recruited from June 2013 and 666 subjects were followed up next year. At each phase, semen and blood samples were collected for an assessment of semen quality and six sex hormones levels. Eighteen urinary metal/metalloid elements were quantified by ICP-MS as internal exposure biomarkers. Cluster analysis was conducted to characterize reproductive outcomes in the subgroups for different overall estimated exposure levels. Effects of each metal/metalloid element were analyzed using multiple statistical strategies: single-element mixed model, multiple-elements model and self before-after comparison design. RESULTS The urine concentration for 18 metal/metalloid elements was at a typically lower level (far away from the exposure limits) and positively associated with each other. After adjustment of the potential confounders, a decrease of 11.53% (95% CI: -18.61, -3.84%) and 10.84% (95% CI: -17.93, -3.14%) in spermatid morphology was observed in the highest quantile groups of vanadium (V) and nickel (Ni), respectively. Urinary silver (Ag) was dose-dependent associated with an increase in total sperm number (6.91%, 95% CI: 1.14, 13.00%), sperm concentration (16.38%, 95% CI: 5.15, 28.81%) and semen volume (23.73%, 95% CI: 10.46, 38.60%). Further, hormone testosterone presented a significant decrease in subgroup with higher overall estimated exposure and a stable negative association with lithium (Li). The above relationships remained significant across different statistical strategies (all p values <0.05). CONCLUSION Our study provided new evidences that exposure to metal/metalloid elements potentially exert bidirectional influences on semen quality at a relatively low level. And serum testosterone appears as a vulnerable index for metal exposure.
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Affiliation(s)
- Zili Chai
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, China
| | - Guanghui Zhang
- Department of Environmental Health, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, China
| | - Xi Ling
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, China
| | - Tingting Dong
- Department of Environmental Health, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, China
| | - Jingrong Wang
- Tianjin Key Laboratory of Biomaterial Research, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300192, China
| | - Yanqi Zhang
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, China
| | - Peng Zou
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, China
| | - Huan Yang
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, China
| | - Niya Zhou
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, China
| | - Qing Chen
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, China
| | - Yuxin Zheng
- School of Public Health, Qingdao University, Qingdao 266000, China
| | - Jinyi Liu
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, China
| | - Jia Cao
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, China.
| | - Lin Ao
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, China.
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13
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Schoeters G, Verheyen VJ, Colles A, Remy S, Martin LR, Govarts E, Nelen V, Den Hond E, De Decker A, Franken C, Loots I, Coertjens D, Morrens B, Bastiaensen M, Gys C, Malarvannan G, Covaci A, Nawrot T, De Henauw S, Bellemans M, Leermakers M, Van Larebeke N, Baeyens W, Jacobs G, Voorspoels S, Nielsen F, Bruckers L. Internal exposure of Flemish teenagers to environmental pollutants: Results of the Flemish Environment and Health Study 2016-2020 (FLEHS IV). Int J Hyg Environ Health 2022; 242:113972. [PMID: 35453051 DOI: 10.1016/j.ijheh.2022.113972] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/07/2022] [Accepted: 04/09/2022] [Indexed: 12/12/2022]
Abstract
The Flemish Environment and Health Study (FLEHS) collects information on internal exposure to a broad range of environmental chemicals in the general population in Flanders, the Northern region of Belgium. The aim is to establish biomonitoring exposure distributions for the general population in support of public health and environmental policy, environmental risk assessment and risk management decisions. In 2017-2018, urine and blood samples were collected from 428 teenagers by a stratified clustered two stage randomized design. Samples were analyzed for a broad range of biomarkers related to exposure to chlorinated and newer pesticides, brominated and organophosphate flame retardants (BFR/OPFR), polychlorinated biphenyls (PCBs), bisphenols, phthalates and alternative plasticizers, per-and polyfluoroalkyl substances (PFAS), polycyclic aromatic hydrocarbons (PAHs), benzene, metals and trace elements. The geometric mean levels and percentiles of the distribution were estimated for each biomarker, for the whole study population and following stratification for sex, the household educational attainment and the residence area's urbanicity. Geometric means of biomarkers of lead, dichlorodiphenyltrichloroethane (DDT), PCBs, PAHs, regulated phthalates and bisphenol A (BPA) were lower than in the previous FLEHS cycles. Most biomarker levels were below health-based guidance values (HB-GVs). However, HB-GVs of urinary arsenic, blood lead, blood cadmium, sum of serum perfluorooctane sulfonate (PFOS) and perfluoro-1-hexanesulfonate (PFHxS) and the urinary pyrethroid metabolite (3-PBA) were exceeded in respectively 25%, 12%, 39.5%, 10% and 22% of the teenagers. These results suggest that the levels of exposure in the Flemish population to some environmental chemicals might be of concern. At the same time, we noticed that biomarkers for BPA substitutes, metabolites of OPFRs, an expanded list of PFAS, glyphosate and its metabolite could be measured in substantial proportions of participants. Interpretation of these levels in a health-risk context remains uncertain as HB-GVs are lacking. Household educational attainment and residential urbanicity were significant exposure determinants for many biomarkers and could influence specific biomarker levels up to 70% as shown by multiple regression analysis. The research consortium also took care of the broader external communication of results with participants, policy makers, professional groups and civil society organizations. Our study demonstrated that teenagers are exposed to a wide range of chemicals, it demonstrates the success of public policies to reduce exposure but also points to concern and further priorities and needs for follow up.
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Affiliation(s)
- G Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium; Department of Biomedical Sciences, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium.
| | - V J Verheyen
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium; Department of Biomedical Sciences, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - A Colles
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium
| | - S Remy
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium
| | - L Rodriguez Martin
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium
| | - E Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium
| | - V Nelen
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000, Antwerp, Belgium
| | - E Den Hond
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000, Antwerp, Belgium
| | - A De Decker
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000, Antwerp, Belgium
| | - C Franken
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000, Antwerp, Belgium
| | - I Loots
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Sint-Jacobstraat 2, 2000, Antwerp, Belgium
| | - D Coertjens
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Sint-Jacobstraat 2, 2000, Antwerp, Belgium
| | - B Morrens
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Sint-Jacobstraat 2, 2000, Antwerp, Belgium
| | - M Bastiaensen
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - C Gys
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - G Malarvannan
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - A Covaci
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - T Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan building D, 3590, Diepenbeek, Belgium
| | - S De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
| | - M Bellemans
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
| | - M Leermakers
- Analytical, Environmental and Geo- Chemistry, Vrije Universiteit Brussel, Brussels, Belgium
| | - N Van Larebeke
- Analytical, Environmental and Geo- Chemistry, Vrije Universiteit Brussel, Brussels, Belgium
| | - W Baeyens
- Analytical, Environmental and Geo- Chemistry, Vrije Universiteit Brussel, Brussels, Belgium
| | - G Jacobs
- VITO GOAL, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium
| | - S Voorspoels
- VITO GOAL, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium
| | - F Nielsen
- Institute of Public Health, Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - L Bruckers
- BioStat, Data Science Institute, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium
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Xiao L, Yang C, Gu W, Liu R, Chen D. Associations between serum copper, zinc, selenium level and sex hormones among 6-19 years old children and adolescents in NHANES 2013-2016. Front Endocrinol (Lausanne) 2022; 13:924338. [PMID: 36171898 PMCID: PMC9511025 DOI: 10.3389/fendo.2022.924338] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/19/2022] [Indexed: 12/04/2022] Open
Abstract
Copper, zinc, and selenium are essential trace elements for human and have important effects on sex hormones. There are few studies on the relationships between the three trace elements and sex hormones. Therefore, our study aimed to investigate the relationships between serum copper, zinc, selenium and testosterone, estradiol, SHBG using data from the National Health and Nutrition Examination Survey (NHANES) 2013-2016 in participants 6-19 years. 1097 participants were enrolled and stratified into male/female children and adolescents. Weighted linear regression models combined regression diagnosis were used to estimate the relationships between trace elements and sex hormones according to the different stratifications. Our results showed that copper was inversely associated with testosterone and estradiol but positively correlated with SHBG. Zinc had positive relationships with testosterone in male adolescents and female children but an inverse relationship with testosterone in female adolescents. Furthermore, a negative association was observed between zinc and SHBG. With the rise of selenium level, testosterone and estradiol were increased but SHBG was decreased. In general, this study used more standardized statistical methods to investigate the relationships between copper, zinc, selenium and testosterone, estradiol, SHBG. Further study should pay attention to some details in statistical methods.
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Affiliation(s)
- Lishun Xiao
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, China
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, China
- Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, Xuzhou, China
| | - Chengcheng Yang
- The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Wen Gu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Rong Liu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, China
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, China
- Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, Xuzhou, China
- *Correspondence: Rong Liu, ; Ding Chen,
| | - Ding Chen
- School of medical information and engineering, Xuzhou Medical University, Xuzhou, China
- *Correspondence: Rong Liu, ; Ding Chen,
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Vogel N, Murawski A, Schmied-Tobies MIH, Rucic E, Doyle U, Kämpfe A, Höra C, Hildebrand J, Schäfer M, Drexler H, Göen T, Kolossa-Gehring M. Lead, cadmium, mercury, and chromium in urine and blood of children and adolescents in Germany - Human biomonitoring results of the German Environmental Survey 2014-2017 (GerES V). Int J Hyg Environ Health 2021; 237:113822. [PMID: 34454255 DOI: 10.1016/j.ijheh.2021.113822] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/22/2021] [Accepted: 07/27/2021] [Indexed: 02/03/2023]
Abstract
Metals reach humans through food and drinking water intake and inhalation of airborne particles and can have detrimental health effects in particular for children. The metals presented here (lead, cadmium, chromium, and mercury) could lead to toxic effects such as neurotoxicity, mutagenicity, and have been classified as (possible) carcinogens. Using population representative data from the German Environmental Survey 2014-2017 (GerES V) from 3- to 17-year-old children on lead and cadmium in blood (n = 720) and on cadmium, chromium, and mercury in urine (n = 2250) we describe current internal exposure levels, and socio-demographic and substance-specific exposure determinants. Average internal exposure (geometric means) in blood was 9.47 μg/L for lead and below 0.06 μg/L (limit of quantification) for cadmium, and in urine 0.072 μg/L for cadmium, 0.067 μg/L for mercury, and 0.393 μg/L for chromium, respectively. Younger children have higher concentrations of lead and chromium compared to 14-17-year-old adolescents, and boys have slightly higher mercury concentrations than girls. With respect to substance specific determinants, higher lead concentrations emerged in participants with domestic fuel and in non-smoking children with smokers in the household, higher levels of cadmium were associated with smoking and vegetarian diet and higher levels of mercury with the consumption of seafood and amalgam teeth fillings. No specific exposure determinants emerged for chromium. The health based guidance value HBM-I was not exceeded for mercury and for cadmium in urine it was exceeded by 0.6% of the study population. None of the exceedances was related to substantial tobacco smoke exposure. Comparisons to previous GerES cycles (GerES II, 1990-1992; GerES IV, 2003-2006) indicate continuously lower levels.
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Affiliation(s)
- Nina Vogel
- German Environment Agency (UBA); Wörlitzer Platz 1, 06844, Dessau-Roßlau, Germany.
| | - Aline Murawski
- German Environment Agency (UBA); Wörlitzer Platz 1, 06844, Dessau-Roßlau, Germany
| | | | - Enrico Rucic
- German Environment Agency (UBA); Wörlitzer Platz 1, 06844, Dessau-Roßlau, Germany
| | - Ulrike Doyle
- German Environment Agency (UBA); Wörlitzer Platz 1, 06844, Dessau-Roßlau, Germany
| | - Alexander Kämpfe
- German Environment Agency (UBA); Wörlitzer Platz 1, 06844, Dessau-Roßlau, Germany
| | - Christian Höra
- German Environment Agency (UBA); Wörlitzer Platz 1, 06844, Dessau-Roßlau, Germany
| | - Jörg Hildebrand
- IPASUM - Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine; Henkestrasse 9-11, 91054, Erlangen, Germany
| | - Moritz Schäfer
- IPASUM - Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine; Henkestrasse 9-11, 91054, Erlangen, Germany
| | - Hans Drexler
- IPASUM - Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine; Henkestrasse 9-11, 91054, Erlangen, Germany
| | - Thomas Göen
- IPASUM - Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine; Henkestrasse 9-11, 91054, Erlangen, Germany
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16
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Zheng J, Li M, Tang B, Luo W, Ma Y, Ren M, Yu Y, Luo X, Mai B. Levels, Spatial Distribution, and Impact Factors of Heavy Metals in the Hair of Metropolitan Residents in China and Human Health Implications. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:10578-10588. [PMID: 34296597 DOI: 10.1021/acs.est.1c02001] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Chronic exposure to low levels of heavy metals threatens human health. However, few studies evaluated the health effects and spatial distributions of chronic exposure to heavy metals in metropolitan residents throughout mainland China using unified sampling methods and evaluation indicators at the national level. Here, the concentrations and spatial distributions of heavy metals (As, Cd, Cr, Sb, Pb, and Hg) in the hair of 1202 metropolitan residents from mainland China were analyzed, and differences in age and sex were evaluated. Most target metals exhibited higher concentrations in the hair of residents from South Central China. Generally, male hair had higher As and Se concentrations, whereas female hair had higher Cd and Pb levels (p < 0.05). A significant pairwise correlation existed between most metals in hair, especially Cd-Pb (r = 0.638, p < 0.05). The Se/heavy metal molar ratio is used as an indicator to assess the detoxification ability. The results demonstrated that protecting metropolitan residents in South Central China from heavy metals in their daily life is crucial, particularly for Hg, Pb, and Cr with Se/(Hg, Pb, or Cr) molar ratios < 1. This is the first study to comprehensively consider the antagonistic effects of Se and heavy metals using the molar ratio of Se/heavy metals to evaluate health implications and propose health management policies for metropolitan residents in China.
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Affiliation(s)
- Jing Zheng
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, Ministry of Ecology and Environment, South China Institute of Environmental Sciences, Guangzhou 510655, P. R. China
| | - Min Li
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, Ministry of Ecology and Environment, South China Institute of Environmental Sciences, Guangzhou 510655, P. R. China
- State Key Laboratory of Organic Geochemistry and Guangdong Key Laboratory of Environmental Resources Utilization and Protection, Chinese Academy of Sciences, Guangzhou Institute of Geochemistry, Guangzhou 510640, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Bin Tang
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, Ministry of Ecology and Environment, South China Institute of Environmental Sciences, Guangzhou 510655, P. R. China
| | - Weikeng Luo
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, Ministry of Ecology and Environment, South China Institute of Environmental Sciences, Guangzhou 510655, P. R. China
| | - Yan Ma
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, Ministry of Ecology and Environment, South China Institute of Environmental Sciences, Guangzhou 510655, P. R. China
| | - Mingzhong Ren
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, Ministry of Ecology and Environment, South China Institute of Environmental Sciences, Guangzhou 510655, P. R. China
| | - Yunjiang Yu
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, Ministry of Ecology and Environment, South China Institute of Environmental Sciences, Guangzhou 510655, P. R. China
| | - Xiaojun Luo
- State Key Laboratory of Organic Geochemistry and Guangdong Key Laboratory of Environmental Resources Utilization and Protection, Chinese Academy of Sciences, Guangzhou Institute of Geochemistry, Guangzhou 510640, P. R. China
- Guangdong-Hong Kong-Macao Joint Laboratory for Environmental Pollution and Control, Chinese Academy of Sciences, Guangzhou Institute of Geochemistry, Guangzhou 510640, P. R. China
| | - Bixian Mai
- State Key Laboratory of Organic Geochemistry and Guangdong Key Laboratory of Environmental Resources Utilization and Protection, Chinese Academy of Sciences, Guangzhou Institute of Geochemistry, Guangzhou 510640, P. R. China
- Guangdong-Hong Kong-Macao Joint Laboratory for Environmental Pollution and Control, Chinese Academy of Sciences, Guangzhou Institute of Geochemistry, Guangzhou 510640, P. R. China
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17
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Dominguez S, Lencinas I, Bartos M, Gallegos C, Bras C, Mónaco N, Minetti A, Gumilar F. Neurobehavioral and neurochemical effects in rats offspring co-exposed to arsenic and fluoride during development. Neurotoxicology 2021; 84:30-40. [PMID: 33609566 DOI: 10.1016/j.neuro.2021.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/11/2021] [Accepted: 02/14/2021] [Indexed: 11/29/2022]
Abstract
Arsenic (iAs) and fluoride (F) are ubiquitous in the environment. All over the world, in many countries, thousands of people are suffering from the toxic effects of arsenicals ad fluorides. These two elements are recognized worldwide as the most serious inorganic contaminants in drinking water. When two different types of toxicants are simultaneously going inside the human body they may function independently or can act as synergistic or antagonistic to one another. Although there have been reports in literature of individual toxicity of iAs and F, however, not much is known about the effects following the combined exposure to the toxicants above mentioned. In this work, we investigated the effect of the co-exposure to low levels of iAs/F through drinking water during pregnancy and lactation on central nervous system functionality in the exposed rats offspring. Wistar rats were exposed to one of these solutions: 0.05 mg/L iAs and 5 mg/L F (Concentration A) or 0.10 mg/L iAs and 10 mg/L F (Concentration B) from gestational day 0 up to post-gestational day 21. Sensory-motor reflexes a Functional Observational Battery and the locomotor activity in an open field were assessed in offspring. Additionally, the transaminases, acethylcholinesterase and catalase levels in the striatum were determined to elucidate the possible molecular mechanisms involved in locomotor and neurobehavioral disorders. The results showed that iAs/F exposition during development produces a delay reach the maturity of sensorimotor reflexes. A decrease in the nociceptive reflex response, and increase in the locomotor activity in adult rats offspring were observed. The increase in oxidative stress, the inhibition of transaminases enzymes and the inhibition of AChE in the striatum may partially regulate all the neurobehavioral disorders observed.
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Affiliation(s)
- Sergio Dominguez
- Laboratorio de Toxicología, Instituto de Investigaciones Biológicas y Biomédicas del Sur (INBIOSUR), Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Depto. de Biología, Bioquímica y Farmacia, San Juan 670, 8000, Bahía Blanca, Argentina
| | - Ileana Lencinas
- Laboratorio de Toxicología, Instituto de Investigaciones Biológicas y Biomédicas del Sur (INBIOSUR), Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Depto. de Biología, Bioquímica y Farmacia, San Juan 670, 8000, Bahía Blanca, Argentina
| | - Mariana Bartos
- Laboratorio de Toxicología, Instituto de Investigaciones Biológicas y Biomédicas del Sur (INBIOSUR), Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Depto. de Biología, Bioquímica y Farmacia, San Juan 670, 8000, Bahía Blanca, Argentina
| | - Cristina Gallegos
- Laboratorio de Toxicología, Instituto de Investigaciones Biológicas y Biomédicas del Sur (INBIOSUR), Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Depto. de Biología, Bioquímica y Farmacia, San Juan 670, 8000, Bahía Blanca, Argentina
| | - Cristina Bras
- Laboratorio de Toxicología, Instituto de Investigaciones Biológicas y Biomédicas del Sur (INBIOSUR), Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Depto. de Biología, Bioquímica y Farmacia, San Juan 670, 8000, Bahía Blanca, Argentina
| | - Nina Mónaco
- Laboratorio de Toxicología, Instituto de Investigaciones Biológicas y Biomédicas del Sur (INBIOSUR), Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Depto. de Biología, Bioquímica y Farmacia, San Juan 670, 8000, Bahía Blanca, Argentina
| | - Alejandra Minetti
- Laboratorio de Toxicología, Instituto de Investigaciones Biológicas y Biomédicas del Sur (INBIOSUR), Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Depto. de Biología, Bioquímica y Farmacia, San Juan 670, 8000, Bahía Blanca, Argentina
| | - Fernanda Gumilar
- Laboratorio de Toxicología, Instituto de Investigaciones Biológicas y Biomédicas del Sur (INBIOSUR), Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Depto. de Biología, Bioquímica y Farmacia, San Juan 670, 8000, Bahía Blanca, Argentina.
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18
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Koppen G, Franken C, Den Hond E, Plusquin M, Reimann B, Leermakers M, Covaci A, Nawrot T, Van Larebeke N, Schoeters G, Bruckers L, Govarts E. Pooled analysis of genotoxicity markers in relation to exposure in the Flemish Environment and Health Studies (FLEHS) between 1999 and 2018. ENVIRONMENTAL RESEARCH 2020; 190:110002. [PMID: 32745535 DOI: 10.1016/j.envres.2020.110002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 07/18/2020] [Accepted: 07/25/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The Flemish Environment and Health Studies (FLEHS) are human biomonitoring surveys running in Flanders since 1999. Additionally to biomarkers of exposure, markers of genotoxicity and oxidative stress have been measured, including the alkaline comet and micronucleus assay in peripheral whole blood cells, and urinary concentrations of 8-oxo-2'-deoxyguanosine (8-oxodG). AIM Exposure-effect associations were explored in a pooled dataset of nine different cross-sectional FLEHS surveys. Data of adolescents collected in a time frame of about 20 years (1999-2018) were compiled. The aim of the study was to examine whether increased variation in exposure, lifestyle and environmental factors would lead to more powerful and robust exposure-effect associations. MATERIALS & METHODS The biomarkers were measured in 2283 adolescents in the age range of 14-18 years. Exposure to polycyclic aromatic hydrocarbons [1-hydroxypyrene (1-OHP)], benzene (tt'-muconic acid), metals (arsenic, cadmium, copper, nickel, thallium, lead, chromium), persistent organochlorines and phthalates were assessed in blood or urine. Furthermore, outdoor air levels of particulate matter (PM10 and PM2.5) at the residences of the youngsters were calculated. Pooled statistical analysis was done using mixed models. Study-specific differences in the genotoxicity markers and in the strength/direction of the association were accounted for. This was done by incorporating the random factor 'study' and a random study slope (if possible). The exposure markers were centered around the study-specific mean in order to correct for protocol changes over time. RESULTS A significant association was observed for the urinary oxidative stress marker 8-oxodG, which was positively associated with 1-OHP (5% increase for doubling of 1-OHP levels, p = 0.001), and with urinary copper (26% increase for doubling of copper levels, p = 0.001), a metal involved in the Fenton reaction in biological systems. 8-oxodG was also associated with the sum of the metabolites of the phthalate di(2-ethylhexyl) phthalate (DEHP) (3% increase for doubling of the DEHP levels, p = 0.02). For those associations, data pooling increased the statistical power. However, some of the associations in the individual surveys, were not confirmed in the pooled analysis (such as comet assay and 8-oxodG vs. atmospheric PM; and 8-oxodG vs. urinary nickel). This may be due to inconsistencies in exposure-effect relations and/or variations in the pollutant mix over time and regions. CONCLUSION Pooled analysis including a large population of 2283 Flemish adolescents showed that 8-oxodG, a marker of oxidative DNA damage is a valuable marker to assess impact of daily life pollutants, such as PAHs, Cu and the phthalate DEHP.
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Affiliation(s)
- G Koppen
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium.
| | - C Franken
- Provincial Institute of Hygiene (PIH), Antwerp, Belgium.
| | - E Den Hond
- Provincial Institute of Hygiene (PIH), Antwerp, Belgium.
| | - M Plusquin
- Center for Environment and Health, University Hasselt, Agoralaan, Diepenbeek, Belgium.
| | - B Reimann
- Center for Environment and Health, University Hasselt, Agoralaan, Diepenbeek, Belgium.
| | - M Leermakers
- Analytical, Environmental and Geo- Chemistry, Free University Brussels, Belgium.
| | - A Covaci
- Toxicological Center, University of Antwerp, Belgium.
| | - T Nawrot
- Center for Environment and Health, University Hasselt, Agoralaan, Diepenbeek, Belgium.
| | - N Van Larebeke
- Analytical, Environmental and Geo- Chemistry, Free University Brussels, Belgium.
| | - G Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium; Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Belgium; University of Southern Denmark, Institute of Public Health/ Department of Environmental Medicine, Odense, Denmark.
| | - L Bruckers
- Center for Statistics, University Hasselt, Agoralaan, Diepenbeek, Belgium.
| | - E Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium.
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19
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Legler J, Zalko D, Jourdan F, Jacobs M, Fromenty B, Balaguer P, Bourguet W, Munic Kos V, Nadal A, Beausoleil C, Cristobal S, Remy S, Ermler S, Margiotta-Casaluci L, Griffin JL, Blumberg B, Chesné C, Hoffmann S, Andersson PL, Kamstra JH. The GOLIATH Project: Towards an Internationally Harmonised Approach for Testing Metabolism Disrupting Compounds. Int J Mol Sci 2020; 21:E3480. [PMID: 32423144 PMCID: PMC7279023 DOI: 10.3390/ijms21103480] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/29/2020] [Accepted: 05/08/2020] [Indexed: 12/13/2022] Open
Abstract
The purpose of this project report is to introduce the European "GOLIATH" project, a new research project which addresses one of the most urgent regulatory needs in the testing of endocrine-disrupting chemicals (EDCs), namely the lack of methods for testing EDCs that disrupt metabolism and metabolic functions. These chemicals collectively referred to as "metabolism disrupting compounds" (MDCs) are natural and anthropogenic chemicals that can promote metabolic changes that can ultimately result in obesity, diabetes, and/or fatty liver in humans. This project report introduces the main approaches of the project and provides a focused review of the evidence of metabolic disruption for selected EDCs. GOLIATH will generate the world's first integrated approach to testing and assessment (IATA) specifically tailored to MDCs. GOLIATH will focus on the main cellular targets of metabolic disruption-hepatocytes, pancreatic endocrine cells, myocytes and adipocytes-and using an adverse outcome pathway (AOP) framework will provide key information on MDC-related mode of action by incorporating multi-omic analyses and translating results from in silico, in vitro, and in vivo models and assays to adverse metabolic health outcomes in humans at real-life exposures. Given the importance of international acceptance of the developed test methods for regulatory use, GOLIATH will link with ongoing initiatives of the Organisation for Economic Development (OECD) for test method (pre-)validation, IATA, and AOP development.
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Affiliation(s)
- Juliette Legler
- Institute for Risk Assessment Sciences, Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, 3508 TD Utrecht, The Netherlands;
| | - Daniel Zalko
- INRAE Toxalim (Research Centre in Food Toxicology), Metabolism and Xenobiotics (MeX) Team, Université de Toulouse, INRAE, ENVT, INP-Purpan, UPS, 31027 Toulouse, France; (D.Z.); (F.J.)
| | - Fabien Jourdan
- INRAE Toxalim (Research Centre in Food Toxicology), Metabolism and Xenobiotics (MeX) Team, Université de Toulouse, INRAE, ENVT, INP-Purpan, UPS, 31027 Toulouse, France; (D.Z.); (F.J.)
| | - Miriam Jacobs
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton OXON. OX11 0RQ, UK;
| | - Bernard Fromenty
- Institut NUMECAN (Nutrition Metabolisms and Cancer) INSERM UMR_A 1341, UMR_S 1241, Université de Rennes, F-35000 Rennes, France;
| | - Patrick Balaguer
- Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM U1194, ICM, Université de Montpellier, 34298 Montpellier, France;
| | - William Bourguet
- Center for Structural Biochemistry (CBS), INSERM, CNRS, Université de Montpellier, 34090 Montpellier, France;
| | - Vesna Munic Kos
- Department of Physiology and Pharmacology, Karolinska Institutet, 17177 Stockholm, Sweden;
| | - Angel Nadal
- IDiBE and CIBERDEM, Universitas Miguel Hernandez, 03202 Elche (Alicante), Spain;
| | - Claire Beausoleil
- ANSES, Direction de l’Evaluation des Risques, Agence Nationale de Sécurité Sanitaire de l’Alimentation, de l’Environnement et du Travail, 14 rue Pierre et Marie Curie, 94701 Maisons-Alfort CEDEX, France;
| | - Susana Cristobal
- Department of Biomedical and Clinical Sciences (BKV), Cell Biology, Medical Faculty, Linköping University, SE-581 85 Linköping, Sweden;
| | - Sylvie Remy
- Sustainable Health, Flemish Institute for Technological Research, VITO, 2400 Mol, Belgium;
| | - Sibylle Ermler
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK; (S.E.); (L.M.-C.)
| | - Luigi Margiotta-Casaluci
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK; (S.E.); (L.M.-C.)
| | - Julian L. Griffin
- Section of Biomolecular Medicine, Division of Systems Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, South Kensington, London SW7 2AZ, UK;
| | - Bruce Blumberg
- Department of Developmental and Cell Biology, University of California Irvine, 2011 BioSci 3, University of California, Irvine, CA 92697-2300, USA;
| | - Christophe Chesné
- Biopredic International, Parc d’Activité de la Bretèche Bâtiment A4, 35760 Saint Grégoire, France;
| | | | | | - Jorke H. Kamstra
- Institute for Risk Assessment Sciences, Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, 3508 TD Utrecht, The Netherlands;
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20
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Ren J, Cui J, Chen Q, Zhou N, Zhou Z, Zhang GH, Wu W, Yang H, Cao J. Low-level lead exposure is associated with aberrant sperm quality and reproductive hormone levels in Chinese male individuals: Results from the MARHCS study low-level lead exposure is associated with aberrant sperm quality. CHEMOSPHERE 2020; 244:125402. [PMID: 31809925 DOI: 10.1016/j.chemosphere.2019.125402] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/09/2019] [Accepted: 11/17/2019] [Indexed: 06/10/2023]
Abstract
Studies in animals suggest an adverse effect of high-level lead exposure on male reproductive outcomes. However, evidence of the effects of low-level lead exposure is inconsistent. The purpose of our study was to explore the relationship between low-level lead exposure from daily environmental contaminants and semen quality in a community population without occupational exposure. We recruited 751 students in the Male Reproductive Health in Chongqing College Students (MARHCS) study and 190 community males from Bishan, Chongqing. Eight urinary metals (Pb, Cd, As, Cu, Zn, Ni, Mn, and Cr), semen quality, and serum sex hormones were detected. Even if the blood lead concentration was below the US lead poisoning standard for children (100 μg/L), a significant dose-response relationship was found between lead exposure and a decrease in semen quality. Multilinear regression showed that urinary Pb was negatively associated with sperm concentration, total sperm count, progressive motility and total sperm motility (regression coefficient: -0.074, -0.103, -0.024, and -0.014, respectively; p: <0.001, <0.001, 0.007, and <0.001, respectively), accompanied by decreased serum follicle-stimulating hormone, serum testosterone and the testosterone/luteinizing hormone ratio (β coefficient: -0.090, -0.082, and -0.020, respectively; p: 0.002, <0.001, and 0.021, respectively). Logistic regression also indicated that the risk of having abnormal semen quality was higher in the high Pb group (OR: 2.501, 95% CI: 1.411, 4.435, p = 0.002) than in the low Pb group after adjusting for confounders, with a dose-response relationship in the trend test (p = 0.007). Our results revealed an inverse association between Pb exposure at low levels and semen quality.
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Affiliation(s)
- Jingchao Ren
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, 453003, China
| | - Junpeng Cui
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, 453003, China
| | - Qing Chen
- Institute of Toxicology, College of Preventive Medicine, Army Medical University, Chongqing, China
| | - Niya Zhou
- Institute of Toxicology, College of Preventive Medicine, Army Medical University, Chongqing, China
| | - Ziyuan Zhou
- Institute of Toxicology, College of Preventive Medicine, Army Medical University, Chongqing, China
| | - Guang-Hui Zhang
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, 453003, China
| | - Weidong Wu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, 453003, China
| | - Huan Yang
- Institute of Toxicology, College of Preventive Medicine, Army Medical University, Chongqing, China.
| | - Jia Cao
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, 453003, China; Institute of Toxicology, College of Preventive Medicine, Army Medical University, Chongqing, China.
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21
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A Comparison of the Nephrotoxicity of Low Doses of Cadmium and Lead. TOXICS 2020; 8:toxics8010018. [PMID: 32131418 PMCID: PMC7151741 DOI: 10.3390/toxics8010018] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/06/2020] [Accepted: 02/25/2020] [Indexed: 11/29/2022]
Abstract
Environmental exposure to moderate-to-high levels of cadmium (Cd) and lead (Pb) is associated with nephrotoxicity. In comparison, the health impacts of chronic low-level exposure to Cd and Pb remain controversial. The aim of this study was to therefore evaluate kidney dysfunction associated with chronic low-level exposure to Cd and Pb in a population of residents in Bangkok, Thailand. The mean age and the estimated glomerular filtration rate (eGFR) for 392 participants (195 men and 197 women) were 34.9 years and 104 mL/min/1.73 m2, respectively, while the geometric mean concentrations of urinary Cd and Pb were 0.25 μg/L (0.45 μg/g of creatinine) and 0.89 μg/L (1.52 μg/g of creatinine), respectively. In a multivariable regression analysis, the eGFR varied inversely with blood urea nitrogen in both men (β = −0.125, p = 0.044) and women (β = −0.170, p = 0.008), while inverse associations of the eGFR with urinary Cd (β = −0.132, p = 0.043) and urinary Pb (β = −0.130, p = 0.044) were seen only in women. An increased urinary level of Cd to the median level of 0.38 μg/L (0.44 μg/g of creatinine) was associated with a decrease in the eGFR by 4.94 mL/min/1.73 m2 (p = 0.011). The prevalence odds of a reduced eGFR rose 2.5-, 2.9- and 2.3-fold in the urinary Cd quartile 3 (p = 0.013), the urinary Cd quartile 4 (p = 0.008), and the urinary Pb quartile 4 (p = 0.039), respectively. This study suggests that chronic exposure to low-level Cd is associated with a decline in kidney function and that women may be more susceptible than men to nephrotoxicity due to an elevated intake of Cd and Pb.
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Ashrap P, Sánchez BN, Téllez-Rojo MM, Basu N, Tamayo-Ortiz M, Peterson KE, Meeker JD, Watkins DJ. In utero and peripubertal metals exposure in relation to reproductive hormones and sexual maturation and progression among girls in Mexico City. ENVIRONMENTAL RESEARCH 2019; 177:108630. [PMID: 31421446 PMCID: PMC6734930 DOI: 10.1016/j.envres.2019.108630] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 07/23/2019] [Accepted: 08/04/2019] [Indexed: 05/08/2023]
Abstract
There is increasing evidence that several metals are endocrine disrupting chemicals (EDCs). In utero development and adolescence are critical windows of susceptibility to EDC exposure. With the exception of a few heavy metals, few human studies have evaluated the impact of metal exposure on pubertal development. Our aim was to investigate measures of in utero and peripubertal metal exposure in relation to reproductive hormone levels and sexual maturation and progression among girls from the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) cohorts. We measured urinary concentrations of aluminum (Al), arsenic (As), barium (Ba), cadmium (Cd), cobalt (Co), copper (Cu), iron (Fe), manganese (Mn), molybdenum (Mo), nickel (Ni), antimony (Sb), selenium (Se), and zinc (Zn) in samples collected from women during their third trimester of pregnancy and from their female children at 8-13 years (n = 132). We measured serum testosterone, estradiol, dehydroepiandrosterone sulfate (DHEA-S), inhibin B, and sex hormone-binding globulin (SHBG) at age 8-13, and assessed Tanner stages for sexual maturation (breast, pubic hair development, and menarche status), at two time points (8-13, 14-18 years). We used linear regression to independently examine in utero and peripubertal metal concentrations as predictors of peripubertal hormones. In a longitudinal analysis using generalized estimation equations, we evaluated Tanner stage and menarche progression in relation to individual in utero and peripubertal metal concentrations. We found that higher in utero Zn was associated with increased inhibin B. Several metals at 8-13 years were associated with higher DHEA-S and estradiol, while Ni was positively but Cu was negatively associated with testosterone. In utero Ni, Al, and Cd were associated with slower progression of breast development after adjustment for child age and BMI z-score. For example, an IQR increase in in utero Al exposure was associated with 0.82 times lower odds of progressing to a higher Tanner stage for breast development per year (95% CI: 0.68, 0.99). Peripubertal concentrations of Ba and Al were also associated with being at a higher pubic hair Tanner stage and menarche at 8-13, but lower odds of progressing to the next stage at 14-18 years. We used Bayesian kernel machine regression (BKMR) to model the joint effect of multiple metals while accounting for correlated exposures, as well as potential non-linear relationships between metals and outcomes of interest, which yielded results similar to individual analyses. These findings suggest that female reproductive development may be vulnerable to the effects of metal exposure, and using both Tanner stages and hormone levels may provide clues about underlying mechanisms in two sensitive periods of development.
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Affiliation(s)
- Pahriya Ashrap
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Brisa N Sánchez
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Niladri Basu
- Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Quebec, Canada
| | - Marcela Tamayo-Ortiz
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico; Mexican Council for Science and Technology, Mexico City, Mexico
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Deborah J Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States.
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Jiang F, Zhi X, Xu M, Li B, Zhang Z. Gender-specific differences of interaction between cadmium exposure and obesity on prediabetes in the NHANES 2007-2012 population. Endocrine 2018; 61:258-266. [PMID: 29846900 DOI: 10.1007/s12020-018-1623-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 04/30/2018] [Indexed: 12/29/2022]
Abstract
PURPOSE Data from National Health and Nutrition Examination Survey (NHANES) for the years 2007-2012 were used to evaluate the interactions of cadmium (Cd) exposure with being overweight/obesity on the risk of prediabetes among adults 20 years older. METHODS A total of 3552 subjects were included in the analysis. Urinary cadmium levels (UCd) was used as a biomarker for long-term exposure to Cd. Additive interaction was estimated using relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (S). RESULTS Following covariates adjustments, we found significant associations of UCd with higher prediabetes prevalence, and this association was more apparent in males (Q4 vs Q1: OR = 1.95, 95%CI: 1.34-2.84); while overweight/obesity was associated with prediabetes both in males and in females. Additionally, there was a significant interaction between Cd exposure and being overweight/obesity on prediabetes risk among males (RERI = 1.18, 95% CI: 0.42-1.93; AP = 0.35, 95% CI: 0.12-0.58; S = 2.00, 95% CI: 0.92-4.34). CONCLUSIONS Our results suggest that being overweight/obesity may substantially amplify the adverse effects of long-term cadmium exposure on prediabetes risk, and this interaction is more severe in male adults. Further studies are needed to confirm these findings.
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Affiliation(s)
- Fei Jiang
- Department of Occupational and Environmental Health, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Xueyuan Zhi
- Department of Occupational and Environmental Health, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Miao Xu
- Department of Occupational and Environmental Health, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Bingyan Li
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Zengli Zhang
- Department of Occupational and Environmental Health, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China.
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Dickerson AS, Rotem RS, Christian MA, Nguyen VT, Specht AJ. Potential Sex Differences Relative to Autism Spectrum Disorder and Metals. Curr Environ Health Rep 2018; 4:405-414. [PMID: 28988324 DOI: 10.1007/s40572-017-0164-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PURPOSE OF REVIEW This study aims to summarize the current body of literature on the relationship between various toxic metals exposures (i.e., aluminum, antimony, arsenic, beryllium, cadmium, chromium, lead, manganese, and nickel) and autism spectrum disorder (ASD), with a focus on potential sex differences in these associations. RECENT FINDINGS Sex differences in ASD diagnosis and mutagenic effects of toxic exposures indicate that sex differences may play a major part in the causal relationship of any potential associations seen; however, we were only able to find three studies that reported on sex differences in observed associations with toxic metals exposure and ASD. We also found several studies investigating associations between ASD and metals exposures, including 11 on aluminum, 6 on antimony, 15 on arsenic, 5 on beryllium, 17 on cadmium, 11 on chromium, 25 on lead, 14 on manganese, and 13 on nickel with markers of exposure in hair, urine, blood, teeth, fingernails, and air pollution. Results for each metal were conflicting, but studies on cadmium and lead yielded the highest proportion of studies with positive results (72% and 36%, respectively). Based on our examination of existing literature, the current evidence warrants a considerable need for evaluations of sex differences in future studies assessing the association between metals exposures and ASD. Additionally, failure to account for potential sex differences could result in bias and misinterpretation of exposure-disease relationships.
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Affiliation(s)
- Aisha S Dickerson
- Departments of Epidemiology and Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02215, USA. .,Environmental and Occupation Medicine and Epidemiology Division of the Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Street, Landmark Center L3-125, Boston, MA, USA.
| | - Ran S Rotem
- Department Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02215, USA
| | - MacKinsey A Christian
- Division of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, and Center for Clinical and Translational Sciences (CCTS), University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Vy T Nguyen
- Department Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02215, USA
| | - Aaron J Specht
- Department Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02215, USA
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