Association of low-level blood lead with serum uric acid in U.S. adolescents: a cross-sectional study

Association between urinary methylparaben level and bone mineral density in children and adolescents aged 8-19 years

Previous epidemiological study has explored a positive association between methylparaben (Mep) and bone mineral density (BMD) in adults. Evidence linking Mep and BMD in children and adolescents is very limited. This study examined the association between Mep and BMD in children and adolescents aged 8-19 years. In this cross-sectional study, 1830 children and adolescents aged 8-19 years from NHANES 2011-2016 were analyzed. Mep was ln-transformed for analysis of the skewed distribution. Multiple linear regression analyses were performed to evaluate Mep's association with BMD (containing total BMD, trunk bone BMD, pelvis BMD, lumbar spine BMD, and thoracic spine BMD). Moreover, a generalized additive model (GAM) and a fitted smoothing curve (penalized spline method) were conducted to explore the exact shape of curve between them. In the fully adjusted model, ln-transformed Mep and BMD showed an independent and positive association (total BMD (β = 0.003, 95% CI (0.001, 0.005), P = 0.01), trunk bone BMD (β = 0.002, 95% CI (0.000, 0.005), P = 0.04), pelvis BMD (β = 0.004, 95% CI (0.001, 0.008), P = 0.02), lumbar spine BMD (β = 0.005, 95% CI (0.001, 0.008), P = 0.01), thoracic spine BMD (β = 0.003, 95% CI (0.001, 0.005), P = 0.02)) and a linear association. Subgroup analysis showed positive association between ln-transformed Mep and BMD. Furthermore, the positive association was significant in females and children aged 12-19 years (P for trend < 0.05). This study is the first study to find evidence demonstrating that exposure to Mep may be positively associated with BMD in children and adolescents aged 8-19 years. Validation of our findings will need further research.

Associations of circulating multiple metals with the risk of incident hyperuricemia and the average annual change in uric acid levels

BACKGROUND

Hyperuricemia has been linked to exposure to certain metals in cross-sectional studies. However, prospective studies evaluating the associations of multiple metal exposures with incident hyperuricemia are scarce.

OBJECTIVES

To prospectively investigate the associations of multiple metal/metalloid concentrations with incident hyperuricemia as well as average annual change in uric acid levels in a longitudinal cohort.

METHODS

A longitudinal cohort study included 3957 subjects who were free of cardiovascular disease with certain risk factors for cardiovascular disease at baseline. Incident hyperuricemia was ascertained if serum uric acid level was ≥ 420 μmol/L for men and ≥ 360 μmol/L for women during the follow-up visit in 2013. The relationships between 17 single plasma metals/metalloids and incident hyperuricemia were assessed using unconditional logistic regression models. For metals/metalloids significantly related to incident hyperuricemia, we further utilized generalized linear regression models to evaluate their associations with the average annual change in uric acid levels. Finally, we applied the weighted quantile sum (WQS) regression to investigate the joint effects of metals/metalloids on hyperuricemia risk and uric acid changes, and to identify the most significant metals.

RESULTS

After adjusting for potential confounders, plasma aluminum, arsenic, barium, lead, strontium, vanadium, and zinc concentrations were positively associated with incident hyperuricemia in both main analyses and sensitivity analyzes. Compared to the lowest quartiles, participants in the highest quartiles had 63 %-125 % higher risks of incident hyperuricemia (all FDR < 0.05). Furthermore, the positive associations of these seven metals with an average annual uric acid increase reinforced the findings. Finally, the WQS analyses showed that plasma metals mixtures were positively associated with the risk of incident hyperuricemia (OR: 1.47; 95 % CI: 1.23, 1.76) and the average annual change in uric acid levels (β: 3.17; 95 % CI: 2.42, 3.93), and strontium and vanadium were the most heavily weighted metals, respectively.

CONCLUSION

Our findings identify aluminum, arsenic, barium, lead, strontium, vanadium, and zinc exposures as independent risk factors for hyperuricemia and provide new insights into the prevention of hyperuricemia.

High-density lipoprotein cholesterol modifies the association between blood lead and uric acid: results from NHANES 2005-2016

BACKGROUND

The association between blood lead (PbB) and uric acid (SUA) remains unclear in US adults without a high level of lead exposure. Additionally, the effects of high-density lipoprotein cholesterol (HDL-C) modifying this association are still unclear. Therefore, this study aims to assess the effect of modification of high-density lipoprotein cholesterol on the association between PbB and SUA.

METHOD

This research analyzed National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2016. Through several screenings, 18,578 participants over the age of 20 were eligible for the analysis. Multivariable linear regression was used to evaluate the association between PbB and SUA. By having stratified participants based on the HDL-C intake category (low HDL-C intake < 50 mg/dl; high HDL-C intake ≥ 50 mg/dl), effect modification by HDL-C was assessed through a likelihood ratio test between PbB and SUA.

RESULT

Multivariable linear regression indicated that PbB positively affects SUA (β = 0.19, 95% CI 0.16-0.22). The relationship between PbB and SUA was different in the low and high HDL-C intake group (β 0.12 95% Cl 0.08-0.16 vs. β 0.26 95% Cl 0.22 ~ - 0.30). Furthermore, high-density lipoprotein cholesterol significantly modified the relationship between PbB and SUA in all models which indicates that the interaction of lead exposure and HDL-C is more dangerous than the sum of the individual effects.

CONCLUSIONS

Our study shows that high-density lipoprotein cholesterol and blood lead have an interactive effect on increasing uric acid, which may have great importance for clinical medication.

Environmental Triggers of Hyperuricemia and Gout

Gout is the most prevalent type of inflammatory arthritis worldwide and environmental factors contribute to hyperuricemia and risk for gout flare. Causes of hyperuricemia include increased purine consumption from meat, alcohol, and high fructose corn syrup as well as medications such as cyclosporine, low-dose aspirin, or diuretics. Triggers for gout flares include increased purine consumption and medication use such as urate lowering therapy and diuretics. Environmental exposures including lead exposure, particulate matter exposure, temperature fluctuations, and physiologic stress have been found to trigger flares. In the right clinical scenario, these factors should be considered when treating gout patients.

Association between sleep duration and albumin in US adults: a cross-sectional study of NHANES 2015–2018

Background

Albumin has multiple functions and is used in the clinical assessment of liver function, kidney function and nutritional status. However, few epidemiological studies have evaluated the association between sleep duration and albumin. Therefore, we carried out a cross-sectional study to address this issue. The aim of the study was to investigate the association between sleep duration and albumin in American adults based on the NHANES (National Health and Nutrition Examination Survey).

Methods

A total of 9,973 participants aged \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\ge$$\end{document}≥ 20 years were included in this study from NHANES 2015–2018. Weighted data were calculated according to analytical guidelines. Linear regression models and smooth curve fitting were used to assess and describe the relationship between sleep duration and albumin. The inflection point was determined by a two-step recursive method. Moreover, univariate and stratified analyses were performed.

Results

There was an inverted U-shaped association between sleep duration and albumin levels. Albumin levels were highest when the sleep duration was 7.5 h. Compared to 7–8 h of sleep, short sleep duration was linked to lower albumin levels [sleep duration \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\le$$\end{document}≤ 5 h: β \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$=$$\end{document}=-1.00, 95% CI (-1.26, -0.74), P < 0.0001]. Compared to 7–8 h of sleep, long sleep duration was related to lower albumin levels [sleep duration \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$>$$\end{document}> 9 h: β \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$=$$\end{document}= -0.48, 95% CI (-0.68, -0.27), P < 0.0001].

Conclusions

Sleep duration had an inverted U-shaped relationship with albumin, with short or long sleep duration associated with significantly lower albumin levels.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13524-y.

Association of Dietary Magnesium Intake With Leukocyte Telomere Length in United States Middle-Aged and Elderly Adults

Aim

Magnesium supplementation may extend the life span; however, the biological mechanism is still unknown. Leukocyte telomere length (LTL) is a marker of cell aging and biological health in humans. Data concerning whether magnesium supplementation can maintain telomere length, thus prolonging life are limited. We aimed to investigate the association between dietary magnesium intake and LTL in United States middle-aged and elderly adults.

Methods

A total of 4,039 United States adults aged ≥ 45 years from National Health and Nutrition Examination Survey (1999–2002). Dietary magnesium intake was collected by a trained interviewer using 24-h dietary recall method and LTL was obtained using the quantitative polymerase chain reaction method. Multiple linear regression analysis was performed to evaluate the crude and adjusted association of dietary magnesium intake with LTL.

Results

The overall mean (SD) of LTL was 5.6 (0.6) kp. After adjusting potential confounders, every 1 mg increase in log-transformed dietary magnesium intake was associated with 0.20 kp (95% confidence intervals: 0.05–0.34) longer LTL. Participants with the highest tertile (≥299 mg) of dietary magnesium intake had statistically significant longer LTL (β = 0.07, P = 0.038) compared with the lowest tertile (&lt;198 mg), with significant linear trends across tertiles. Moreover, the association between dietary magnesium intake and LTL was significantly stronger in participants with higher levels of education (≥high school compared with &lt; high school, P for interaction = 0.002). E-value analysis suggested robustness to unmeasured confounding.

Conclusion

Our findings showed that increased dietary magnesium intake was associated with longer LTL, which suggested that magnesium was conducive to a longer life expectancy.

Association Between Four Anthropometric Indexes and Metabolic Syndrome in US Adults

OBJECTIVE

To study the association between anthropometric indexes [lipid accumulation products (LAP), visceral obesity index (VAI), triglyceride and glucose index (TyG) and waist triglyceride index (WTI)] and metabolic syndrome (MetS) in a representative sample of American adult population surveyed by National Health and Nutrition Examination Survey (NHANES).

METHODS

Cross-sectional data from the NHANES were used. Participants were adults aged 18-80 y from 1996-2006. MetS were defined by the updated National Cholesterol Education Program/Adult Treatment Panel III criteria (NCEP-ATP III) for Americans. Receiver operating characteristic (ROC) curve was drawn and the areas under the curve (AUC) were used to assess the ability of these indexes in screening MetS. Statistical differences among the AUC values of these indexes were compared. The association between the anthropometric indexes and MetS was investigated using weighted multivariable-adjusted logistic regression.

RESULTS

560 (35.2%) males and 529 (26.4%) females were diagnosed with MetS. LAP was the strongest predictor of MetS for men (AUC=0.87, 95% CI 0.85-0.89), and also was the strongest for women [AUC=0.85, 95% confidence interval (CI) 0.83-0.86], according to the ROC curve analysis. In men, differences in AUC values between LAP and other anthropometric indicators were also significant (all P<0.001). In women, there was a significant difference in AUC values between LAP and WTI (P<0.001), but differences in AUC values between LAP and TyG, VAI were not significant.

CONCLUSION

The present study indicated that LAP is a better predictor in the clinical setting for identifying individuals with MetS in the American adult population.

No association between serum uric acid and lumbar spine bone mineral density in US adult males: a cross sectional study

Available evidence linking serum uric acid (SUA) and bone mineral density (BMD) remains controversial, and data on this association are limited among adult men in the general population. Thus, the aim of this study was to evaluate the association of SUA with lumbar spine BMD in US adult males. A cross-sectional study was conducted based on the National Health and Nutrition Examination Survey (NHANES, 1999–2006) database. Multivariate linear regression analyses were employed to assess the association of SUA with lumbar spine BMD, considering complex survey design and sampling weights. Through rigorous eligibility criteria, a total of 6704 individuals were yielded for final data analysis (average age, 40.5 years; 70.6% white). After fully adjusting potential confounders, no associations were detected between SUA and lumbar spine BMD [β (95% confidence interval, CI), − 0.003 (− 0.007, 0.002)]. Additionally, similar results were observed in all stratification analyses, and no interactions were found based on all priori specifications. In brief, our findings did not provide an inspiring clue for the hypothesis that SUA may be beneficial to lumbar spine BMD. Future more prospective studies are needed to further explore the causal relationship of SUA with lumbar spine BMD.

Circulating lead modifies hexavalent chromium-induced genetic damage in a chromate-exposed population: An epidemiological study

Chromium (Cr) can coexist with other heavy metals in the blood of chronically chromate-exposed individuals. However, few studies have explored the health impacts of other hazardous metals after exposure to hexavalent chromium [Cr(VI)]. This study aimed to assess the modification effects of blood lead (Pb) on the genetic damage induced by Cr(VI). During 2010-2019, 1000 blood samples were collected from 455 workers exposed to chromate and 545 workers not exposed to chromate from the same factory with similar labor intensity. The levels of Cr and Pb were measured in whole blood samples. Micronucleus frequency (MNF) and urinary 8-hydroxydeoxyguanosine (8-OHdG) were measured to reflect different types of genetic damage. Multivariate linear regression analyses were performed to evaluate the associations between hazardous metals and the modification effects of Pb on genetic damage. The geometric mean levels of Cr and Pb in the exposure group were significantly higher than those in the control group [Cr: 6.42 (6.08- 6.79) vs. 1.29 (1.22- 1.36) μg/L; Pb: 38.82 (37.22- 40.50) vs. 34.47 (33.15- 35.85) μg/L]. The geometric means of urinary 8-OHdG and MNF in exposure group were 4.00 (3.64- 4.40) μg/g and 5.40 (4.89- 5.97) ‰, respectively, significantly higher than the 3.20 (2.94- 3.48) μg/g and 4.57 (4.15- 5.03) ‰, respectively, in control group. log₂Cr was independently and positively associated with urinary 8-OHdG (β_-adjusted = 0.143, 95% CI: 0.082- 0.204) and MNF (β_-adjusted = 0.303, 95%CI: 0.020- 0.587). With the change in circulating Pb levels, the types of genetic damage induced by Cr(VI) were different. At low levels of circulating Pb (<30.80 μg/L), chromate mainly caused changes in 8-OHdG, while at high circulating Pb levels (≥44.88 μg/L), chromate induced alterations in MNF. The findings suggested that chromate exposure could cause multiple types of genetic damage, and circulating Pb might modify the association between circulating Cr and the form of genetic damage.

Association between pyrethroid pesticide exposure and hearing loss in adolescents

BACKGROUND

Hearing loss in adolescents is a serious public health problem with a high prevalence. Pyrethroids are one of the most widely applied insecticides that have been linked to neurotoxicity. However, there is no study about the effect of pyrethroid insecticide exposure on the auditory system in the general population.

OBJECTIVE

To investigate the association between pyrethroid pesticide exposure and hearing loss in adolescents in the United States.

METHODS

A total of 720 adolescents aged 12-19 years who participated in the National Health and Nutrition Examination Survey (NHANES, 2007-2010) were considered. 3-phenoxybenzoic acid (3-PBA), a urinary metabolite, was applied as a biomarker to assess pyrethroid exposure. Hearing loss in adolescents was defined as a pure-tone average (PTA) > 15 dB in either ear. Multivariate linear and logistic regression analyses were conducted to examine the associations of urinary 3-PBA with PTA hearing thresholds and risk of hearing loss, respectively.

RESULTS

The weighted geometric mean of 3-PBA levels in urine was 0.32 μg/g creatinine, and 7.62% of adolescents had hearing loss. After adjusting for age, sex, race/ethnicity, BMI, serum cotinine, annual family income and exposure to loud noise/music, linear regression analyses found that Ln-transformed 3-PBA was positively correlated with increase of hearing thresholds in either left (β = 0.61, 95% CI: 0.20-1.01) or right ear (β = 0.52, 95% CI: 0.16-0.89). Logistic regression analyses showed that adjusted odds ratio (OR) for hearing loss in adolescents with the highest tertile (≥0.52 μg/g creatinine) of 3-PBA were 3.12 (95% CI: 1.42-6.83) compared with the lowest tertile (<0.18 μg/g creatinine), with significant linear trends across tertiles.

CONCLUSION

Pyrethroid pesticide exposure was positively associated with hearing loss in U.S. adolescents. This study provides new evidence for the association between pyrethroid exposure and auditory function.