Chromium levels in healthy and newly diagnosed type 1 diabetic children

Relationships between emissions of toxic airborne molecules and type 1 diabetes incidence in children: An ecologic study

BACKGROUND

Type 1 diabetes originates from gene-environment interactions, with increasing incidence over time.

AIM

To identify correlates of childhood type 1 diabetes in European countries using an ecological approach. Several environmental variables potentially influencing the onset of type 1 diabetes have been previously evaluated. However, the relationships between epidemiologic data and exposure to toxic airborne molecules are scarcely studied.

METHODS

We employed an ecological model to explore, in a wide time period (1990-2018), associations between type 1 diabetes incidence in 19 European countries (systematic literature review) and the nationwide production of five widely diffused air pollutants: particulate matter < 10 μm (PM10), nitrogen oxides (NO), non-methane volatile organic compounds (VOCs), sulphur oxide (SO₂), and ammonia.

RESULTS

Data confirm a raising incidence of type 1 diabetes in 18 out of 19 explored countries. The average difference (last vs first report, all countries) was +6.9 × 100000/year, with values ranging from -1.4 (Germany) to +16.6 (Sweden) per 100000/year. Although the overall production of pollutants decreased progressively from 1990 to 2018, type 1 diabetes incidence was positively associated with the nationwide emissions of PM10, VOCs, and NO but not with those of SO2 and ammonia. Type 1 diabetes incidence was significantly higher in countries with high emissions than in those with low emissions of PM10 (27.5 ± 2.4 vs 14.6 ± 2.4 × 100000 residents, respectively), VOCs (24.5 ± 4.4 vs 13.2 ± 1.7 × 100000 residents, respectively), and NO (26.6 ± 3 vs 13.4 ± 2.4 × 100000 residents, respectively), but not of SO₂ or ammonia.

CONCLUSION

Evidence justify further studies to explore better links between long-term air quality and type 1 diabetes onset at the individual level, which should include exposures during pregnancy. In this respect, type 1 diabetes could be, at least in part, a preventable condition. Thus, primary prevention policies acting through a marked abatement of pollutant emissions might attenuate future type 1 diabetes incidence throughout Europe.

Comparison of Chromium and Iron Distribution in Serum and Urine among Healthy People and Prediabetes and Diabetes Patients

The effect of chromium (Cr) and iron (Fe) on prevalence of diabetes has received great attention. This study investigated serum and urinary Cr and Fe levels among patients with impaired fasting glucose (IFG), impaired glucose tolerance (IGT), type 1 diabetes (T1D), and type 2 diabetes (T2D) in the Northeast Chinese population. From January 2010 to October 2011, patients with IFG (n=12), IGT (n=15), T1D (n=25), T2D (n=137) and healthy controls (n=50) were enrolled in the First Hospital of Jilin University. Trace elements were detected using an inductively coupled plasma spectrometer. Serum Cr levels decreased in T2D without complications, diabetic retinopathy (DR), diabetic peripheral neuropathy (DPN), and diabetic nephropathy (DN) (P<0.05). The urinary Cr level in T1D was the highest of all, which significantly exceeded those of the T2D groups with and without complications. No significant differences of serum Fe levels were found among all groups. The urinary Fe level of T1D was significantly increased (P<0.05). The correlation between serum Cr and serum Fe in T2D was obviously positive (P<0.05). One month of simvastatin therapy exerted no effects on serum or urinary Cr and Fe levels. These results suggest the potential role of Cr and Fe in diabetes should receive attention.

Environmental Exposure of Children to Toxic Trace Elements (Hg, Cr, As) in an Urban Area of Yucatan, Mexico: Water, Blood, and Urine Levels

Merida is the largest urban center in the Mexican State of Yucatan. Here domestic sewage is deposited in poorly built septic tanks and is not adequately treated. Because of contamination from such waste, water from the top 20 m of the aquifer is unsuitable for human consumption. Given this situation and because children are highly vulnerable to environmental pollution, including exposure to toxic trace elements, this study focused on evaluating the exposure of children to arsenic (As), chromium (Cr), and mercury (Hg) in water. It also evaluated the relationship between the levels of these elements in water and their concentrations in urine and blood. Among the 33 children monitored in the study, arsenic surpassed WHO limits for blood in 37% of the cases, which could result from the ingestion of poultry contaminated with organoarsenic compounds. In the case of WHO limits for Mercury, 65% of the water samples analyzed, 28% of urine samples, and 12% of blood samples exceeded them. Mercury exposure was correlated with biological sex, some lifestyle factors, and the zone in Merida in which children live. These data suggest that the levels of some toxic metals in children may be affected by water source, socioeconomic factors, and individual behavior.

Water Consumption as Source of Arsenic, Chromium, and Mercury in Children Living in Rural Yucatan, Mexico: Blood and Urine Levels

Studies investigating the correlation between metal content in water and metal levels in children are scarce worldwide, but especially in developing nations. Therefore, this study investigates the correlation between arsenic, chromium, and mercury concentrations in drinking and cooking water and in blood and urine samples collected from healthy and supposedly non-exposed children from a rural area in Yucatan, Mexico. Mercury in water shows concentrations above the recommended World Health Organization (WHO) value for drinking and cooking water. Also, 25% of the children show mercury in urine above the WHO recommended value. Multivariate analyses show a significant role for drinking and cooking water as a vector of exposure in children. Also, the factor analysis shows chronic exposure in the case of arsenic, as well as an ongoing detoxification process through urine in the case of mercury. Further studies should be done in order to determine other potential metal exposure pathways among children.

Type I diabetes in paediatric age in Apulia (Italy): Incidence and associations with outdoor air pollutants

AIM

This study aimed to explore Type 1 diabetes (T1D) incidence and possible relations with specific air pollutants in a large population of children, during a wide time period.

METHODS

T1D rates and trends were examined (2001-2013, GAM and Joinpoint Regression analysis) by data on the first hospitalization in all children (0-14 years) living in Apulia (Southern Italy, average yearly population aged 0-14 years in the examined period: 631,275 subjects), and linked with levels of PM10, NOx, CO and ozone.

RESULTS

A total of 1501 children were first discharged in the selected area with a diagnosis of T1D. Incidence decreased from 48.5 (95% CI 43.3; 54.0, 2001) to 16.9 per 100,000 (95% CI 13.7; 20.6, 2013), with differences according to age at onset (constant at 0-4 years, continuously decreasing at 5-9 years, decreasing until 2003 at 10-14 years), and with a positive relation with PM10--but not ozone, NOx and CO average air levels. The OR was 1.037 (1.002; 1.074) in the high tertile of PM10 concentrations, and mean incidence was higher with PM10 levels in the highest, than in the medium/reference tertile. Mean age at T1D onset was linked with yearly PM10 and ozone air levels.

CONCLUSIONS

On a wide period, a stable or decreased incidence of T1D was evident in children with early- or later onset of disease, respectively. PM10 exposure significantly affects the incidence of T1D, which might be considered, at least in part, a preventable condition.

Magnesium, zinc, and chromium levels in children, adolescents, and young adults with type 1 diabetes

BACKGROUND & AIMS

Several trace elements are involved in insulin signal transduction and glucose metabolism. Our aim for this present study was to determine the levels of three important elements-magnesium, chromium, and zinc-as well as one oxidative stress marker-malondialdehyde (MDA)-in young type 1 diabetic patients at different periods of their growth, and to realize the relationships between trace elements, oxidative stress, and growth stages.

METHODS

A total of 88 patients with type 1 diabetes mellitus in different growth stages and 76 gender- and age-matched healthy subjects were included in this study. The levels of MDA were measured through HPLC using a C-18 column. Zinc, magnesium, and chromium concentrations in serum were assessed using atomic absorption spectrophotometry.

RESULTS

We found higher levels of blood malondialdehyde (MDA; p < 0.001), significantly lower levels of magnesium (p < 0.001), and no differences in zinc and chromium levels (p = 0.153 and 0.515, respectively) in younger type 1 diabetic subjects relative to those of control subjects. Only 3.4% (3/88) of younger diabetic subjects exhibited hypomagnesemia; similar results were obtained when comparing different subgroups: children, adolescents, and adults. We also observed no differences in the levels of the three elements between the genders and among the growth stages (p > 0.05) of the diabetic subjects. There were no correlations between the three trace elements and HbA1C, diabetes duration, and insulin dose/BMI (all p > 0.05), but there was a significant difference between zinc levels and insulin dose/BMI (p = 0.043) in the diabetic patients.

CONCLUSIONS

We found elevated blood MDA, decreased magnesium, and no changes in zinc and chromium levels in younger type 1 diabetic subjects relative to those of control subjects. Only 3.4% of younger diabetic subjects exhibited hypomagnesemia. Whether magnesium supplementation is suitable for improving insulin sensitivity and decreasing oxidative stress and inflammation will require confirmation through additional studies.

Fat, epigenome and pancreatic diseases. Interplay and common pathways from a toxic and obesogenic environment

The worldwide obesity epidemic is paralleled by a rise in the incidence of pancreatic disorders ranging from "fatty" pancreas to pancreatitis and cancer. Body fat accumulation and pancreatic dysfunctions have common pathways, mainly acting through insulin resistance and low-grade inflammation, frequently mediated by the epigenome. These mechanisms are affected by lifestyle and by the toxic effects of fat and pollutants. An early origin is common, starting in pediatric age or during the fetal life in response to nutritional factors, endocrine disruptor chemicals (EDCs) or parental exposure to toxics. A "fatty pancreas" is frequent in obese and is able to induce pancreatic damage. The fat is a target of EDCs and of the cytotoxic/mutagenic effects of heavy metals, and is the site of bioaccumulation of lipophilic and persistent pollutants related with insulin resistance and able to promote pancreatic cancer. Increased Body Mass Index (BMI) can act as independent risk factor for a more severe course of acute pancreatitis and obesity is also a well-known risk factor for pancreatic cancer, that is related with BMI, insulin resistance, and duration of exposure to the toxic effects of fat and/or of environmental pollutants. All these mechanisms involve gene-environment interactions through epigenetic factors, and might be manipulated by primary prevention measures. Further studies are needed, pointing to better assess the interplays of modifiable factors on both obesity and pancreatic diseases, and to verify the efficacy of primary prevention strategies involving lifestyle and environmental exposure to toxics.