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Jiang H, Zhang S, Lin Y, Meng L, Li J, Wang W, Yang K, Jin M, Wang J, Tang M, Chen K. Roles of serum uric acid on the association between arsenic exposure and incident metabolic syndrome in an older Chinese population. J Environ Sci (China) 2025; 147:332-341. [PMID: 39003051 DOI: 10.1016/j.jes.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 07/15/2024]
Abstract
Growing evidences showed that heavy metals exposure may be associated with metabolic diseases. Nevertheless, the mechanism underlying arsenic (As) exposure and metabolic syndrome (MetS) risk has not been fully elucidated. So we aimed to prospectively investigate the role of serum uric acid (SUA) on the association between blood As exposure and incident MetS. A sample of 1045 older participants in a community in China was analyzed. We determined As at baseline and SUA concentration at follow-up in the Yiwu Elderly Cohort. MetS events were defined according to the criteria of the International Diabetes Federation (IDF). Generalized linear model with log-binominal regression model was applied to estimate the association of As with incident MetS. To investigate the role of SUA in the association between As and MetS, a mediation analysis was conducted. In the fully adjusted log-binominal model, per interquartile range increment of As, the risk of MetS increased 1.25-fold. Compared with the lowest quartile of As, the adjusted relative risk (RR) of MetS in the highest quartile was 1.42 (95% confidence interval, CI: 1.03, 2.00). Additionally, blood As was positively associated with SUA, while SUA had significant association with MetS risk. Further mediation analysis demonstrated that the association of As and MetS risk was mediated by SUA, with the proportion of 15.7%. Our study found higher As was remarkably associated with the elevated risk of MetS in the Chinese older adults population. Mediation analysis indicated that SUA might be a mediator in the association between As exposure and MetS.
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Affiliation(s)
- Haiyan Jiang
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Simei Zhang
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Yaoyao Lin
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Lin Meng
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Jiayi Li
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Wenqing Wang
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Kaixuan Yang
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Mingjuan Jin
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Jianbing Wang
- Department of Public Health, National Clinical Research Center for Child Health of Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Mengling Tang
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China.
| | - Kun Chen
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China.
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Fontes A, Jauch AT, Sailer J, Engler J, Azul AM, Zischka H. Metabolic Derangement of Essential Transition Metals and Potential Antioxidant Therapies. Int J Mol Sci 2024; 25:7880. [PMID: 39063122 PMCID: PMC11277342 DOI: 10.3390/ijms25147880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 07/08/2024] [Accepted: 07/13/2024] [Indexed: 07/28/2024] Open
Abstract
Essential transition metals have key roles in oxygen transport, neurotransmitter synthesis, nucleic acid repair, cellular structure maintenance and stability, oxidative phosphorylation, and metabolism. The balance between metal deficiency and excess is typically ensured by several extracellular and intracellular mechanisms involved in uptake, distribution, and excretion. However, provoked by either intrinsic or extrinsic factors, excess iron, zinc, copper, or manganese can lead to cellular damage upon chronic or acute exposure, frequently attributed to oxidative stress. Intracellularly, mitochondria are the organelles that require the tightest control concerning reactive oxygen species production, which inevitably leaves them to be one of the most vulnerable targets of metal toxicity. Current therapies to counteract metal overload are focused on chelators, which often cause secondary effects decreasing patients' quality of life. New therapeutic options based on synthetic or natural antioxidants have proven positive effects against metal intoxication. In this review, we briefly address the cellular metabolism of transition metals, consequences of their overload, and current therapies, followed by their potential role in inducing oxidative stress and remedies thereof.
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Affiliation(s)
- Adriana Fontes
- Institute of Molecular Toxicology and Pharmacology, Helmholtz Center Munich, German Research Center for Environmental Health, D-85764 Neuherberg, Germany;
- CNC-Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- CIBB-Center for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
| | - Adrian T. Jauch
- School of Medicine and Health, Institute of Toxicology and Environmental Hygiene, Technical University Munich, D-80802 Munich, Germany
| | - Judith Sailer
- School of Medicine and Health, Institute of Toxicology and Environmental Hygiene, Technical University Munich, D-80802 Munich, Germany
| | - Jonas Engler
- School of Medicine and Health, Institute of Toxicology and Environmental Hygiene, Technical University Munich, D-80802 Munich, Germany
| | - Anabela Marisa Azul
- CNC-Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- CIBB-Center for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
- IIIUC-Institute for Interdisciplinary Research, University of Coimbra, 3030-789 Coimbra, Portugal
| | - Hans Zischka
- Institute of Molecular Toxicology and Pharmacology, Helmholtz Center Munich, German Research Center for Environmental Health, D-85764 Neuherberg, Germany;
- School of Medicine and Health, Institute of Toxicology and Environmental Hygiene, Technical University Munich, D-80802 Munich, Germany
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Zhong J, Yang T, Wang Z, Zhang Y, Shen Y, Hu Y, Hong F. Associations between individual and mixed urinary metal exposure and dyslipidemia among Chinese adults: Data from the China Multi-Ethnic Cohort Study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 282:116696. [PMID: 38986334 DOI: 10.1016/j.ecoenv.2024.116696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 07/03/2024] [Accepted: 07/04/2024] [Indexed: 07/12/2024]
Abstract
The prevalence of dyslipidemia is increasing, and it has become a significant global public health concern. Some studies have demonstrated contradictory relationships between urinary metals and dyslipidemia, and the combined effects of mixed urinary metal exposure on dyslipidemia remain ambiguous. In this study, we examined how individual and combined urinary metal exposure are associated with the occurrence of dyslipidemia. According to the data from the 2018-2019 baseline survey database of the China Multi-Ethnic Cohort (CMEC) Study, a population of 9348 individuals was studied. Inductively coupled plasmamass spectrometry (ICP-MS) was used to measure 21 urinary metal concentrations in the collected adult urinary samples. The associations between urinary metals and dyslipidemia were analyzed by logistic regression, weighted quantile sum regression (WQS), and quantile-based g-computation (qgcomp), controlled for potential confounders to examine single and combined effects. Dyslipidemia was detected in 3231 individuals, which represented approximately 34.6 % of the total population. According to the single-exposure model, Al and Na were inversely associated with the risk of dyslipidemia (OR = 0.95, 95 % CI: 0.93, 0.98; OR = 0.89, 95 % CI: 0.83, 0.95, respectively), whereas Zn, Ca, and P were positively associated (OR = 1.69, 95 % CI: 1.42, 2.01; OR = 1.12, 95 % CI: 1.06, 1.18; OR = 1.21, 95 % CI: 1.09, 1.34, respectively). Moreover, Zn and P were significantly positively associated even after adjusting for these metals, whereas Al and Cr were negatively associated with the risk of dyslipidemia. The results of the WQS and qgcomp analyses showed that urinary metal mixtures were positively associated with the risk of dyslipidemia (OR = 1.26, 95 % CI: 1.15, 1.38; OR = 1.09, 95 % CI: 1.01, 1.19). This positive association was primarily driven by Zn, P, and Ca. In the sensitivity analyses with collinearity diagnosis, interaction, and stratified analysis, the results remained, confirming the reliability of the study findings. In this study, the individual and combined effects of urinary Zn, P, and Ca on dyslipidemia were determined, which provided novel insights into the link between exposure to metals and dyslipidemia.
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Affiliation(s)
- Jianqin Zhong
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, No.6 Ankang Road, Guian New Area, Guizhou 561113, China
| | - Tingting Yang
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, No.6 Ankang Road, Guian New Area, Guizhou 561113, China
| | - Ziyun Wang
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, No.6 Ankang Road, Guian New Area, Guizhou 561113, China
| | - Yuxin Zhang
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, No.6 Ankang Road, Guian New Area, Guizhou 561113, China
| | - Yili Shen
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, No.6 Ankang Road, Guian New Area, Guizhou 561113, China
| | - Yuxin Hu
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, No.6 Ankang Road, Guian New Area, Guizhou 561113, China
| | - Feng Hong
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, No.6 Ankang Road, Guian New Area, Guizhou 561113, China.
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Wei X, Ho KF, Yu T, Lin C, Chang LY, Chen D, Tam T, Huang B, Lau AKH, Lao XQ. The joint effect of long-term exposure to multiple air pollutants on non-accidental and cause-specific mortality: A longitudinal cohort study. JOURNAL OF HAZARDOUS MATERIALS 2024; 472:134507. [PMID: 38718510 DOI: 10.1016/j.jhazmat.2024.134507] [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: 01/11/2024] [Revised: 04/20/2024] [Accepted: 04/30/2024] [Indexed: 05/30/2024]
Abstract
The long-term joint impacts of fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3) on mortality are inconclusive. To bridge this research gap, we included 283,568 adults from the Taiwan MJ cohort between 2005 and 2016 and linked with the mortality data until 31 May 2019. Participants' annual average exposures to PM2.5, NO2, and O3 were estimated using satellite-based spatial-temporal models. We applied elastic net-regularised Cox models to construct a weighted environmental risk score (WERS) for the joint effects of three pollutants on non-accidental, cardiovascular, and cancer mortality and evaluated the contribution of each pollutant. The three pollutants jointly raised non-accidental mortality risk with a WERS hazard ratio (HR) of 1.186 (95% CI: 1.118-1.259) per standard deviation increase in each pollutant and weights of 72.8%, 15.2%, and 12.0% for PM2.5, NO2, and O3, respectively. The WERS increased cardiovascular death risk [HR: 1.248 (1.042-1.496)], with PM2.5 as the first contributor and O3 as the second. The WERS also elevated the cancer death risk [HR: 1.173 (1.083-1.270)], where PM2.5 played the dominant role and NO2 ranked second. Coordinated control of these three pollutants can optimise the health benefits of air quality improvements.
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Affiliation(s)
- Xianglin Wei
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Kin Fai Ho
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Tsung Yu
- Department of Public Health, College of Medicine, National Cheng Kung University, Taiwan
| | - Changqing Lin
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong Special Administrative Region of China
| | - Ly-Yun Chang
- Institute of Sociology, Academia Sinica, Taipei, Taiwan
| | - Dezhong Chen
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Tony Tam
- Department of Sociology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Bo Huang
- Department of Geography, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Alexis K H Lau
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong Special Administrative Region of China; Department of Civil and Environmental Engineering, The Hong Kong University of Science and Technology, Hong Kong Special Administrative Region of China
| | - Xiang Qian Lao
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong Special Administrative Region of China.
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Li H, Cheng BJ, Yang PY, Wang C, Meng K, Li TL, Wang J, Liu R. Associations of Urinary Heavy Metal Mixtures with High Remnant Cholesterol among US Adults: Evidence from the National Health and Nutrition Examination Survey (1998-2018). TOXICS 2024; 12:430. [PMID: 38922110 PMCID: PMC11209470 DOI: 10.3390/toxics12060430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/06/2024] [Accepted: 06/10/2024] [Indexed: 06/27/2024]
Abstract
The main objective of our study is to explore the associations between combined exposure to urinary heavy metals and high remnant cholesterol (HRC), a known cardiovascular risk factor. Utilizing data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, we conducted a cross-sectional analysis of 5690 participants, assessing urinary concentrations of ten heavy metals. Ten heavy metals in urine were measured by inductively coupled plasma mass spectrometry (ICP-MS). Fasting residual cholesterol ≥0.8 mmol/L was defined as HRC (using blood samples). Statistical analyses included weighted multivariable logistic regression, weighted quantile sum (WQS) regression, quantile g-computation (qgcomp), and Bayesian kernel machine regression (BKMR) to evaluate the associations of heavy metal exposure with HRC. Stratified analyses based on individual characteristics were also conducted. Multivariable logistic regression found that the four metals (OR Q4 vs. Q1: 1.33, 95% CI: 1.01-1.75 for barium (Ba); OR Q4 vs. Q1: 1.50, 95% CI: 1.16-1.94 for cadmium (Cd); OR Q4 vs. Q1: 1.52, 95% CI: 1.15-2.01 for mercury (Hg); OR Q4 vs. Q1: 1.35, 95% CI: 1.06-1.73 for lead (Pb)) were positively correlated with the elevated risk of HRC after adjusting for covariates. In addition, all three mixed models, including WQS (OR: 1.25; 95% CI: 1.07-1.46), qgcomp (OR: 1.17; 95% CI: 1.03-1.34), and BKMR, consistently showed a significant positive correlation between co-exposure to heavy metal mixtures and HRC, with Ba and Cd being the main contributors within the mixture. These associations were more pronounced in younger adults (20 to 59 years), males, and those with a higher body mass index status (≥25 kg/m2). Our findings reveal a significant relationship between exposure to the mixture of heavy metals and HRC among US adults, with Ba and Cd being the major contributors to the mixture's overall effect. Public health efforts aimed at reducing heavy metal exposure can help prevent HRC and, in turn, cardiovascular disease.
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Affiliation(s)
| | | | | | | | | | | | | | - Ran Liu
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China; (H.L.); (B.-J.C.); (P.-Y.Y.); (C.W.); (K.M.); (T.-L.L.); (J.W.)
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Perrais M, Trächsel B, Lenglet S, Pruijm M, Ponte B, Vogt B, Augsburger M, Rousson V, Bochud M, Thomas A. Reference values for plasma and urine trace elements in a Swiss population-based cohort. Clin Chem Lab Med 2024; 0:cclm-2023-1433. [PMID: 38641868 DOI: 10.1515/cclm-2023-1433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 04/07/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVES Trace elements (TEs) are ubiquitous. TE concentrations vary among individuals and countries, depending on factors such as living area, workplaces and diet. Deficit or excessive TEs concentrations have consequences on the proper functioning of human organism so their biomonitoring is important. The aim of this project was to provide reference values for TEs concentrations in the Swiss population. METHODS The 1,078 participants to the SKiPOGH cohort included in this study were aged 18-90 years. Their 24-h urine and/or plasma samples were analyzed by inductively coupled plasma mass spectrometry (ICP-MS) to determine 24 TEs concentrations: Ag, Al, As, Be, Bi, Cd, Co, Cr, Cu, Hg, I, Li, Mn, Mo, Ni, Pb, Pd, Pt, Sb, Se, Sn, Tl, V and Zn. Statistical tests were performed to evaluate the influence of covariates (sex, age, BMI, smoking) on these results. Reference intervals for the Swiss adult population were also defined. RESULTS TEs concentrations were obtained for respectively 994 and 903 persons in plasma and urine matrices. It was possible to define percentiles of interest (P50 and P95) for almost all the TEs. Differences in TEs distribution between men and women were noticed in both matrices; age was also a cofactor. CONCLUSIONS This first Swiss biomonitoring of a large TEs-panel offers reference values in plasma and in urine for the Swiss population. The results obtained in this study were generally in line with clinical recommendations and comparable to levels reported in other population-based surveys.
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Affiliation(s)
- Maïwenn Perrais
- Unit of Forensic Chemistry and Toxicology, 658784 University Centre of Legal Medicine Lausanne-Geneva , Geneva University Hospital and University of Geneva, Geneva, Switzerland
- Faculty Unit of Toxicology, 658784 University Centre of Legal Medicine Lausanne-Geneva , Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Bastien Trächsel
- 569258 Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Sébastien Lenglet
- Unit of Forensic Chemistry and Toxicology, 658784 University Centre of Legal Medicine Lausanne-Geneva , Geneva University Hospital and University of Geneva, Geneva, Switzerland
| | - Menno Pruijm
- Service of Nephrology, Lausanne University Hospitals and University of Lausanne, Lausanne, Switzerland
| | - Belen Ponte
- Division of Nephrology and Hypertension, Geneva University Hospitals, Geneva, Switzerland
| | - Bruno Vogt
- 27252 University Department of Nephrology and Hypertension, Inselspital, University Hospital Bern , Bern, Switzerland
| | - Marc Augsburger
- Unit of Forensic Chemistry and Toxicology, 658784 University Centre of Legal Medicine Lausanne-Geneva , Geneva University Hospital and University of Geneva, Geneva, Switzerland
| | - Valentin Rousson
- 569258 Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Murielle Bochud
- 569258 Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Aurélien Thomas
- Unit of Forensic Chemistry and Toxicology, 658784 University Centre of Legal Medicine Lausanne-Geneva , Geneva University Hospital and University of Geneva, Geneva, Switzerland
- Faculty Unit of Toxicology, 658784 University Centre of Legal Medicine Lausanne-Geneva , Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Du M, Qiu M, Qian Y, Wang T, Chen X. Serum Copper/Zinc Ratio in Overweight and Obese Children: a Cross-Sectional Study. Biol Trace Elem Res 2024; 202:1539-1549. [PMID: 37505435 DOI: 10.1007/s12011-023-03790-1] [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: 03/06/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023]
Abstract
To assess the association between serum copper/zinc ratio (CZR) and overweight/obesity in children. Sociodemographic and clinical data of children aged 8-18 years old were extracted from the National Health and Nutrition Examination Survey (NHANES) database in this cross-sectional study. These associations were explored using weighted univariate and multivariate logistic regression analyses with the odds ratios (ORs) and 95% confidence intervals (CIs). High serum CZR level was related to higher odds of overweight (OR = 1.74), obesity (OR = 5.26), and central obesity (OR = 2.99). Subgroup analyses showed that high serum CZR levels were associated with high odds of overweight in children aged ≥ 12 years old (OR = 2.19) and females (OR = 2.02), while the increased odds of obesity and central obesity were found in children aged ≥ 12 years old and both male and female. Elevated serum CZR level was linked to high odds of childhood overweight, obesity, and central obesity, and this relationship was also found in children with different age and gender.
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Affiliation(s)
- Mu Du
- Department of Endocrinology, Children's Hospital of Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, 100020, Beijing, People's Republic of China
| | - Mingfang Qiu
- Department of Endocrinology, Children's Hospital of Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, 100020, Beijing, People's Republic of China
| | - Ye Qian
- Department of Endocrinology, Children's Hospital of Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, 100020, Beijing, People's Republic of China
| | - Tianqi Wang
- Department of Endocrinology, Children's Hospital of Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, 100020, Beijing, People's Republic of China
| | - Xiaobo Chen
- Department of Endocrinology, Children's Hospital of Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, 100020, Beijing, People's Republic of China.
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Wang C, Shang X, Fu Y, Guo P, Wang P, Yan S. Investigating the impact of elevated urinary trace elements on non-alcoholic fatty liver disease using vibration-controlled transient elastography. Front Endocrinol (Lausanne) 2024; 15:1310044. [PMID: 38532896 PMCID: PMC10963415 DOI: 10.3389/fendo.2024.1310044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/19/2024] [Indexed: 03/28/2024] Open
Abstract
Introduction Non-alcoholic fatty liver disease (NAFLD) is a global public health concern. However, limited data are available on urinary trace elements and NAFLD caused by various exposure factors. This study aimed to investigate the relationship between the presence of 16 trace elements in urine and NAFLD using data from the National Health and Nutrition Examination Survey (NHANES). Methods By utilizing the NHANES data from 2017 to 2018, 1613 participants who fulfilled the research criteria were identified from the initial pool of 2979 participants with available urine trace element detection data. Among them, 706 individuals had been diagnosed with NAFLD based on a coefficient of attenuation parameter (CAP) value of at least 274 db/m, determined using vibration-controlled transient elastography (VCTE); whereas the remaining 907 participants were classified as non-NAFLD. The data obtained were used to construct univariate and multivariate logistic regression models and restricted cubic spline models (RCS) analyses. Results The presence of arsenic, iodine, barium, cesium, molybdenum, lead, tin, and tungsten in the urine of individuals with NAFLD showed a positive correlation with the likelihood of developing NAFLD. The risk of NAFLD had a non-linear dose-dependent relationship with urinary iodine, molybdenum, barium, and cesium. NAFLD was also associated with elevated levels of barium and cesium in urine, which were identified as significant risk factors. Conclusion These findings suggest a positive association between exposure to trace elements in the urine and the risk of NAFLD. Specifically, urinary barium and cesium appeared to have the greatest impact on the risk of NAFLD. These results provide novel insights into the diagnosis and treatment of NAFLD.
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Affiliation(s)
- Chenxiao Wang
- Department of Gastroenterology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Xin Shang
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Yu Fu
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Panpan Guo
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Ping Wang
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Shuxun Yan
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
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Huang J, Zheng W, Wang A, Han W, Chen J, An H, Yan L, Li Z, Li G. Maternal cobalt concentration and risk of spontaneous preterm birth: the role of fasting blood glucose and lipid profiles. Front Nutr 2024; 11:1336361. [PMID: 38362103 PMCID: PMC10867207 DOI: 10.3389/fnut.2024.1336361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/05/2024] [Indexed: 02/17/2024] Open
Abstract
Introduction Spontaneous preterm birth (SPB) is a significant cause of neonatal mortality, yet its etiology remains unclear. Cobalt, an essential trace element, might be a risk factor for SPB. This study aims to investigate the relationship between maternal serum cobalt concentration and SPB, and to clarify the role of blood lipids and fasting blood glucose (FBG) in this relationship. Methods We conducted a nested case-control study within the Beijing Birth Cohort Study. Serum samples were obtained from 222 pregnant women with SPB and 224 controls during the first (7-13 weeks of pregnancy) and third trimesters (32-42 weeks of pregnancy). Serum cobalt concentration was determined using inductively coupled plasma mass spectrometry (ICP-MS). Fasting blood glucose and lipids levels were detected using a fully automated biochemical immunoassay instrument. Logistic regression models and linear regression models were established to explore the association between serum cobalt concentration and the risk of SPB in pregnant women, and to test the mediating effect of fasting blood glucose (FBG) and lipids. Results We found that the serum cobalt concentration in mothers with SPB and controls was similar in the first trimester, with values of 0.79 (0.58-1.10) ng/mL and 0.75 (0.51-1.07) ng/mL, respectively. However, in the third trimester, the cobalt concentration increased to 0.88 (0.59-1.14) ng/mL and 0.84 (0.52-1.19) ng/mL, respectively. In the logistic regression model, when considering the third trimester of pregnancy, after adjusting for ethnicity, pre-pregnancy body mass index (BMI), maternal age, education, income, and parity, it was observed that the medium level of cobalt concentration (0.63-1.07 ng/ml) had a negative correlation with the risk of SPB. The odds ratio (OR) was 0.56, with a 95% confidence interval of 0.34-0.90 ng/mL and a p-value of 0.02. This suggests that cobalt in this concentration range played a protective role against SPB. Additionally, it was found that FBG in the third trimester of pregnancy had a partial intermediary role, accounting for 9.12% of the association. However, no relationship between cobalt and SPB risk was found in the first trimester. Conclusion During the third trimester, intermediate levels of maternal cobalt appear to offer protection against SPB, with FBG playing a partial mediating role. To further clarify the optimal cobalt concentrations during pregnancy for different populations, a multi-center study with a larger sample size is necessary. Additionally, exploring the specific mechanism of FBG's mediating role could provide valuable insights for improving the prevention of SPB.
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Affiliation(s)
- Junhua Huang
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Wei Zheng
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Aili Wang
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department of Obstetrics and Gynecology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Weiling Han
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Junxi Chen
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Hang An
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Lailai Yan
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Zhiwen Li
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Guanghui Li
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
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10
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Zhang Z, Xiao Y, Long P, Yu Y, Liu Y, Liu K, Yang H, Li X, He M, Wu T, Yuan Y. Associations between plasma metal/metalloid mixtures and the risk of central obesity: A prospective cohort study of Chinese adults. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 270:115838. [PMID: 38128312 DOI: 10.1016/j.ecoenv.2023.115838] [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: 09/19/2023] [Revised: 12/07/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023]
Abstract
Central obesity has increased rapidly over the past decade and posed a substantial disease burden worldwide. Exposure to metals/metalloids has been acknowledged to be involved in the development of central obesity through regulation of cortisol, insulin resistance, and glucocorticoid receptor reduction. Despite the importance, it is lack of prospective study which comprehensively evaluate the relations between multiple metals exposure and central obesity. We explored the prospective associations of plasma metal concentrations with central obesity in a prospective study of the Dongfeng-Tongji cohort. The present study included 2127 participants with a 6.87-year mean follow-up duration. We measured 23 plasma metal/metalloid concentrations at baseline. The associations between metals and incident central obesity were examined utilizing the Cox proportional hazard regression in single and multiple metals models. Additionally, we applied elastic net (ENET), Bayesian kernel machine regression (BKMR), plasma metal score (PMS), and quantile-based g-computation (Qgcomp) models to explore the joint associations of metal mixtures with central obesity. After adjusting potential confounders, we found significant associations of plasma manganese (Mn) and thallium (Tl) concentrations with a higher risk of central obesity, whereas plasma rubidium (Rb) concentration was associated with a lower risk of central obesity both in single and multiple metals models (all FDR <0.05). The ENET and Qqcomp models verified similar metals (Mn, Rb, and Tl) as important predictors for central obesity. The results of both BKMR model and PMS suggested cumulative exposure to metal mixtures was associated with a higher risk of central obesity. Our findings suggested that co-exposure to metals was associated with a higher risk of central obesity. This study expands our knowledge that the management of metals/metalloids exposure may be beneficial for the prevention of new-onset central obesity, which may subsequently alleviate the disease burden of late-life health outcomes.
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Affiliation(s)
- Zirui Zhang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Xiao
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pinpin Long
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanqiu Yu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yiyi Liu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kang Liu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Handong Yang
- Department of Cardiovascular Diseases, Dongfeng Central Hospital, Hubei University of Medicine, Shiyan, China
| | - Xiulou Li
- Department of Cardiovascular Diseases, Dongfeng Central Hospital, Hubei University of Medicine, Shiyan, China
| | - Meian He
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tangchun Wu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Yuan
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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11
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Deng Q, Wei Y, Liu K, Wu D, Zhu X, Xu M, Bai Y. Essential metals modified the effects of polycyclic aromatic hydrocarbons on the metabolic syndrome: Mediation effects of miRNA. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 906:167506. [PMID: 37788778 DOI: 10.1016/j.scitotenv.2023.167506] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 10/05/2023]
Abstract
Metabolic syndrome (MetS) prevalence has increased dramatically worldwide and has become a public health issue. Polycyclic aromatic hydrocarbons (PAHs) were identified as risk factors of MetS, while essential metals are integral parts of metalloenzymes catalyzing metabolic processes. However, effects of co-exposure to PAHs and essential metals have not been investigated yet. We aimed to assess whether essential metals could modify the hazard effects of PAHs on MetS, and underlying mediation effects of microRNA (miRNAs) were further explored. A cross-sectional study of 1451 males including 278 MetS cases was conducted. Internal exposure levels of 5 classes of PAH metabolites, 7 essential metals, as well as expressions of PAHs-associated 8 plasma miRNAs were assessed. Multiple exposure models, Bayesian kernel machine regression (BKMR), and quantile g-computation (QGcomp) were used simultaneously to identify MetS-related critical chemicals. Mutual effect modification between chemicals and mediation effects of miRNAs on chemical-MetS association was testified. In this study, hydroxyphenanthrene (OHPhe) and selenium (Se) were consistently identified as MetS-related key chemicals in three statistical methods. OHPhe was positively associated with MetS [OR (95 % CI) = 1.79 (1.21, 2.65), P = 0.004], while Se had a negative relationship with MetS [OR (95 % CI) = 0.61 (0.43, 0.87), P = 0.007]. Effect modification analysis observed the association between OHPhe and MetS was weakened with increased Se exposure. Only the expression of miR-24-3p was negatively associated with MetS [OR (95 % CI) = 0.81 (0.66, 0.95), P = 0.048] and could mediate 16.1 % of OHPhe-MetS association in subjects with low Se exposure (≤0.87 μg/mmol creatinine) (P = 0.019). We found a mutual effect modification between OHPhe and Se on MetS, and the positive OHPhe-MetS association was attenuated with increased Se exposure. Mediation effects of miR-24-3p on OHPhe-MetS association were dependent on Se dose. Our findings may provide new insight into the prevention and intervention of MetS.
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Affiliation(s)
- Qifei Deng
- Institute for Chemical Carcinogenesis, School of Public Health, Guangzhou Medical University, Xinzao, Panyu District, Guangzhou 511416, China
| | - Yanzhu Wei
- Institute for Chemical Carcinogenesis, School of Public Health, Guangzhou Medical University, Xinzao, Panyu District, Guangzhou 511416, China
| | - Kang Liu
- Institute for Chemical Carcinogenesis, School of Public Health, Guangzhou Medical University, Xinzao, Panyu District, Guangzhou 511416, China
| | - Degang Wu
- Institute for Chemical Carcinogenesis, School of Public Health, Guangzhou Medical University, Xinzao, Panyu District, Guangzhou 511416, China
| | - Xinyu Zhu
- Institute for Chemical Carcinogenesis, School of Public Health, Guangzhou Medical University, Xinzao, Panyu District, Guangzhou 511416, China
| | - Mengya Xu
- Institute for Chemical Carcinogenesis, School of Public Health, Guangzhou Medical University, Xinzao, Panyu District, Guangzhou 511416, China
| | - Yansen Bai
- Institute for Chemical Carcinogenesis, School of Public Health, Guangzhou Medical University, Xinzao, Panyu District, Guangzhou 511416, China.
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12
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Tower SS, Gessner BD, Cho CS, Bridges RL. The association of cobalturia with cobaltism symptoms a prospective blinded study of 229 post-arthroplasty patients. PLoS One 2023; 18:e0295203. [PMID: 38127904 PMCID: PMC10734948 DOI: 10.1371/journal.pone.0295203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023] Open
Abstract
INTRODUCTION Cobalt is a mitochondrial toxin, clinical cobaltism manifests with constitutional, neurologic, and cardiovascular symptomatology. Cobalt's severe toxidrome is known through case reports from extreme wear or corrosion of cobalt-chromium arthroplasty components. However, the spectrum and epidemiology of orthopedic-implant cobaltism and its relationship to duration and degree of cobalt exposure are not well defined. METHODS The relationship of urine-cobalt concentration and duration of exposure to cobalt-chromium joint implants and cobaltism symptomatology were prospectively studied in 229 patients. Subjects received a Cobaltism-Symptom-Inventory-Score (CSIS) based on a protocolized interview and examination followed by a spot urine-cobalt measurement. RESULTS 129 (56%) subjects were cobalturic (urine-cobalt ≥1.0 ppb). 122 (53%) subjects had a CSIS of >2, this status significantly associates with cobalturia. Median [IQR] urine-cobalt in the subjects with a CSIS >2 was 4.1[1.1-17.0] ppb compared to 0.5[0.5-1.4] ppb in subjects with CSIS ≤ 2. Cobalturia has a sensitivity of 0.69, a specificity of 0.77, and a positive predictive value of 0.74 for a CSIS of >2. The product of years-exposed to a cobalt-chromium implant and urine-cobalt by quartiles significantly positively associates with the Cobaltism-Symptom-Inventory-Score. CONCLUSION A urine-cobalt of ≥1 ppb likely indicates adverse systemic exposure to orthopedic-implant generated cobalt. Cobaltism severity as quantified by the CSIS significantly correlates with the product of spot urine-cobalt concentration and years-exposed to a cobalt-chromium orthopedic-implant indicating a dose-response relationship. Medical provider and public awareness of orthopedic-implant cobaltism is vital because tens-of-millions are at-risk and early cobaltism is reversible. Further use of cobalt-chromium orthopedic-implants should be questioned given cobaltism becomes clinically apparent at a spot urine-cobalt of 1 ppb or greater. Monitoring of patients with high-risk cobalt-chromium orthopedic-implants appears to be indicated.
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Affiliation(s)
- Stephen S. Tower
- University of Alaska, Medical School, Anchorage, Alaska, United States of America
| | | | - Christina S. Cho
- University of Alaska, Medical School, Anchorage, Alaska, United States of America
| | - Robert L. Bridges
- Aegis Imaging Consultants, Girdwood, Alaska, United States of America
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Zha B, Liu Y, Xu H. Associations of mixed urinary metals exposure with metabolic syndrome in the US adult population. CHEMOSPHERE 2023; 344:140330. [PMID: 37783357 DOI: 10.1016/j.chemosphere.2023.140330] [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: 04/20/2023] [Revised: 09/19/2023] [Accepted: 09/28/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND Metals are harmful to human health in many ways. However, the association between metals and metabolic syndrome (MetS) remains unclear. Aims of this study is to discuss the relationship between urinary metal and MetS. METHODS This study included 3419 adult participants from the National Health and Nutrition Examination Survey (NHANES) (2005-2018). Logistic regression analysis, Bayesian kernel machine regression (BKMR), weighted quantile sum (WQS), and restricted cubic spline (RCS) were used to explore the associations of nine urinary metal and MetS. RESULTS BKMR and WQS showed the effects of combined nine urinary metal were negatively correlated with MetS. Logistic regression analysis, WQS, and BKMR all suggested that cesium (Cs) and lead (Pb) were negatively correlated with MetS (all PFDCR <0.05). And RCS suggested log2-transformed Cs (χ2 = 20, P < 0.001) and log2-transformed Pb (χ2 = 19.9, P < 0.001) were negatively and linearly associated with MetS. CONCLUSION Existing evidence suggests that urine metal content is related to MetS. Cs and Pb are negatively related to MetS. It is still necessary to study and further discuss the causal relationship and mechanism.
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Affiliation(s)
- Bowen Zha
- Department of Education, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, PR China; Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, PR China.
| | - Yuqi Liu
- Department of Education, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, PR China
| | - Huanchang Xu
- Department of Education, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, PR China
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14
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Lei JY, Wang PP, Wang HL, Wang Y, Sun L, Hu B, Wang SF, Zhang DM, Chen GM, Liang CM, Tao FB, Yang LS, Wu QS. The associations of non-essential metal mixture with fasting plasma glucose among Chinese older adults without diabetes. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:100613-100625. [PMID: 37639099 DOI: 10.1007/s11356-023-29503-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/22/2023] [Indexed: 08/29/2023]
Abstract
The evidence about the effect of non-essential metal mixture on fasting plasma glucose (FPG) levels among older adults without diabetes is limited. This study aims to estimate the individual and joint relationship between five non-essential metals and FPG levels in Chinese older adults without diabetes. This study included 2362 older adults without diabetes. Urinary concentrations of five non-essential metals, i.e., cesium (Cs), aluminum (Al), thallium (Tl), cadmium (Cd), and arsenic (As), were detected by inductively coupled plasma mass spectrometry (ICP-MS). The associations of single metals and the metal mixture with FPG levels were assessed using linear regression and Bayesian kernel machine regression (BKMR) models, respectively. Adjusted single-metal linear regression models showed positive associations of urinary Al (β = 0.016, 95%CI: 0.001-0.030) and Cs (β = 0.018, 95%CI: 0.006-0.031) with FPG levels. When comparing the 2th, 3th, and 4th quartiles of urine Cs to its 1th quartile, the significant associations between Cs and FPG levels were found and presented as an "inverted U" trend (βQ2 vs. Q1: 0.034; βQ3 vs. Q1:0.054; βQ4 vs. Q1: 0.040; all P<0.05). BKMR analyses showed urinary level of Cs exhibited an "inverted U" shape association with FPG levels. Moreover, the FPG levels increased linearly with the raised levels of the non-essential metal mixture, and the posterior inclusion probability (PIP) of Cs was the highest (0.92). Potential positive interaction of As and Cs on FPG levels was found in BKMR model. Stratified analysis displayed significant interactions of hyperlipidemia and urine Cs or Tl on FPG levels. An inverse U-shaped association between Cs and FPG was found, individually and as mixture. The FPG levels increased with the raised levels of the non-essential metal mixture, and Cs was the most contributor to FPG levels. Further research is required to confirm the correlation between non-essential metals and FPG levels and to clarify the underlying mechanisms.
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Affiliation(s)
- Jing-Yuan Lei
- School of Public Health, Department of Hygiene Inspection and Quarantine, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Pan-Pan Wang
- School of Public Health, Department of Hygiene Inspection and Quarantine, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Hong-Li Wang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Yuan Wang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Liang Sun
- Fuyang Center for Diseases Prevention and Control, Fuyang, 236069, Anhui, China
| | - Bing Hu
- Fuyang Center for Diseases Prevention and Control, Fuyang, 236069, Anhui, China
| | - Su-Fang Wang
- School of Public Health, Department of Nutrition and Food Hygiene, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Dong-Mei Zhang
- School of Health Services Management, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Gui-Mei Chen
- School of Health Services Management, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Chun-Mei Liang
- School of Public Health, Department of Hygiene Inspection and Quarantine, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Fang-Biao Tao
- MOE Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Lin-Sheng Yang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Qing-Si Wu
- Department of Blood Transfusion, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China.
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15
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Martins AC, Ferrer B, Tinkov AA, Caito S, Deza-Ponzio R, Skalny AV, Bowman AB, Aschner M. Association between Heavy Metals, Metalloids and Metabolic Syndrome: New Insights and Approaches. TOXICS 2023; 11:670. [PMID: 37624175 PMCID: PMC10459190 DOI: 10.3390/toxics11080670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 08/26/2023]
Abstract
Metabolic syndrome (MetS) is an important public health issue that affects millions of people around the world and is growing to pandemic-like proportions. This syndrome is defined by the World Health Organization (WHO) as a pathologic condition characterized by abdominal obesity, insulin resistance, hypertension, and hyperlipidemia. Moreover, the etiology of MetS is multifactorial, involving many environmental factors, including toxicant exposures. Several studies have associated MetS with heavy metals exposure, which is the focus of this review. Environmental and/or occupational exposure to heavy metals are a major risk, contributing to the development of chronic diseases. Of particular note, toxic metals such as mercury, lead, and cadmium may contribute to the development of MetS by altering oxidative stress, IL-6 signaling, apoptosis, altered lipoprotein metabolism, fluid shear stress and atherosclerosis, and other mechanisms. In this review, we discuss the known and potential roles of heavy metals in MetS etiology as well as potential targeted pathways that are associated with MetS. Furthermore, we describe how new approaches involving proteomic and transcriptome analysis, as well as bioinformatic tools, may help bring about an understanding of the involvement of heavy metals and metalloids in MetS.
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Affiliation(s)
- Airton C. Martins
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, New York, NY 10461, USA; (A.C.M.)
| | - Beatriz Ferrer
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, New York, NY 10461, USA; (A.C.M.)
| | - Alexey A. Tinkov
- Laboratory of Ecobiomonitoring and Quality Control, Yaroslavl State University, 150003 Yaroslavl, Russia; (A.A.T.)
- IM Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia
| | - Samuel Caito
- School of Pharmacy, Husson University, Bangor, ME 04401, USA
| | - Romina Deza-Ponzio
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, New York, NY 10461, USA; (A.C.M.)
| | - Anatoly V. Skalny
- Laboratory of Ecobiomonitoring and Quality Control, Yaroslavl State University, 150003 Yaroslavl, Russia; (A.A.T.)
- IM Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia
| | - Aaron B. Bowman
- School of Health Sciences, Purdue University, West Lafayette, IN 47907-2051, USA;
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, New York, NY 10461, USA; (A.C.M.)
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16
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Boyer K, Domingo-Relloso A, Jiang E, Haack K, Goessler W, Zhang Y, Umans JG, Belsky DW, Cole SA, Navas-Acien A, Kupsco A. Metal mixtures and DNA methylation measures of biological aging in American Indian populations. ENVIRONMENT INTERNATIONAL 2023; 178:108064. [PMID: 37364305 PMCID: PMC10617409 DOI: 10.1016/j.envint.2023.108064] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/18/2023] [Accepted: 06/22/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION Native American communities suffer disproportionately from elevated metal exposures and increased risk for cardiovascular diseases and diabetes. DNA methylation is a sensitive biomarker of aging-related processes and novel epigenetic-based "clocks" can be used to estimate accelerated biological aging that may underlie increased risk. Metals alter DNA methylation, yet little is known about their individual and combined impact on epigenetic age acceleration. Our objective was to investigate the associations of metals on several DNA methylation-based aging measures in the Strong Heart Study (SHS) cohort. METHODS Blood DNA methylation data from 2,301 SHS participants was used to calculate age acceleration of epigenetic clocks (PhenoAge, GrimAge, DunedinPACE, Hannum, Horvath). Urinary metals [arsenic (As), cadmium (Cd), tungsten (W), zinc (Zn), selenium (Se), molybdenum (Mo)] were creatinine-adjusted and categorized into quartiles. We examined associations of individual metals through linear regression models and used Bayesian Kernel Machine Regression (BKMR) for the impact of the total metal mixture on epigenetic age acceleration. RESULTS The mixture of nonessential metals (W, As, Cd) was associated with greater GrimAge acceleration and DunedinPACE, while the essential metal mixture (Se, Zn, Mo) was associated with lower epigenetic age acceleration. Cd was associated with increased epigenetic age acceleration across all clocks and BKMR analysis suggested nonlinear associations between Se and DunedinPACE, GrimAge, and PhenoAge acceleration. No interactions between individual metals were observed. The associations between Cd, Zn, and epigenetic age acceleration were greater in never smokers in comparison to current/former smokers. CONCLUSION Nonessential metals were positively associated with greater epigenetic age acceleration, with strongest associations observed between Cd and DunedinPACE and GrimAge acceleration. In contrast, essential metals were associated with lower epigenetic aging. Examining the influence of metal mixtures on epigenetic age acceleration can provide insight into metals and aging-related diseases.
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Affiliation(s)
- Kaila Boyer
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Arce Domingo-Relloso
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Carlos III Health Institute, Madrid, Spain; Department of Statistics and Operations Research, University of Valencia, Spain
| | - Enoch Jiang
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Karin Haack
- Population Health Program, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Walter Goessler
- Institute of Chemistry, Universität Graz, Universität Platz 3, 8010 Graz, Austria
| | - Ying Zhang
- Center for American Indian Health Research, Department of Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Jason G Umans
- MedStar Health Research Institute, Washington, DC, USA; Center for Clinical and Translational Sciences, Georgetown/Howard Universities, Washington, DC, USA
| | - Daniel W Belsky
- Department of Epidemiology and Butler Columbia Aging Center, Columbia University, New York, USA
| | - Shelley A Cole
- Population Health Program, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Allison Kupsco
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
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17
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Yu YJ, Li ZC, Tian JL, Hao CJ, Kuang HX, Dong CY, Zhou Y, Wu QZ, Gong YC, Xiang MD, Chen XC, Yang X, Dong GH. Why Do People Gain Belly Fat in Rural Areas? A Study of Urinary Metal(loid)s and Abdominal Obesity in China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:7938-7949. [PMID: 37202343 DOI: 10.1021/acs.est.2c09464] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Obesity is prevalent in rural areas of China, and there are inconsistent findings regarding the association between metal(loid) exposure and the risk of obesity. Abdominal obesity (AOB), which reflects visceral fat abnormity, is a crucial factor in studying obesity-related diseases. We conducted a study measuring 20 urinary metal(loid)s, 13 health indicators, and the waist circumference (WC) in 1849 participants from 10 rural areas of China to investigate their relationships. In the single exposure models, we found that urinary chromium (Cr) was significantly associated with the odds of having AOB [adjusted odds ratio (OR) = 1.81 (95% confidence interval (CI): 1.24, 2.60)]. In the mixture exposure models, urinary Cr consistently emerged as the top contributor to AOB, while the overall effect of mixed metal(loid)s was positive toward the odds of having AOB [adjusted OR: 1.33 (95% CI: 1.00, 1.77)], as revealed from the quantile g-computation model. After adjusting for the effects of other metal(loid)s, we found that the elevation of apolipoprotein B and systolic blood pressure significantly mediated the association between urinary Cr and the odds of having AOB by 9.7 and 19.4%, respectively. Our results suggest that exposure to metal(loid)s is a key factor contributing to the prevalence of AOB and WC gain in rural areas of China.
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Affiliation(s)
- Yun-Jiang Yu
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou 510655, China
| | - Zhen-Chi Li
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou 510655, China
| | - Jing-Lin Tian
- Vascular Disease Research Center, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen 518060, China
| | - Chao-Jie Hao
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou 510655, China
| | - Hong-Xuan Kuang
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou 510655, China
| | - Chen-Yin Dong
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou 510655, China
| | - Yang Zhou
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou 510655, China
| | - Qi-Zhen Wu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yan-Chen Gong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Ming-Deng Xiang
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou 510655, China
| | - Xi-Chao Chen
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou 510655, China
| | - Xiao Yang
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou 510655, China
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
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18
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Li B, Zhang Q, Chang X, Shen Y, Liu T, Liang X, Gao Q, Liu L, Qiu Y, Yan X, Huang J, Wang T, Yin J. Association of urinary metal levels with metabolic syndrome in coal workers. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:62892-62904. [PMID: 36952162 DOI: 10.1007/s11356-023-26452-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/10/2023] [Indexed: 05/10/2023]
Abstract
Studies have indicated that metal exposure is associated with an increased risk of metabolic syndrome (MetS). However, it is unclear whether overexposure to heavy metals occurs in miners and is associated with MetS risk remains unclear. In a cross-sectional study, analysis for metal exposure levels of 3428 participants from three types of workplaces was conducted. Relationships between metals in urine and MetS were characterized using a multivariate binary logistic regression model and restricted cubic spline analysis. The association between urinary metals and workplaces with respect to MetS was studied via mediation analysis and multiplicative interaction analysis. And a sensitivity analysis was performed to assess the robustness of the association between MetS and urinary metals in participants without obesity (n = 2811). Zn, Cu, Fe, Co, and Ni were found to be associated with MetS in the single-metal models, whereas only Zn and Cu showed considerable associations in the multimetal model. The odds ratios (95% CI) for MetS in the highest quartiles were 2.089 (1.611, 2.707) for urinary Zn and 1.394 (1.084, 1.794) for urinary Cu (both false discovery rate for both was < 0.05). Urinary Zn and Cu were positively associated with hypertriglyceridemia. In addition, higher Zn exposure was confirmed in underground workers than ground workers and office workers, and there was a significant association between urinary metal exposure and workplace, which together influenced the occurrence of MetS. These results provided scientific evidence for the relationship between Zn, Cu, workplaces, and MetS in coal workers and indicated that it is critical to reduce occupational metal exposure, especially in underground workers.
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Affiliation(s)
- Ben Li
- School of Public Health, Shanxi Medical University, Taiyuan, China
- Shanxi Health Commission Key Laboratory of Nervous System Disease Prevention and Treatment, Sinopharm Tongmei General Hospital, 1 Wei 7 Street, Datong, Shanxi, China
- Shanxi Coal Mine Public Health Graduate Education Innovation Center, Datong, Shanxi, China
| | - Qianwen Zhang
- School of Public Health, Shanxi Medical University, Taiyuan, China
- Shanxi Coal Mine Public Health Graduate Education Innovation Center, Datong, Shanxi, China
| | - Xiaohan Chang
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yongmei Shen
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Ting Liu
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Xiaomin Liang
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Qian Gao
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Liangpo Liu
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yulan Qiu
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Xiaoyan Yan
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jianjun Huang
- Shanxi Health Commission Key Laboratory of Nervous System Disease Prevention and Treatment, Sinopharm Tongmei General Hospital, 1 Wei 7 Street, Datong, Shanxi, China
- Shanxi Coal Mine Public Health Graduate Education Innovation Center, Datong, Shanxi, China
- Department of Neurosurgery, Sinopharm Tongmei General Hospital, No. 1, Wei Qi Road, Datong Mining Area, Datong, 037003, Shanxi, China
| | - Tong Wang
- School of Public Health, Shanxi Medical University, Taiyuan, China
- Shanxi Health Commission Key Laboratory of Nervous System Disease Prevention and Treatment, Sinopharm Tongmei General Hospital, 1 Wei 7 Street, Datong, Shanxi, China
- Shanxi Coal Mine Public Health Graduate Education Innovation Center, Datong, Shanxi, China
| | - Jinzhu Yin
- Shanxi Health Commission Key Laboratory of Nervous System Disease Prevention and Treatment, Sinopharm Tongmei General Hospital, 1 Wei 7 Street, Datong, Shanxi, China.
- Shanxi Coal Mine Public Health Graduate Education Innovation Center, Datong, Shanxi, China.
- Department of Neurosurgery, Sinopharm Tongmei General Hospital, No. 1, Wei Qi Road, Datong Mining Area, Datong, 037003, Shanxi, China.
- Central Laboratory of Sinopharm Tongmei General Hospital, Datong, 037003, Shanxi, China.
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19
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Tan Y, El-Kersh K, Watson SE, Wintergerst KA, Huang J, Cai L. Cardiovascular Effects of Environmental Metal Antimony: Redox Dyshomeostasis as the Key Pathogenic Driver. Antioxid Redox Signal 2023; 38:803-823. [PMID: 36424825 PMCID: PMC10402706 DOI: 10.1089/ars.2022.0185] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 11/19/2022] [Indexed: 11/27/2022]
Abstract
Significance: Cardiovascular diseases (CVDs) are the leading cause of death worldwide, which may be due to sedentary lifestyles with less physical activity and over nutrition as well as an increase in the aging population; however, the contribution of pollutants, environmental chemicals, and nonessential metals to the increased and persistent CVDs needs more attention and investigation. Among environmental contaminant nonessential metals, antimony has been less addressed. Recent Advances: Among environmental contaminant nonessential metals, several metals such as lead, arsenic, and cadmium have been associated with the increased risk of CVDs. Antimony has been less addressed, but its potential link to CVDs is being gradually recognized. Critical Issues: Several epidemiological studies have revealed the significant deleterious effects of antimony on the cardiovascular system in the absence or presence of other nonessential metals. There has been less focus on whether antimony alone can contribute to the pathogenesis of CVDs and the proposed mechanisms of such possible effects. This review addresses this gap in knowledge by presenting the current available evidence that highlights the potential role of antimony in the pathogenesis of CVDs, most likely via antimony-mediated redox dyshomeostasis. Future Directions: More direct evidence from preclinical and mechanistic studies is urgently needed to evaluate the possible roles of antimony in mitochondrial dysfunction and epigenetic regulation in CVDs. Antioxid. Redox Signal. 38, 803-823.
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Affiliation(s)
- Yi Tan
- Department of Pediatrics, Pediatric Research Institute, University of Louisville School of Medicine, Louisville, Kentucky, USA
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky, USA
- Wendy Novak Diabetes Institute, Norton Children's Hospital, Louisville, Kentucky, USA
| | - Karim El-Kersh
- Division of Pulmonary Critical Care and Sleep Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Sara E. Watson
- Wendy Novak Diabetes Institute, Norton Children's Hospital, Louisville, Kentucky, USA
- Division of Endocrinology, Department of Pediatrics, Norton Children's Hospital, University of Louisville, Louisville, Kentucky, USA
| | - Kupper A. Wintergerst
- Wendy Novak Diabetes Institute, Norton Children's Hospital, Louisville, Kentucky, USA
- Division of Endocrinology, Department of Pediatrics, Norton Children's Hospital, University of Louisville, Louisville, Kentucky, USA
- The Center for Integrative Environmental Health Sciences, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Jiapeng Huang
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky, USA
- The Center for Integrative Environmental Health Sciences, University of Louisville School of Medicine, Louisville, Kentucky, USA
- Department of Anesthesiology and Perioperative Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA
- Department of Cardiovascular and Thoracic Surgery, Cardiovascular Innovation Institute, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Lu Cai
- Department of Pediatrics, Pediatric Research Institute, University of Louisville School of Medicine, Louisville, Kentucky, USA
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky, USA
- Wendy Novak Diabetes Institute, Norton Children's Hospital, Louisville, Kentucky, USA
- The Center for Integrative Environmental Health Sciences, University of Louisville School of Medicine, Louisville, Kentucky, USA
- Department of Radiation Oncology; University of Louisville School of Medicine, Louisville, Kentucky, USA
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20
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Xu P, Lai S, Wu L, Chen W, Chen Y, Xu D, Xiang J, Cheng P, Chen Z, Wang X, Lou X, Tang J. Insights into the health status of the general population living near an electroplating industry zone: metal elevations and renal impairment. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:31905-31915. [PMID: 36459323 DOI: 10.1007/s11356-022-24411-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
A cross-sectional study was conducted in 2016 in Zhejiang Province, China, to evaluate the body burdens of metals and metalloids associated with renal dysfunction in populations living near electroplating industries. We recruited 236 subjects and performed physical examinations, determined the blood and urinary levels of arsenic (As), cadmium (Cd), chromium (Cr), manganese (Mn), nickel (Ni), lead (Pb), antimony (Sb), and selenium (Se) by an inductively coupled plasma mass spectrometer (ICP-MS), and measured three renal impairment biomarkers, namely nacetyl-β-D-glucosaminidase (NAG), retinol-binding protein (RBP), and β2-microglobulin (BMG). The proportion of abnormal nasal symptoms in the exposure group (10.1%) was much higher than in the control group (0; p < 0.05). The blood and urinary levels of As, Cd, and Se in the exposure group were significantly higher than those in the control group (p < 0.05). The blood levels of Mn and Pb, as well as the urinary levels of Cr and Ni, were significantly higher in the exposure group than in the control group (p < 0.05). The exposure group demonstrated higher levels of NAG, RBP, and BMG than the control group (0.51 vs. 0.14 mg/g creatinine, 12.79 vs. 9.26 IU/g creatinine, and 1.39 vs. 0.78 mg/g creatinine, respectively; p < 0.05). Urinary BMG was positively correlated with urinary Cd levels (r = 0.223, p < 0.05), while urinary RBP was correlated with blood Cd levels (r = 0.151, p < 0.05) and urinary Cd, Cr, Ni, and Se levels (r = 0.220, 0.303, 0.162, and 0.306, respectively; p < 0.05). In conclusion, our study indicated that a population living in the vicinity of electroplating industries had high body burdens of certain metals and metalloids associated with non-negligible renal dysfunction.
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Affiliation(s)
- Peiwei Xu
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Shiming Lai
- Quzhou Center for Disease Control and Prevention, 154 Xi'an Road, Xin'an District, Quzhou, 324003, China
| | - Lizhi Wu
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Weizhong Chen
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Yuan Chen
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Dandan Xu
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Jie Xiang
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Ping Cheng
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Zhijian Chen
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Xiaofeng Wang
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Xiaoming Lou
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Jun Tang
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China.
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21
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Zhang Y, Huang B, Jin J, Xiao Y, Ying H. Recent advances in the application of ionomics in metabolic diseases. Front Nutr 2023; 9:1111933. [PMID: 36726817 PMCID: PMC9884710 DOI: 10.3389/fnut.2022.1111933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/30/2022] [Indexed: 01/19/2023] Open
Abstract
Trace elements and minerals play a significant role in human health and diseases. In recent years, ionomics has been rapidly and widely applied to explore the distribution, regulation, and crosstalk of different elements in various physiological and pathological processes. On the basis of multi-elemental analytical techniques and bioinformatics methods, it is possible to elucidate the relationship between the metabolism and homeostasis of diverse elements and common diseases. The current review aims to provide an overview of recent advances in the application of ionomics in metabolic disease research. We mainly focuses on the studies about ionomic or multi-elemental profiling of different biological samples for several major types of metabolic diseases, such as diabetes mellitus, obesity, and metabolic syndrome, which reveal distinct and dynamic patterns of ion contents and their potential benefits in the detection and prognosis of these illnesses. Accumulation of copper, selenium, and environmental toxic metals as well as deficiency of zinc and magnesium appear to be the most significant risk factors for the majority of metabolic diseases, suggesting that imbalance of these elements may be involved in the pathogenesis of these diseases. Moreover, each type of metabolic diseases has shown a relatively unique distribution of ions in biofluids and hair/nails from patients, which might serve as potential indicators for the respective disease. Overall, ionomics not only improves our understanding of the association between elemental dyshomeostasis and the development of metabolic disease but also assists in the identification of new potential diagnostic and prognostic markers in translational medicine.
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Affiliation(s)
- Yan Zhang
- Shenzhen Key Laboratory of Marine Bioresources and Ecology, Brain Disease and Big Data Research Institute, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, China,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China,*Correspondence: Yan Zhang ✉
| | - Biyan Huang
- Shenzhen Key Laboratory of Marine Bioresources and Ecology, Brain Disease and Big Data Research Institute, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, China
| | - Jiao Jin
- Shenzhen Key Laboratory of Marine Bioresources and Ecology, Brain Disease and Big Data Research Institute, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, China
| | - Yao Xiao
- Shenzhen Key Laboratory of Marine Bioresources and Ecology, Brain Disease and Big Data Research Institute, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, China
| | - Huimin Ying
- Affiliated Hangzhou Xixi Hospital, Zhejiang University School of Medicine, Hangzhou, China,Huimin Ying ✉
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22
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Altered Metal Homeostasis Associates with Inflammation, Oxidative Stress, Impaired Glucose Metabolism, and Dyslipidemia in the Crosstalk between Childhood Obesity and Insulin Resistance. Antioxidants (Basel) 2022; 11:antiox11122439. [PMID: 36552647 PMCID: PMC9774623 DOI: 10.3390/antiox11122439] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/05/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
Metals are redox-active substances that participate in central biological processes and may be involved in a multitude of pathogenic events. However, considering the inconsistencies reported in the literature, further research is crucial to disentangle the role of metal homeostasis in childhood obesity and comorbidities using well-characterized cohorts and state-of-the-art analytical methods. To this end, we studied an observational population comprising children with obesity and insulin resistance, children with obesity without insulin resistance, and healthy control children. A multi-elemental approach based on the size-fractionation of metal species was applied to quantify the total content of various essential and toxic elements in plasma and erythrocyte samples, and to simultaneously investigate the metal fractions conforming the metalloproteome and the labile metal pool. The most important disturbances in childhood obesity were found to be related to elevated circulating copper levels, decreased content of plasmatic proteins containing chromium, cobalt, iron, manganese, molybdenum, selenium, and zinc, as well as the sequestration of copper, iron, and selenium within erythrocytes. Interestingly, these metal disturbances were normally exacerbated among children with concomitant insulin resistance, and in turn were associated to other characteristic pathogenic events, such as inflammation, oxidative stress, abnormal glucose metabolism, and dyslipidemia. Therefore, this study represents one-step further towards a better understanding of the involvement of metals in the crosstalk between childhood obesity and insulin resistance.
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23
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Guo X, Li N, Wang H, Su W, Song Q, Liang Q, Liang M, Sun C, Li Y, Lowe S, Bentley R, Song EJ, Zhou Q, Ding X, Sun Y. Combined exposure to multiple metals on cardiovascular disease in NHANES under five statistical models. ENVIRONMENTAL RESEARCH 2022; 215:114435. [PMID: 36174761 DOI: 10.1016/j.envres.2022.114435] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 09/13/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND It is well-documented that heavy metals are associated with cardiovascular disease (CVD). However, there is few studies exploring effect of metal mixture on CVD. Therefore, the primary objective of present study was to investigate the joint effect of heavy metals on CVD and to identify the most influential metals in the mixture. METHODS Original data for study subjects were obtained from the National Health and Nutrition Examination Survey. In this study, adults with complete data on 12 kinds of urinary metals (antimony, arsenic, barium, cadmium, cobalt, cesium, molybdenum, mercury, lead, thallium, tungsten, and uranium), cardiovascular disease, and core covariates were enrolled. We applied five different statistical strategies to examine the CVD risk with metal exposure, including multivariate logistic regression, adaptive elastic net combined with Environmental Risk Score, Quantile g-computation, Weighted Quantile Sum regression, and Bayesian kernel machine regression. RESULTS Higher levels of cadmium, tungsten, cobalt, and antimony were significantly associated with Increased risk of CVD when covariates were adjusted for multivariate logistic regression. The results from multi-pollutant strategies all indicated that metal mixture was positively associated with the risk of CVD. Based on the results of multiple statistical strategies, it was determined that cadmium, tungsten, cobalt, and antimony exhibited the strongest positive correlations, whereas barium, lead, molybdenum, and thallium were most associated with negative correlations. CONCLUSION Overall, our study demonstrates that exposure to heavy metal mixture is linked to a higher risk of CVD. Meanwhile, this association may be driven primarily by cadmium, tungsten, cobalt, and antimony. Further prospective studies are warranted to validate or refute our primary findings as well as to identify other important heavy metals linked with CVD.
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Affiliation(s)
- Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, PR China
| | - Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, PR China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, PR China
| | - Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, PR China
| | - Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, PR China
| | - Qiwei Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, PR China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, PR China
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago, 2900 N. Lake Shore Drive, Chicago, IL, 60657, USA
| | - Yaru Li
- Internal Medicine, Swedish Hospital, 5140 N California Ave, Chicago, IL, 60625, USA
| | - Scott Lowe
- College of Osteopathic Medicine, Kansas City University, 1750 Independence Ave, Kansas City, MO, 64106, USA
| | - Rachel Bentley
- College of Osteopathic Medicine, Kansas City University, 1750 Independence Ave, Kansas City, MO, 64106, USA
| | - Evelyn J Song
- Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Qin Zhou
- Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, PR China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, PR China; Chaohu Hospital, Anhui Medical University, Hefei, 238006, Anhui, PR China.
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24
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Lin Y, Yuan Y, Ouyang Y, Wang H, Xiao Y, Zhao X, Yang H, Li X, Guo H, He M, Zhang X, Xu G, Qiu G, Wu T. Metabolome-Wide Association Study of Multiple Plasma Metals with Serum Metabolomic Profile among Middle-to-Older-Aged Chinese Adults. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:16001-16011. [PMID: 36269707 PMCID: PMC9671050 DOI: 10.1021/acs.est.2c05547] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/04/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
Metal exposure has been associated with risk of various cardio-metabolic disorders, and investigation on the association between exposure to multiple metals and metabolic responses may reveal novel clues to the underlying mechanisms. Based on a metabolome-wide association study of 17 plasma metals with untargeted metabolomic profiling of 189 serum metabolites among 1992 participants within the Dongfeng-Tongji cohort, we replicated two metal-associated pathways, linoleic acid metabolism and aminoacyl-tRNA biosynthesis, with novel metal associations (false discovery rate, FDR < 0.05), and we also identified two novel pathways, including biosynthesis of unsaturated fatty acids and alpha-linolenic acid metabolism, as associated with metal exposure (FDR < 0.05). Moreover, two-way orthogonal partial least-squares analysis showed that five metabolites, including aspartylphenylalanine, free fatty acid 14:1, uridine, carnitine C14:2, and LPC 18:2, contributed most to the joint covariation between the two data matrices (12.3%, 8.3%, 8.0%, 7.4%, and 7.3%, respectively). Further BKMR analysis showed significant positive joint associations of plasma Al, As, Ba, and Zn with aspartylphenylalanine and of plasma Ba, Co, Mn, and Pb with carnitine C14:2, when all the metals were at the 55th percentiles or above, compared with the median. We also found significant interactions between As and Ba in the association with aspartylphenylalanine (P for interaction = 0.048) and between Ba and Pb in the association with carnitine C14:2 (P for interaction < 0.001). Together, these findings may provide new insights into the mechanisms underlying the adverse health effects induced by metal exposure.
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Affiliation(s)
- Yuhui Lin
- Ministry
of Education and State Key Laboratory of Environmental Health (Incubating),
School of Public Health, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yu Yuan
- Ministry
of Education and State Key Laboratory of Environmental Health (Incubating),
School of Public Health, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yang Ouyang
- CAS
Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy
of Sciences, Dalian 116023, China
- University
of Chinese Academy of Sciences, Beijing 100049, China
| | - Hao Wang
- Ministry
of Education and State Key Laboratory of Environmental Health (Incubating),
School of Public Health, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yang Xiao
- Ministry
of Education and State Key Laboratory of Environmental Health (Incubating),
School of Public Health, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xinjie Zhao
- CAS
Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy
of Sciences, Dalian 116023, China
- University
of Chinese Academy of Sciences, Beijing 100049, China
| | - Handong Yang
- Department
of Cardiovascular Disease, Dongfeng Central
Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - Xiulou Li
- Department
of Cardiovascular Disease, Dongfeng Central
Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - Huan Guo
- Ministry
of Education and State Key Laboratory of Environmental Health (Incubating),
School of Public Health, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Meian He
- Ministry
of Education and State Key Laboratory of Environmental Health (Incubating),
School of Public Health, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xiaomin Zhang
- Ministry
of Education and State Key Laboratory of Environmental Health (Incubating),
School of Public Health, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Guowang Xu
- CAS
Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy
of Sciences, Dalian 116023, China
- University
of Chinese Academy of Sciences, Beijing 100049, China
| | - Gaokun Qiu
- Ministry
of Education and State Key Laboratory of Environmental Health (Incubating),
School of Public Health, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Tangchun Wu
- Ministry
of Education and State Key Laboratory of Environmental Health (Incubating),
School of Public Health, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan 430030, China
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25
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Zhong J, Liu L, Zhang L, Xu Z, Peng L, Zhao X, Yang Q, Yang T, Xu D, Hong F. Association of Urinary Zinc Concentrations with Dyslipidemia and Its Subtypes: Baseline Data from the Chinese Multi-Ethnic Cohort (CMEC) Study. Biol Trace Elem Res 2022:10.1007/s12011-022-03454-6. [PMID: 36284051 DOI: 10.1007/s12011-022-03454-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/17/2022] [Indexed: 11/02/2022]
Abstract
This study elucidates the association between urinary zinc concentration and the risk of developing dyslipidemia and its subtypes in China's ethnic minority residents. Based on the baseline survey data of the Chinese Multi-Ethnic Cohort (CMEC) study, 10,620 subjects were included in the study. Logistic regression analysis evaluated the relationship between urinary zinc concentration and dyslipidemia and its subtypes. After adjustment, compared with urinary zinc concentration quartile 1 (Q1), the odds ratios (ORs) and 95% confidence intervals (95% CIs) of dyslipidemia participants in the quartile 2 (Q2), quartile 3 (Q3), and quartile 4 (Q4) groups were 1.091 (0.963, 1.237), 1.151 (1.051, 1.304), and 1.393 (1.230, 1.579), respectively (P for trend < 0.001). While that of hypertriglyceridemia participants in the Q2, Q3, and Q4 groups were 1.130 (0.979, 1.306), 1.283 (1.113, 1.480), and 1.483 (1.287, 1.709), respectively (P for trend < 0.001). Lastly, the ORs and 95% CIs of hyperbetalipoproteinemia participants in the Q2, Q3, and Q4 groups were 1.166 (0.945, 1.439), 1.238 (1.007, 1.522), and 1.381 (1.126, 1.695), respectively (P for trend < 0.002). This study found that urinary zinc concentrations were not associated with hypercholesterolemia and hypoalphalipoproteinemia. The dose-response relationship was non-linear between urinary zinc concentration and dyslipidemia, hypertriglyceridemia and hyperbetalipoproteinemia (P for trend < 0.001). In the stratified analysis, urinary zinc levels were positively associated with the risk of dyslipidemia, hypertriglyceridemia, and hyperbetalipoproteinemia in male, ≥ 60 years old, Miao nationality, hypertension, diabetes, and BMI ≥ 24.0 kg/m2 subgroups. Our study provides some possible evidence that elevated urinary zinc concentrations are associated with an increased risk of dyslipidemia, hypertriglyceridemia, hyperbetalipoproteinemia.
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Affiliation(s)
- Jianqin Zhong
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Leilei Liu
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Linyuan Zhang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Zixuan Xu
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Lian Peng
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Xiaolan Zhao
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Qianyuan Yang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Tingting Yang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Degan Xu
- Guiyang Center for Disease Control and Prevention, Guiyang, 550003, China
| | - Feng Hong
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China.
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Liu M, Li M, Guo W, Zhao L, Yang H, Yu J, Liu L, Fang Q, Lai X, Yang L, Zhu K, Dai W, Mei W, Zhang X. Co-exposure to priority-controlled metals mixture and blood pressure in Chinese children from two panel studies. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 306:119388. [PMID: 35526645 DOI: 10.1016/j.envpol.2022.119388] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 06/14/2023]
Abstract
Metals may affect adversely cardiovascular system, but epidemiological evidence on the associations of priority-controlled metals including antimony (Sb), arsenic (As), cadmium, lead, and thallium with children's blood pressure (BP) was scarce and inconsistent. We conducted two panel studies with 3 surveys across 3 seasons among 144 and 142 children aged 4-12 years in Guangzhou and Weinan, respectively. During each seasonal survey, urine samples were collected for 4 consecutive days and BP was measured on the 4th day. We obtained 786 BP values and urinary metals measurements at least once within 4 days, while 773, 596, 612, and 754 urinary metals measurements were effective on the health examination day (Lag 0), and the 1st, 2nd, and 3rd day preceding BP measurement (Lag 1, lag 2 and lag 3), respectively. We used linear mixed-effect models, generalized estimating equations and multiple informant models to assess the associations of individual metal at each lag day and accumulated lag day (4 days averaged, lag 0-3) with BP and hypertension, and Bayesian Kernel Machine Regression to evaluate the relations of metals mixture at lag 0-3 and BP outcomes. We found Sb was positively and consistently related to systolic BP (SBP), mean arterial pressure (MAP), and odds of having hypertension within 4 days, which were the strongest at lag 0 and declined over time. And such relationships at lag 0-3 showed in a dose-response manner. Meanwhile, Sb was the only contributor to the relations of mixture with SBP, MAP, and odds of having hypertension. Also, synergistic interaction between Sb and As was significant. In addition, modification effect of passive smoking status on the association of Sb and SBP was more evident in passive smokers. Accordingly, urinary Sb was consistently and dose-responsively associated with increased BP and hypertension, of which Sb was the major contributor among children.
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Affiliation(s)
- Miao Liu
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Meng Li
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Wenting Guo
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lei Zhao
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Department of Public Health, Medical College of Qinghai University, Xining, Qinghai, China
| | - Huihua Yang
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jie Yu
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Linlin Liu
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qin Fang
- Department of Medical affairs, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), Zhuhai, Guangdong, China
| | - Xuefeng Lai
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Liangle Yang
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Kejing Zhu
- Zhuhai Center for Disease Control and Prevention, Zhuhai, Guangdong, China
| | - Wencan Dai
- Zhuhai Center for Disease Control and Prevention, Zhuhai, Guangdong, China
| | - Wenhua Mei
- Zhuhai Center for Disease Control and Prevention, Zhuhai, Guangdong, China
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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