Relationship between the concentrations of heavy metals and bioelements in aging men with metabolic syndrome

Re-thinking the link between exposure to mercury and blood pressure

Hypertension or high blood pressure (BP) is a prevalent and manageable chronic condition which is a significant contributor to the total global disease burden. Environmental chemicals, including mercury (Hg), may contribute to hypertension onset and development. Hg is a global health concern, listed by the World Health Organization (WHO) as a top ten chemical of public health concern. Most people are exposed to some level of Hg, with vulnerable groups, including Indigenous peoples and small-scale gold miners, at a higher risk for exposure. We published a systematic review and meta-analysis in 2018 showing a dose-response relationship between Hg exposure and hypertension. This critical review summarizes the biological effects of Hg (both organic and inorganic form) on the underlying mechanisms that may facilitate the onset and development of hypertension and related health outcomes and updates the association between Hg exposure (total Hg concentrations in hair) and BP outcomes. We also evaluated the weight of evidence using the Bradford Hill criteria. There is a strong dose-response relationship between Hg (both organic and inorganic) exposure and BP in animal studies and convincing evidence that Hg contributes to hypertension by causing structural and functional changes, vascular reactivity, vasoconstriction, atherosclerosis, dyslipidemia, and thrombosis. The underlying mechanisms are vast and include impairments in antioxidant defense mechanisms, increased ROS production, endothelial dysfunction, and alteration of the renin-angiotensin system. We found additional 16 recent epidemiological studies that have reported the relationship between Hg exposure and hypertension in the last 5 years. Strong evidence from epidemiological studies shows a positive association between Hg exposure and the risk of hypertension and elevated BP. The association is mixed at lower exposure levels but suggests that Hg can affect BP even at low doses when co-exposed with other metals. Further research is needed to develop robust conversion factors among different biomarkers and standardized measures of Hg exposure. Regulatory agencies should consider adopting a 2 µg/g hair Hg level as a cut-off for public health regulation, especially for adults older than child-bearing age.

Age-dependent interaction between serum zinc and triglyceride-glucose index among American adults: National Health and Nutrition Examination Survey

Introduction

Zinc plays a crucial role in glucose metabolism. The association between serum zinc and insulin resistance has recently been investigated as well, but the findings are inconsistent. The triglyceride-glucose index (TyG) is frequently utilized in epidemiological research to assess insulin resistance. The association between serum zinc levels and TyG has not yet been explored. Therefore, we designed this cross-sectional study to assess the relationship between serum zinc and TyG in adults using data from the National Health and Nutrition Examination Survey (NHANES).

Methods

A cross-sectional analysis was performed on 1,610 adults aged ≥20 years who participated in the National Health and Nutrition Examination Survey (NHANES) 2011-2016. The participants were stratified by age, and the differences in log-transformed serum zinc quartiles and TyG were further evaluated in age groups <60 years and ≥60 years using multivariable linear regression with an interaction test. Additionally, a restricted cubic spline (RCS) model was employed to examine the dose-response relationships between log-transformed serum zinc and TyG.

Results

In this cross-sectional study, a significant interaction was observed between log-transformed serum zinc and TyG in individuals aged <60 years and those aged ≥60 years when log-transformed serum zinc was transformed into a categorical variable (P-value for the likelihood ratio test for the interaction was P = 0.017). Additionally, in the fully adjusted analyses, the association between log-transformed serum zinc and TyG in the age <60 years group demonstrated a J-shaped nonlinear pattern (P for nonlinearity = 0.014), with an inflection point at ~1.94 μg/dL. While in the age ≥60 years group, it exhibited an inverted-L shaped nonlinear pattern (P for nonlinearity < 0.001***).

Conclusion

There is a significant relationship between log-transformed serum zinc and TyG in adults in the United States, with age potentially influencing this association. Further prospective studies are needed to offer additional evidence and insights into these findings.

Multi-Omics Assessment of Puff Volume-Mediated Salivary Biomarkers of Metal Exposure and Oxidative Injury Associated with Electronic Nicotine Delivery Systems

BACKGROUND

Since their inception, electronic nicotine delivery systems (ENDS) have gained increasing popularity, sparking a vaping epidemic among adolescents in the US and globally. Several ENDS safety concerns have emerged as device features and formats that contribute to heavy metal exposure and toxicity continue to evolve and outpace regulatory efforts.

OBJECTIVES

Our objective was to integrate ENDS emission profiles with salivary proteome and metabolome data to characterize exposure factors that may influence adverse vaping-mediated health outcomes.

METHODS

A total of 56 participants (38 exclusive ENDS users and 18 non-ENDS users) were recruited. A subset of 15 exclusive ENDS users completed puffing topography assessments to obtain individual vaping behavior patterns using each participant's ENDS device. Inductively coupled plasma mass spectrometry was used to determine the metal content of emissions (12 ENDS devices) generated using a programmable ENDS aerosol generation system and saliva (15 exclusive ENDS users and 5 non-ENDS users). Saliva samples from 10 exclusive ENDS users and 5 non-ENDS users were analyzed for proteomic, metabolomic, inflammatory, and oxidative stress/damage biomarkers.

RESULTS

A linear puff volume-dependent increase in particle emissions and heavy metals was observed in ENDS aerosols and saliva of exclusive ENDS users. Elevated puff volume-dependent levels of salivary cytokines, including tumor necrosis factor-alpha (TNFα ), interleukin-1 beta (IL-1β ), and IL-6, were observed alongside the oxidative damage indicators malondialdehyde (MDA), superoxide dismutase (SOD), and 8-hydroxy-2'-deoxyguanosine (8-OHdG). Proteome-metabolome network analysis showed a higher risk of potentially developing neurological and respiratory diseases in ENDS users compared with non-ENDS users. Integrated salivary proteome-metabolome-metallome network analysis further demonstrated that heavy metals were associated with proteomic and metabolomic perturbations, with notable alterations in inflammatory response, immune function, and disease-related pathways.

DISCUSSION

A significant correlation between heavy metals, cytokines, and oxidative stress markers reveals a potential role of vaping behavior in exposure to metals and changes in markers associated with DNA damage and inflammation. Our study demonstrates the importance of characterizing vaping behavior and puffing topography when examining the human health implications of ENDS use. https://doi.org/10.1289/EHP14321.

Association of heavy metals and bio-elements blood level with metabolic syndrome: a systematic review and meta-analysis of observational studies

Background and objectives

The literature has reported heavy metals might alter the physiological and biochemical functions of body organs and cause several health problems. So, the present systematic review and meta-analysis aimed to investigate the association of blood levels of essential or non-essential metals with metabolic syndrome (MetS).

Methods

In this systematic review, some international databases including PubMed, Embase, Scopus, and Web of Science were searched up to February 2024. All observational studies which assessed the association of three heavy metals (cadmium, mercury, lead) and bio-elements (chromium, iron, manganese, and magnesium, copper) with the risk of MetS were included. There was no limitation in the time of publication and language. A random-effects meta-analysis was performed to estimate the pooled effect sizes. Possible sources of heterogeneity were explored by meta-regression analysis.

Results

Totally, 29 studies were eligible for meta-analysis. Our results showed that increased level of cadmium (pooled OR: 1.24, 95% CI: 1.05, 1.46) and mercury (pooled OR: 1.22, 95% CI: 1.08, 1.38) significantly increased the risk of MetS. In contrast, increased level of chromium significantly reduced the risk of developing MetS (pooled OR: 0.68, 95% CI: 0.56, 0.83). Moreover, association between lead, iron, copper, magnesium, and manganese with MetS was not statistically significant (P > 0.05). However, elevated lead levels in men increased the odds of MetS.

Conclusion

Our results show a significant association between blood levels of some heavy metals, including cadmium, mercury, and lead, with increased odds of MetS. On the other hand, chromium as a biometal decreased the odds of MetS.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-024-01500-9.

Biochemical study of the risk of diabetes, prediabetic and insulin resistance in car painters and its association with mercury exposure: a retrospective case-control study

Purpose

There is controversy about the effect of mercury (Hg) exposure on developing diabetes and insulin resistance. This study aimed to assess the risk of diabetes and insulin resistance in car painters using biochemical markers and serum Hg levels.

Methods

A retrospective case-control study involving 210 male participants aged between 25 and 50 years. The participants were divided into two groups: Car painters for at least one year and healthy people who had not worked as car painters and had no health concerns or chronic diseases.

Results

The serum levels of Hg, MDA (malondialdehyde), interleukin (IL)-1β, visfatin, fasting insulin, and fasting blood glucose (FBG) were evaluated. Serum Hg levels were significantly higher in car painters compared to the control group (19.00 ± 7.20 vs. 8.339 ± 3.916 μg/L, P-value < 0.001). Serum levels of visfatin, MDA, insulin, FBG, and IL-1β were significantly higher in the car painter compared to the control (P-value < 0.001). There was a significantly higher proportion of people with diabetes in car painters compared to control (8.6% vs. 0%) and higher prediabetic (30.5% vs. 13.3%, P-value < 0.001). In car painter workers, levels of Hg were significantly higher in DM compared to prediabetic and normoglycemic car painter workers (27.01 ± 1.59, 23.98 ± 4.31, and 15.39 ± 6.41 μg/mL, respectively, P-value < 0.001); additionally, levels of Hg were significantly higher car painter with insulin resistance compared to non-insulin resistance workers (21.18 ± 7.29 vs. 16.79 ± 16.7 μg/mL, P-value < 0.001).

Conclusions

Increased serum Hg in car painters increases the risk of insulin resistance and diabetes/prediabetes status.

Effects of Various Heavy Metal Exposures on Insulin Resistance in Non-diabetic Populations: Interpretability Analysis from Machine Learning Modeling Perspective

Increasing and compelling evidence has been proved that heavy metal exposure is involved in the development of insulin resistance (IR). We trained an interpretable predictive machine learning (ML) model for IR in the non-diabetic populations based on levels of heavy metal exposure. A total of 4354 participants from the NHANES (2003-2020) with complete information were randomly divided into a training set and a test set. Twelve ML algorithms, including random forest (RF), XGBoost (XGB), logistic regression (LR), GaussianNB (GNB), ridge regression (RR), support vector machine (SVM), multilayer perceptron (MLP), decision tree (DT), AdaBoost (AB), Gradient Boosting Decision Tree (GBDT), Voting Classifier (VC), and K-Nearest Neighbour (KNN), were constructed for IR prediction using the training set. Among these models, the RF algorithm had the best predictive performance, showing an accuracy of 80.14%, an AUC of 0.856, and an F1 score of 0.74 in the test set. We embedded three interpretable methods, the permutation feature importance analysis, partial dependence plot (PDP), and Shapley additive explanations (SHAP) in RF model for model interpretation. Urinary Ba, urinary Mo, blood Pb, and blood Cd levels were identified as the main influencers of IR. Within a specific range, urinary Ba (0.56-3.56 µg/L) and urinary Mo (1.06-20.25 µg/L) levels exhibited the most pronounced upwards trend with the risk of IR, while blood Pb (0.05-2.81 µg/dL) and blood Cd (0.24-0.65 µg/L) levels showed a declining trend with IR. The findings on the synergistic effects demonstrated that controlling urinary Ba levels might be more crucial for the management of IR. The SHAP decision plot offered personalized care for IR based on heavy metal control. In conclusion, by utilizing interpretable ML approaches, we emphasize the predictive value of heavy metals for IR, especially Ba, Mo, Pb, and Cd.

Associations between APOE genotypes, urine 8-isoprostane and blood trace elements in middle-aged mothers (CROME study)

BACKGROUND

There is almost no data on the combined associations between apolipoprotein E gene (APOE) genotypes, trace elements (TEs), and lipid peroxidation in vivo. The aim of our study was to evaluate the association between APOE genotypes and TE levels in blood (B-TEs) and erythrocytes (E-TEs), and 8-isoprostane in urine (U-8-isoprostane) in women with low exposure to potentially toxic TEs and with adequate supply of essential TEs.

METHODS

B-TEs, E-TEs and U-8-isoprostane were determined in 172 healthy women of childbearing age (30.1-51.4 years) using ICP-MS and ELISA competitive assay, respectively. All women were divided into three APOE genotype groups according to the presence of the ɛ4 allele, ɛ2 allele or ɛ3 homozygotic allele. The associations between B-TEs, E-TE, U-8-isoprostane, and the APOE genotype groups were estimated by multiple variable linear regression models with relevant explanatory variables (e.g., age, BMI, and seafood).

RESULTS

All TE and U-8-isoprostane levels were inside the reference ranges for the healthy population. In the multiple variable linear regression models, our results showed that urine 8-isoprostane levels increased by up to 43.3% in the APOE4 group compared to the APOE3 group and a negligible negative modifying effect for essential TEs. However, the APOE genotype groups were associated also with some TEs. A clear positive association was found between the APOE2 and APOE4 groups (vs. APOE3) with B-molybdenum.

CONCLUSIONS

Our study suggests that the APOE4 genotype played an important role in 8-isoprostane variability in a population with an adequate supply of essential and with low exposure to potentially toxic TEs. Adequate copper, zinc and selenium status seemed to be protective against, while the levels of nonessential TEs were probably too low to play a decisive role in 8-isoprostane formation. The observed impact of the APOE2 and APOE4 groups on increased B-molybdenum opens a new research topic.

Machine learning uncovers manganese as a key nutrient associated with reduced risk of steatotic liver disease

BACKGROUND

Metabolic dysfunction-associated steatotic liver disease (MASLD) affects approximately 20%-30% of the general population and is linked to high-caloric western style diet. However, there are little data that specific nutrients might help to prevent steatosis.

METHODS

We analysed the UK Biobank (ID 71300) 24 h-nutritional assessments and investigated the association between nutrient intake calculated from food questionnaires and hepatic steatosis indicated by imaging or ICD10-coding. The effect of manganese (Mn) on subgroups with risk single nucleotide polymorphism carriage as well as the effect on metabolomics was investigated. All analyses are corrected for age, sex, body mass index, Townsend index for socioeconomic status, kcal, alcohol, protein intake, fat intake, carbohydrate intake, energy from beverages, diabetes, physical activity and for multiple testing.

RESULTS

We used a random forest classifier to analyse the feature importance of 63 nutrients and imaging-proven steatosis in a cohort of over 25 000 UK Biobank participants. Increased dietary Mn intake was associated with a lower likelihood of MRI-diagnosed steatosis. Subsequently, we conducted a cohort study in over 200 000 UK Biobank participants to explore the relationship between Mn intake and hepatic or cardiometabolic outcomes and found that higher Mn intake was associated with a lower risk of ICD-10 coded steatosis (OR = .889 [.838-.943], p < .001), independent of other potential confounders.

CONCLUSION

Our study provides evidence that higher Mn intake may be associated with lower odds of steatosis in a large population-based sample. These findings underline the potential role of Mn in the prevention of steatosis, but further research is needed to confirm these findings and to elucidate the underlying mechanisms.

Associations between multiple urinary metals and metabolic syndrome: Exploring the mediating role of liver function in Chinese community-dwelling elderly

BACKGROUND

Multiple metals exposure has been revealed to be related to metabolic syndrome (MetS). However, the associations and interactions between multiple metals exposure and MetS are remains controversial, and the potential mechanism of the above-mentioned is still unclear.

METHODS

The associations between urinary metals and the MetS were analyzed by multivariable logistic regression model and restricted cubic spline (RCS). Bayesian kernel machine regression (BKMR) model and quantile-based g-computation (qgcomp) were applied to explore the mixed exposure and interaction effect of metals. Mediation analysis was used to explore the role of liver function.

RESULTS

In the single metal model, multiple metals were significantly associated with MetS. RCS analysis further verified the associations between 8 metals and MetS. BKMR model and qgcomp showed that zinc (Zn), iron (Fe), and tellurium (Te) were the main factors affecting the overall effect. In addition, mediation analysis indicated that serum alanine aminotransferase (ALT) mediated 21.54% and 13.29% in the associations of vanadium (V) and Zn with the risk of MetS, respectively.

CONCLUSIONS

Elevated urinary concentration of Zn, V, Te, copper (Cu), molybdenum (Mo), and thallium (Tl) were related to the increased risk of MetS. Conversely, Fe and selenium (Se) may be protective factors for MetS in mixed exposure. Liver function may play a key role in the association of V and Zn exposure with MetS.

Association Between Circulating Zinc Levels and Risk Factors of Metabolic Syndrome: Insights from a Bi-directional Mendelian Randomization Analysis and Cross-Sectional Study

Previous studies on the relationship between zinc and metabolic syndrome (MetS) have yielded inconsistent results. This comprehensive study aimed to elaborately explore the impact of zinc on MetS risk factors. The bi-directional Mendelian randomization (MR) analyses were performed to estimate the causal relationship between zinc and MetS risk factors. Additionally, a retrospective cross-sectional study incorporated 4389 subjects to provide a broader perspective in conjunction with the MR analyses. In the MR analyses, genetically instrumented zinc was positively associated with five of the MetS components in Europeans, including BMI, FBG, HbA1c, TC, and LDL-c (β (95%CI) = 0.023 (0.019-0.027), 0.019 (0.013-0.025), 0.041 (0.022-0.060), 0.027 (0.013-0.042), and 0.018 (0.010-0.026), respectively). In the cross-sectional study, higher concentration of zinc was strongly associated with increased BMI, LDL-c, and UA (β (95%CI) = 0.040 (0.010-0.085), 0.026 (0.018-0.035), and 1.529 (0.614-2.445), respectively). Moreover, these unfavorable associations were more obvious in women compared to men, with a borderline significant interaction effect for BMI (P=0.051). Our study showed that higher blood concentration of zinc, an essential trace element, was associated with unfavorable changes of the component metabolic risk factors of MetS, especially with BMI and LDL-c. Notably, these associations seemed to be more pronounced in women rather than in men. Further studies are warranted to elucidate the role of zinc status in the underlying mechanisms of MetS.

Circulating Copper Is Associated with Inflammatory Biomarkers in Greek Older Adults with Osteoarthritis

Osteoarthritis (OA) is the most common form of arthritis, that causes a significant decrease in the quality of life of the afflicted and constitutes a great burden for the socioeconomic system. Trace elements and heavy metals are implicated in the pathophysiology of OA, exacerbating inflammatory and oxidative stress responses. The aim of this cross-sectional study was to quantify metals in plasma samples of Greek OA patients and explore their link with disease related parameters, health status or quality of life, as well as epigenetic OA markers. This is the first study on plasma metal levels in Greek knee OA patients. To achieve precision in plasma metal and miRNA measurements, high-quality samples were selected from a subset of 34 participants (NCT04783792). Demographic, quality of life, clinical, biochemical, inflammation, oxidative stress, and anthropometric parameters, as well as microRNA levels were assessed. Significant correlations were found between circulating metals with OA related parameters or with measured microRNAs. Also, significant positive associations between plasma copper (Cu) levels and CRP (p = 0.033) or IL-6 (p = 0.001) occurred when adjusting for age, gender, BMI, physical activity level, smoking, disease severity, total arthroplasty, and dietary intake of the respective metal. Cu's role in OA is bidirectional, and this study confirms the findings that in OA, Cu is positively associated with inflammation. Such relationships between lifestyle, environment and OA enhance our understanding and encourage further study on metals related to OA inflammation.

The relationship between heavy metals and metabolic syndrome using machine learning

Background

Exposure to high levels of heavy metals has been widely recognized as an important risk factor for metabolic syndrome (MetS). The main purpose of this study is to assess the associations between the level of heavy metal exposure and Mets using machine learning (ML) method.

Methods

The data used in this study are from the national health and nutrition examination survey 2003-2018. According to the demographic information and heavy metal exposure level of participants, a total of 22 variables were included. Lasso was used to screen out the key variables, and 9 commonly used ML models were selected to establish the associations with the 5-fold cross validation method. Finally, we choose the SHapley Additive exPlanations (SHAP) method to explain the prediction results of Adaboost model.

Results

11,667 eligible individuals were randomly divided into two groups to train and verify the prediction model. Through lasso, characteristic variables were selected from 24 variables as predictors. The AUC (area under curve) of the models selected in this study were all greater than 0.7, and AdaBoost was the best model. The AUC value of AdaBoost was 0.807, the accuracy was 0.720, and the sensitivity was 0.792. It is noteworthy that higher levels of cadmium, body mass index, cesium, being female, and increasing age were associated with an increased probability of MetS. Conversely, lower levels of cobalt and molybdenum were linked to a decrease in the estimated probability of MetS.

Conclusion

Our study highlights the AdaBoost model proved to be highly effective, precise, and resilient in detecting a correlation between exposure to heavy metals and MetS. Through the use of interpretable methods, we identified cadmium, molybdenum, cobalt, cesium, uranium, and barium as prominent contributors within the predictive model.

Associations between metal(loid) exposure with overweight and obesity and abdominal obesity in the general population: A cross-sectional study in China

Previous studies have revealed links between metal(loid)s and health problems; however, the link between metal(loid)s and obesity remains controversial. We evaluated the cross-sectional association between metal(loid) exposure in whole blood and obesity among the general population. Vanadium (V), chromium (Cr), manganese (Mn), cobalt (Co), nickel (Ni), copper (Cu), zinc (Zn), arsenic (As), selenium (Se), molybdenum (Mo), cadmium (Cd), antimony (Sb), thallium (T1), and lead (Pb) were measured in 3029 subjects in Guangdong Province (China) using ICP-MS. The prevalence of overweight and obesity (OWO) and abdominal obesity (AOB) was calculated according to body mass index (BMI) and waist circumference (WC), respectively. Multivariate analysis showed that elevated blood Cu, Cd, and Pb levels were inversely associated with the risk of OWO, and these associations were confirmed by a linear dose-response relationship. Elevated blood Co concentration was associated with a decreased risk of AOB. A quantile g-computation approach showed a significantly negative mixture-effect of 13 metal(loid)s on OWO (OR: 0.96; 95% CI: 0.92, 0.99). Two metals-Ni and Mo-were inversely associated with the risk of OWO but positively associated with AOB. We cross-grouped the two obesity measurement types and found that the extremes of metal content were present in people with AOB only. In conclusion, blood Cu, Mo, Ni, Cd, and Pb were inversely associated with the risk of OWO. The presence of blood Co may be protective, while Ni and Mo exposure might increase the risk of AOB. The association between metal(loid) exposure and obesity warrants further investigation in longitudinal cohort studies.

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

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

Association between plasma and dietary trace elements and obesity in a rural Chinese population

Trace elements may play an important role in obesity. This study aimed to assess the plasma and dietary intake levels of four trace elements, Mn, Cu, Zn and Se in a rural Chinese population, and analyse the relationship between trace elements and obesity. A cross-sectional study involving 2587 participants was conducted. Logistic regression models were used to analyse the association between trace elements and obesity; restricted cubic spline (RCS) models were used to assess the dose-response relationship between trace elements and obesity; the weighted quantile sum (WQS) model was used to examine the potential interaction of four plasma trace elements on obesity. Logistic regression analysis showed that plasma Se concentrations in the fourth quartile (Q4) exhibited a lower risk of developing obesity than the first quartile (Q1) (central obesity: OR = 0·634, P = 0·002; general obesity: OR = 0·525, P = 0·005). Plasma Zn concentration in the third quartile (Q3) showed a lower risk of developing obesity in general obesity compared with the first quartile (Q1) (OR = 0·625, P = 0·036). In general obesity, the risk of morbidity was 1·727 and 1·923 times higher for the second and third (Q2, Q3) quartiles of dietary Mn intake than for Q1, respectively. RCS indicated an inverse U-shaped correlation between plasma Se and obesity. WQS revealed the combined effects of four trace elements were negatively associated with central obesity. Plasma Zn and Se were negatively associated with obesity, and dietary Mn was positively associated with obesity. The combined action of the four plasma trace elements had a negative effect on obesity.

Consequences of Disturbing Manganese Homeostasis

Manganese (Mn) is an essential trace element with unique functions in the body; it acts as a cofactor for many enzymes involved in energy metabolism, the endogenous antioxidant enzyme systems, neurotransmitter production, and the regulation of reproductive hormones. However, overexposure to Mn is toxic, particularly to the central nervous system (CNS) due to it causing the progressive destruction of nerve cells. Exposure to manganese is widespread and occurs by inhalation, ingestion, or dermal contact. Associations have been observed between Mn accumulation and neurodegenerative diseases such as manganism, Alzheimer's disease, Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis. People with genetic diseases associated with a mutation in the gene associated with impaired Mn excretion, kidney disease, iron deficiency, or a vegetarian diet are at particular risk of excessive exposure to Mn. This review has collected data on the current knowledge of the source of Mn exposure, the experimental data supporting the dispersive accumulation of Mn in the brain, the controversies surrounding the reference values of biomarkers related to Mn status in different matrices, and the competitiveness of Mn with other metals, such as iron (Fe), magnesium (Mg), zinc (Zn), copper (Cu), lead (Pb), calcium (Ca). The disturbed homeostasis of Mn in the body has been connected with susceptibility to neurodegenerative diseases, fertility, and infectious diseases. The current evidence on the involvement of Mn in metabolic diseases, such as type 2 diabetes mellitus/insulin resistance, osteoporosis, obesity, atherosclerosis, and non-alcoholic fatty liver disease, was collected and discussed.

Mercury Content in Impacted Wisdom Teeth from Patients of the Legnica-Głogów Copper Area-An In Vitro Pilot Study

The aim of this study was to determine the content of mercury in impacted third molars from Legnica-Głogów Copper Area residents to emphasize the effects of environmental pollution on the human body. A group of 72 patients with an average age of 27.3 ± 6.9 years participated in the study. Within this study, the research group (Legnica-Głogów Copper Area residents) comprised 51 individuals, while the control group (residents of Wrocław) consisted of 21 participants. A higher number of female individuals participated in the research (55). The amount of mercury present in the samples was determined through atomic absorption spectrometry with the use of a SpectraAA atomic absorption spectrometer and a V2 AA240FS flame attachment that utilized an air-acetylene flame. The accumulation of Hg in the teeth of members of the control group residing in Wrocław was studied, with a focus on identifying the risk factors that contribute to this phenomenon. The final model analyzed the presence of various factors, including thyroid and parathyroid gland diseases, cardiac diseases, and interval-scale Vit. D3 concentration. Among these factors, the presence of cardiac diseases was deemed statistically significant in relation to an increase in Hg concentration in third molars (rate ratio = 2.27, p < 0.0001). The concentration of mercury increased with the age and time of residence in the L-G Copper District.

Association between Heavy Metals, Metalloids and Metabolic Syndrome: New Insights and Approaches

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.

The ratio of monocyte count and high-density lipoprotein cholesterol mediates the association between urinary tungsten and cardiovascular disease: a study from NHANES 2005-2018

Tungsten (W) is an emerging contaminant that can damage multiple systems in humans. However, studies of its effects on cardiovascular disease (CVD) are limited. The monocyte count to high-density lipoprotein cholesterol ratio (MHR) is a composite inflammatory index of great concern in recent years, derived from lipid and cell inflammation parameters, that is used to indicate the risk of CVD. This study aimed to investigate the association between urinary W and CVD in the general population and compare the mediating effects of lipids, cell inflammatory parameters, and MHR to find a better target for intervention. We analyzed data from 9137 (≥ 20 years) participants in the National Health and Nutrition Examination Survey (NHANES), from 2005 to 2018. Restricted cubic splines (RCS) and survey-weighted generalized linear models (SWGLMs) were used to assess the relationship between W and CVD. Mediated analyses were used to explore lipids, cell inflammatory parameters, and MHR in the possible mediating pathways between W and CVD. In SWGLM, we found that W enhances the risk of CVD, especially congestive heart failure (CHF), coronary heart disease (CHD), and angina pectoris (AP). Women, higher age groups (≥ 55 years), and those with hypertension were vulnerable to W in the subgroup analysis. Mediation analysis showed that monocyte count (MC), white blood cell count (WBC), high-density lipoprotein cholesterol (HDL), and MHR played a mediating role between W and CVD in proportions of 8.49%, 3.70%, 5.18%, and 12.95%, respectively. In conclusion, our study shows that urinary W can increase the risk of CVD, especially for CHF, CHD, and AP. Women, older age groups, and people with hypertension seem to be more vulnerable to W. In addition, MC, WBC, HDL, and MHR mediated the association between W and CVD, especially MHR, which suggests that we should consider it as a priority intervention target in the future.

A Bio-Indicator Pilot Study Screening Selected Heavy Metals in Female Hair, Nails, and Serum from Lifestyle Cosmetic, Canned Food, and Manufactured Drink Choices

Lifestyles, genetic predispositions, environmental factors, and geographical regions are considered key factors of heavy metals initiatives related to health issues. Heavy metals enter the body via the environment, daily lifestyle, foods, beverages, cosmetics, and other products. The accumulation of heavy metals in the human body leads to neurological issues, carcinogenesis, failure of multiple organs in the body, and a reduction in sensitivity to treatment. We screened for Cr, Al, Pb, and Cd in selected foods, beverages, and cosmetics products depending on questionnaire outcomes from female volunteers. We also screened for Cr, Al, Pb, and Cd on hair, nails, and serum samples using inductively coupled plasma mass spectrometry (ICP-MS) from the same volunteers, and we analyzed the serum cholinesterase and complete blood picture (CBC). We performed an AutoDock study on Cr, Al, Pb, and Cd as potential ligands. Our results indicate that the most elevated heavy metal in the cosmetic sample was Al. In addition, in the food and beverages samples, it was Pb and Al, respectively. The results of the questionnaire showed that 71 percent of the female volunteers used the studied cosmetics, food, and beverages, which were contaminated with Cr, Al, Pb, and Cd, reflecting the high concentration of Cr, Al, Cd, and Pb in the three different types of biological samples of sera, nails, and hair of the same females, with 29 percent of the female volunteers not using the products in the studied samples. Our results also show an elevated level of cholinesterase in the serum of group 1 that was greater than group 2, and this result was confirmed by AutoDock. Moreover, the negative variation in the CBC result was compared with the reference ranges. Future studies should concentrate on the actions of these heavy metal contaminations and their potential health consequences for various human organs individually.

An evaluation of the effects of mixed heavy metals on prediabetes and type 2 diabetes: epidemiological and toxicogenomic analysis

The link between mixed heavy metals (mercury, lead, and cadmium), prediabetes, and type 2 diabetes mellitus (T2DM), especially molecular mechanisms, is poorly understood. Thus, we aimed to identify the association between mixed heavy metals and T2DM and its components using a data set from the Korean National Health and Nutrition Examination Survey. We further analyzed the main molecular mechanisms implicated in T2DM development induced by mixed heavy metals using in-silico analysis. Our findings observed that serum mercury was associated with prediabetes, elevated glucose, and ln2-transformed glucose when using different statistical methods. "AGE-RAGE signaling pathway in diabetic complications", "non-alcoholic fatty liver disease", "metabolic Syndrome X", and three miRNAs (hsa-miR-98-5p, hsa-let-7a-5p, and hsa-miR-34a-5p) were listed as the most important molecular mechanisms related to T2DM development caused by mixed heavy metals. These miRNA sponge structures were created and examined, and they may be beneficial in the treatment of T2DM. The predicted cutoff values for three heavy metal levels linked to T2DM and its components were specifically identified. Our results imply that chronic exposure to heavy metals, particularly mercury, may contribute to the development of T2DM. To understand the changes in the pathophysiology of T2DM brought on by a combination of heavy metals, more research is required.

Overweight and Obesity Are Positively Associated with Serum Copper Levels in Mexican Schoolchildren

Due to its relationship with oxidative stress and inflammation responses, obesity and its cardiometabolic implications have been related with serum copper (Cu). Hence, we analyzed the association of overweight (OW) and obesity (OB) status and cardiometabolic traits with serum Cu level in Mexican schoolchildren. Anthropometrical data and cardiometabolic traits were analyzed in this cross-sectional study. Serum Cu level was measured by inductively coupled plasma mass spectrometry. The study involved 191 schoolchildren (93 girls and 98 boys) with a mean age of 8.054 ± 1.170 years. Children with OW and OB had higher serum Cu levels than children with normal weight (NW) (mean difference: OW vs NW = 51.85 µg dL^-1, OB vs NW = 47.22 µg dL^-1, p < 0.001). In a multiple linear regression model, OW and OB status were positively associated with serum Cu levels (β_OW = 49.85, 95% confidence interval (95% CI) 35.84-63.87, p < 0.001; β_OB = 44.38, 95% CI 27.70-61.05, p < 0.001). We did not identify any significant association between cardiometabolic traits and serum Cu level. In conclusion, our results show an association of the presence of OW and OB with higher serum Cu levels, for the first time in Mexican schoolchildren. However, further functional studies are needed to better understand the role of Cu in the pathophysiology of obesity.

Dose-response relationship of elements with blood lipids and the potential interaction: A cross-sectional study from four areas with different pollution levels in China

BACKGROUND

A growing number of researches indicated the association between plasma trace elements and blood lipids. However, the potential interaction and dose-response relationship were less frequently reported.

METHODS

In this study, a total of 3548 participants were recruited from four counties in Hunan Province, South China. Demographic characteristics were collected by face-to-face interviews and inductively coupled plasma mass spectrometry (ICPMS) was used to determine the levels of 23 trace elements in plasma. We applied a fully adjusted generalized linear regression model (GLM) and a multivariate restricted cubic spline (RCS) to estimate the correlation, dose-response relationship and possible interaction between 23 trace elements and four blood lipid markers.

RESULTS

The results indicated positive dose-response relationships of plasma ⁶⁶zinc with triglycerides (TG) and low density lipoprotein cholesterol (LDL-C), plasma ⁷⁸selenium with LDL-C and total cholesterol (TCH), and plasma ⁵⁹cobalt with high-density lipoprotein cholesterol (HDL-C). There was a negative dose-response relationship between ⁵⁹cobalt and LDL-C. Further analysis found that ⁶⁶zinc and ⁵⁹cobalt had an antagonistic effect on the risk of increased LDL-C level.

CONCLUSIONS

This study added new evidence for the potential adverse effects of ⁶⁶Zn and ⁷⁸Se on blood lipids, and provided new insight into the threshold value setting for metals as well as the intervention strategy for dyslipidemia.

Sex-specific and dose-response relationships of urinary cobalt and molybdenum levels with glucose levels and insulin resistance in U.S. adults

Growing studies have linked metal exposure to diabetes risk. However, these studies had inconsistent results. We used a multiple linear regression model to investigate the sex-specific and dose-response associations between urinary metals (cobalt (Co) and molybdenum (Mo)) and diabetes-related indicators (fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), homeostasis model assessment for insulin resistance (HOMA-IR), and insulin) in a cross-sectional study based on the United States National Health and Nutrition Examination Survey. The urinary metal concentrations of 1423 eligible individuals were stratified on the basis of the quartile distribution. Our results showed that the urinary Co level in males at the fourth quartile (Q4) was strongly correlated with increased FPG (β = 0.61, 95% CI: 0.17-1.04), HbA1c (β = 0.31, 95% CI: 0.09-0.54), insulin (β = 8.18, 95% CI: 2.84-13.52), and HOMA-IR (β = 3.42, 95% CI: 1.40-5.44) when compared with first quartile (Q1). High urinary Mo levels (Q4 vs. Q1) were associated with elevated FPG (β = 0.46, 95% CI: 0.17-0.75) and HbA1c (β = 0.27, 95% CI: 0.11-0.42) in the overall population. Positive linear dose-response associations were observed between urinary Co and insulin (P_nonlinear = 0.513) and HOMA-IR (P_nonlinear = 0.736) in males, as well as a positive linear dose-response relationship between urinary Mo and FPG (P_nonlinear = 0.826) and HbA1c (P_nonlinear = 0.376) in the overall population. Significant sex-specific and dose-response relationships were observed between urinary metals (Co and Mo) and diabetes-related indicators, and the potential mechanisms should be further investigated.

Blood and urine manganese exposure in non-alcoholic fatty liver disease and advanced liver fibrosis: an observational study

Manganese was the key activator of biological enzymes-mediated metabolic diseases (Mets)-associated pathophysiological process. Non-alcoholic fatty liver disease (NAFLD), which was the hepatic manifestation of Mets, development remained a mystery. We aimed to explore the association between blood/urine manganese exposure and NAFLD and liver fibrosis diagnosed by vibration-controlled transient elastography (VCTE). All data were extracted from National Health and Nutrition Examination Survey database (2017-2018). A total of 3580 participants with blood manganese data were enrolled and divided into four groups according to the quartile of blood manganese exposure level. In multiple logistic regression models, the higher blood manganese exposure level (groups 2, 3, and 4) had a significant positive association with NAFLD (β = 1.58, 1.30, and 1.69). In subgroup analysis, the main inversely correlation between blood manganese and NAFLD was found in participants with normal/high body mass index and high blood manganese exposure level. Moreover, in 1179 participants with urine manganese data, urine manganese exposure level presented as significantly associated with advanced liver fibrosis in models 1 and 2 (β = 2.00 and 2.02). This study showed that manganese exposure level was positively associated with NAFLD and advanced liver fibrosis among the US population. We suggested that manganese exposure level was a biomarker of the development of NAFLD.

Recent advances in the application of ionomics in metabolic diseases

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.

Exploring the relationship between blood toxic metal(oid)s and serum insulin levels through benchmark modelling of human data: Possible role of arsenic as a metabolic disruptor

The major goal of this study was to estimate the correlations and dose-response pattern between the measured blood toxic metals (cadmium (Cd), mercury (Hg), chromium (Cr), nickel (Ni))/metalloid (arsenic (As)) and serum insulin level by conducting Benchmark dose (BMD) analysis of human data. The study involved 435 non-occupationally exposed individuals (217 men and 218 women). The samples were collected at health care institutions in Belgrade, Serbia, from January 2019 to May 2021. Blood sample preparation was conducted by microwave digestion. Cd was measured by graphite furnace atomic absorption spectrophotometry (GF-AAS), while inductively coupled plasma-mass spectrometry (ICP-MS) was used to measure Hg, Ni, Cr and As. BMD analysis of insulin levels represented as quantal data was done using the PROAST software version 70.1 (model averaging methodology, BMD response: 10%). In the male population, there was no correlation between toxic metal/metalloid concentrations and insulin level. However, in the female population/whole population, a high positive correlation for As and Hg, and a strong negative correlation for Ni and measured serum insulin level was established. BMD modelling revealed quantitative associations between blood toxic metal/metalloid concentrations and serum insulin levels. All the estimated BMD intervals were wide except the one for As, reflecting a high degree of confidence in the estimations and possible role of As as a metabolic disruptor. These results indicate that, in the case of As blood concentrations, even values higher than BMD (BMDL): 3.27 (1.26) (male population), 2.79 (0.771) (female population), or 1.18 (2.96) μg/L (whole population) might contribute to a 10% higher risk of insulin level alterations, meaning 10% higher risk of blood insulin increasing from within reference range to above reference range. The obtained results contribute to the current body of knowledge on the use of BMD modelling for analysing human data.

Relationship Between Serum Levels of Arsenic, Cadmium, and Mercury and Body Mass Index and Fasting Plasma Glucose in a Mexican Adult Population

In Mexico, few studies have analyzed the associations between toxic elements and metabolic diseases. In the present study, we analyzed the associations between serum arsenic (As), cadmium (Cd), and mercury (Hg) levels and body mass index (BMI) and fasting plasma glucose (FPG) in a Mexican adult population. Anthropometric data corresponding to 86 Mexican healthy adults (59 females and 27 men) were analyzed. FPG was analyzed by an enzymatic colorimetric method, and serum As, Cd, and Hg levels were analyzed by inductively coupled plasma-mass spectrometry (ICP-MS). The data show that the median serum As, Cd, and Hg levels were relatively higher in females (As = 1.78 ng mL^-1, Cd = 1.00 ng mL^-1, Hg = 0.96 ng mL^-1) than those in males (As = 1.22 ng mL^-1, Cd = 0.91 ng mL^-1, Hg = 0.95 ng mL^-1). However, these differences were not statistically significant (p ≥ 0.097). We also found that the median level of As significantly increased with an increase in the body weight categories (normal weight = 1.08; overweight = 1.50; obesity = 2.75; p < 0.001). In addition, a positive association between serum As levels and FPG before and after adjustment for BMI was demonstrated (Rho_Unadjusted = 0.012; (RhoA_djusted = 0.243, p = 0.032). Serum As levels are positively associated with BMI and FPG in the adult population of Mexico. Nevertheless, these results need to be replicated and confirmed with a larger sample size.

Association between Blood Manganese Levels and Visceral Adipose Tissue in the United States: A Population-Based Study

Background: Manganese (Mn) is an essential trace element with a narrow toxic margin for human health. The association between Mn exposure and adverse visceral adipose tissue (VAT) accumulation is unclear. Objective: This study aimed to estimate the associations of blood Mn levels with VAT mass or visceral obesity in the general population in the United States. Method: This cross-sectional study included data of 7297 individuals released by National Health and Nutrition Examination Survey (NHANES). VAT was quantified with dual-energy X-ray absorptiometry, and blood Mn was measured using inductively coupled plasma mass spectrometry. The generalized linear model and generalized additive model (GAM) were applied to estimate the linear and non-linear associations between Mn levels and VAT mass, respectively. Logistic regression was used to estimate the associations between blood Mn levels and the risk of visceral obesity. Results: Fully adjusted generalized linear regression revealed that individuals in the higher quantile of Mn had increased VAT mass compared with those in the lower quantile (β per quantile change = 0.025; 95% CI of 0.017, 0.033; p < 0.001). Positive associations were also observed in males and females (males: β per quantile change = 0.012, 95% CI of 0.002, 0.022 (p = 0.020); female: β per quantile change = 0.036; 95% CI of 0.023, 0.048 (p < 0.001)). The GAM illustrated that the non-linear associations between blood Mn levels and VAT mass were in U-shape patterns (effective degree of freedom >1 in total participants, males, and females). A stratified analysis found significant interactions between Mn and the family income-to-poverty ratio (PIR) in males, with stronger associations in males with a PIR < 1.3 (β = 0.109; 95% CI of 0.048, 0.170). Additional analyses revealed that individuals in the highest quantile of Mn had a 39% higher risk of visceral obesity (OR = 1.39; 95% CI of 1.15−1.69; p < 0.001). Conclusions: Higher blood Mn levels were positively associated with increased VAT mass and visceral obesity risk. The adverse VAT phenotype associated with excessive blood Mn levels should be further investigated.

A Longitudinal Study of Exposure to Manganese and Incidence of Metabolic Syndrome

The association between manganese (Mn) and metabolic syndrome (MetS) is unclear, and no prior study has studied this association longitudinally. The aim of this study was to assess longitudinal associations of Mn exposure with MetS and metabolic outcomes. We used data from the San Luis Valley Diabetes Study (SLVDS), a prospective cohort from rural Colorado with data collected from 1984−1998 (n = 1478). Urinary Mn was measured at baseline (range = 0.20−42.5 µg/L). We assessed the shape of the cross-sectional association between Mn and MetS accounting for effect modification by other metals at baseline using Bayesian kernel machine regression. We assessed longitudinal associations between baseline quartiles of Mn and incident MetS using Fine and Gray competing risks regression models (competing risk = mortality) and between quartiles of Mn and metabolic outcomes using linear mixed effects models. We did not observe evidence that quartiles of Mn were associated with incident MetS (p-value for trend = 0.52). Quartiles of Mn were significantly associated with lower fasting glucose (p-value for trend < 0.01). Lead was found to be a possible effect modifier of the association between Mn and incident MetS. Mn was associated with lower fasting glucose in this rural population. Our results support a possible beneficial effect of Mn on diabetic markers.

Single and Combined Associations of Plasma and Urine Essential Trace Elements (Zn, Cu, Se, and Mn) with Cardiovascular Risk Factors in a Mediterranean Population

Trace elements are micronutrients that are required in very small quantities through diet but are crucial for the prevention of acute and chronic diseases. Despite the fact that initial studies demonstrated inverse associations between some of the most important essential trace elements (Zn, Cu, Se, and Mn) and cardiovascular disease, several recent studies have reported a direct association with cardiovascular risk factors due to the fact that these elements can act as both antioxidants and pro-oxidants, depending on several factors. This study aims to investigate the association between plasma and urine concentrations of trace elements and cardiovascular risk factors in a general population from the Mediterranean region, including 484 men and women aged 18−80 years and considering trace elements individually and as joint exposure. Zn, Cu, Se, and Mn were determined in plasma and urine using an inductively coupled plasma mass spectrometer (ICP-MS). Single and combined analysis of trace elements with plasma lipid, blood pressure, diabetes, and anthropometric variables was undertaken. Principal component analysis, quantile-based g-computation, and calculation of trace element risk scores (TERS) were used for the combined analyses. Models were adjusted for covariates. In single trace element models, we found statistically significant associations between plasma Se and increased total cholesterol and systolic blood pressure; plasma Cu and increased triglycerides and body mass index; and urine Zn and increased glucose. Moreover, in the joint exposure analysis using quantile g-computation and TERS, the combined plasma levels of Zn, Cu, Se (directly), and Mn (inversely) were strongly associated with hypercholesterolemia (OR: 2.03; 95%CI: 1.37−2.99; p < 0.001 per quartile increase in the g-computation approach). The analysis of urine mixtures revealed a significant relationship with both fasting glucose and diabetes (OR: 1.91; 95%CI: 1.01−3.04; p = 0.046). In conclusion, in this Mediterranean population, the combined effect of higher plasma trace element levels (primarily Se, Cu, and Zn) was directly associated with elevated plasma lipids, whereas the mixture effect in urine was primarily associated with plasma glucose. Both parameters are relevant cardiovascular risk factors, and increased trace element exposures should be considered with caution.

Linking the Low-Density Lipoprotein-Cholesterol (LDL) Level to Arsenic Acid, Dimethylarsinic, and Monomethylarsonic: Results from a National Population-Based Study from the NHANES, 2003–2020

Arsenic (As) contamination is a global public health problem. Elevated total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) are risk factors for cardiovascular diseases, but data on the association of urinary arsenic species’ level and LDL-C are limited. We performed an association analysis based on urinary arsenic species and blood TC and LDL-C in US adults. Methods: Urinary arsenic, arsenic acid (AA), dimethylarsinic (DMA), monomethylarsonic (MMA), TC, LDL-C, and other key covariates were obtained from the available National Health and Nutrition Examination Survey (NHANES) data from 2003 to 2020. Multiple linear regression analysis and generalized linear model are used to analyze linear and nonlinear relationships, respectively. Results: In total, 6633 adults aged 20 years were enrolled into the analysis. The median total urinary arsenic level was 7.86 µg/L. A positive association of urinary arsenic concentration quartiles was observed with TC (β: 2.42 95% CI 1.48, 3.36). The OR for TC of participants in the 80th versus 20th percentiles of urinary total arsenic was 1.34 (95% CI 1.13, 1.59). The OR for LDL-C of participants in the 80th versus 20th percentiles of urinary total arsenic was 1.36 (95% CI 1.15, 1.62). For speciated arsenics analysis, the OR for arsenic acid and TC was 1.35 (95% CI 1.02, 1.79), whereas the OR for DMA and LDL-L was 1.20 (95% CI 1.03, 1.41), and the OR for MMA and LDL-L was 1.30 (95% CI 1.11, 1.52). Conclusions: Urinary arsenic and arsenic species were positively associated with increased LDL-C concentration. Prevention of exposure to arsenic and arsenic species maybe helpful for the control of TC and LDL-C level in adults.

Serum zinc levels are associated with obesity and low-density lipoprotein cholesterol in Mexican adults

PURPOSE

Little is known about the association between serum zinc (Zn) levels and obesity in the Mexican population. Therefore, we tested the association between serum Zn levels, obesity status, and serum lipid levels in a sample of Mexican adults.

METHODS

Anthropometric data and serum levels of total cholesterol, high- and low-density lipoprotein cholesterol (HDL-C and LDL-C, respectively), and triglycerides were analyzed in 96 Mexican adults. Serum Zn was measured with inductively coupled plasma mass spectrometry. An individual data meta-analysis of the association between serum Zn, overweight, and obesity status was performed in 172 adults from two different provinces in Mexico.

RESULTS

Serum Zn was negatively associated with body mass index (BMI, β = -0.034 ± 0.013, p = 2.0 ×10^-6) and obesity (odds ratio [OR]= 0.990, 95% confidence interval [CI]= 0.980-0.999, p = 3.4 ×10^-5). The association between Zn level and obesity in Mexican adults was confirmed with an individual data meta-analysis (OR= 0.977, 95% CI= 0.966-0.988, p = 3.4 ×10^-5). In addition, a significant interaction effect between serum Zn level and sex was observed on LDL-C level (β = 7.010 ± 3.295, p = 0.037). Serum Zn was negatively associated with LDL-C levels in women (β = -0.188 ± 0.074, p = 0.016).

CONCLUSION

Our results confirm the negative association of serum Zn level with obesity. For the first time, we show a sex-specific association between serum Zn and LDL-C levels in a Mexican population. However, further studies are needed in larger and more varied Mexican cohorts to replicate and confirm our findings.

Targeted therapeutics and novel signaling pathways in non-alcohol-associated fatty liver/steatohepatitis (NAFL/NASH)

Non-alcohol-associated fatty liver/steatohepatitis (NAFL/NASH) has become the leading cause of liver disease worldwide. NASH, an advanced form of NAFL, can be progressive and more susceptible to developing cirrhosis and hepatocellular carcinoma. Currently, lifestyle interventions are the most essential and effective strategies for preventing and controlling NAFL without the development of fibrosis. While there are still limited appropriate drugs specifically to treat NAFL/NASH, growing progress is being seen in elucidating the pathogenesis and identifying therapeutic targets. In this review, we discussed recent developments in etiology and prospective therapeutic targets, as well as pharmacological candidates in pre/clinical trials and patents, with a focus on diabetes, hepatic lipid metabolism, inflammation, and fibrosis. Importantly, growing evidence elucidates that the disruption of the gut-liver axis and microbe-derived metabolites drive the pathogenesis of NAFL/NASH. Extracellular vesicles (EVs) act as a signaling mediator, resulting in lipid accumulation, macrophage and hepatic stellate cell activation, further promoting inflammation and liver fibrosis progression during the development of NAFL/NASH. Targeting gut microbiota or EVs may serve as new strategies for the treatment of NAFL/NASH. Finally, other mechanisms, such as cell therapy and genetic approaches, also have enormous therapeutic potential. Incorporating drugs with different mechanisms and personalized medicine may improve the efficacy to better benefit patients with NAFL/NASH.

SOX2 modulated astrocytic process plasticity is involved in arsenic-induced metabolic disorders

Metabolic disorders induced by arsenic exposure have attracted great public concern. However, it remains unclear whether hypothalamus-based central regulation mechanisms are involved in this process. Here, we exposed mice to 100 μg/L arsenic in drinking water and established a chronic arsenic exposure model. Our study revealed that chronic arsenic exposure caused metabolic disorders in mice including impaired glucose metabolism and decreased energy expenditure. Arsenic exposure also impaired glucose sensing and the activation of proopiomelanocortin (POMC) neurons in the hypothalamus. In particular, arsenic exposure damaged the plasticity of hypothalamic astrocytic process. Further research revealed that arsenic exposure inhibited the expression of sex-determining region Y-Box 2 (SOX2), which decreased the expression level of insulin receptors (INSRs) and the phosphorylation of AKT. The conditional deletion of astrocytic SOX2 exacerbated arsenic-induced effects on metabolic disorders, the impairment of hypothalamic astrocytic processes, and the inhibition of INSR/AKT signaling. Furthermore, the arsenic-induced impairment of astrocytic processes and inhibitory effects on INSR/AKT signaling were reversed by SOX2 overexpression in primary hypothalamic astrocytes. Together, we demonstrated here that chronic arsenic exposure caused metabolic disorders by impairing SOX2-modulated hypothalamic astrocytic process plasticity in mice. Our study provides evidence of novel central regulatory mechanisms underlying arsenic-induced metabolic disorders and emphasizes the crucial role of SOX2 in regulating the process plasticity of adult astrocytes.

Trace element and lipidomic analysis of bottlenose dolphin blubber from the Yucatan coast: Lipid composition relationships

Bottlenose dolphins (Tursiops truncatus) are found in coastal and estuarine ecosystems where they are in continuous contact with multiple abiotic and biotic stressors in the environment. Due to their role as predators, they can bioaccumulate contaminants and are considered sentinel organisms for monitoring the health of coastal marine ecosystems. The northern zonal coast of the Yucatan peninsula of Mexico has a high incidence of anthropogenic activities. The principal objectives of this study were two-fold: 1) to determine the presence of trace metals and their correlation with lipids in bottlenose dolphin blubber, and 2) to use a lipidomics approach to characterize their biological responses. Levels of trace elements (Al, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Se, Cd, Pb) were analyzed using ICP-MS and lipids were measured using a targeted lipidomics approach with LC-MS/MS. Spearman correlation analysis was used to identify associations between lipids and trace elements. The influences of gender, stranding codes, presence of stomach content, growth stages and body length were also analyzed. Blubber lipid composition was dominated by triacylglycerols (TAG). Our results demonstrated the presence of heavy-metal elements such as Cd and As, which were correlated with different lipid species, mainly the ceramides and glycerophospholipids, respectively. Organisms with Cd showed lower concentrations of ceramides (CER, HCER and DCER), TAG and cholesteryl esters (CE). Trace elements Cr, Co, As and Cd increased proportionately with body length. This study provides a novel insight of lipidomic characterization and correlations with trace elements in the bottlenose dolphin which might contribute to having a better understanding of the physiological functions and the risks that anthropogenic activities can bring to sentinel organisms from coastal regions.

Associations of total urinary arsenic with total cholesterol and high-density lipoprotein among 12-17-year-old participants from the 2009-2016 NHANES cycles: A cross-sectional study

INTRODUCTION

Hypertension and diabetes are highly prevalent among US adults. Arsenic exposure is associated with these cardiometabolic morbidities but the relationship between arsenic exposure and cholesterol markers of cardiometabolic disease has not been elucidated, especially at younger ages, when many chronic diseases may initiate. This study examined the association of total urinary arsenic with total cholesterol (TC) and high-density lipoprotein cholesterol (HDL) and explored effect modification by weight status.

METHODS

The study sample consisted of 12-17-year-old participants with complete data from the 2009-2016 National Health and Nutrition Examination Survey cycles. The cross-sectional associations of creatinine-adjusted total urinary arsenic with TC and HDL were assessed using multivariable linear regression models with survey weights. Three models were built, adjusting for varying combinations of age, gender, race/ethnicity, weight status, survey cycle, family income to poverty ratio, reference person education level, arsenobetaine, and dimethylarsinic acid (DMA). Model adjustments for arsenobetaine approximated inorganic arsenic exposure, and further adjustment for DMA approximated unmethylated inorganic arsenic exposure. We also explored weight status (underweight/healthy, overweight, and obese) as a potential effect modifier of these relationships using stratified analyses and interaction tests.

RESULTS

The final analytical sample consisted of 1,177 12-17-year-old participants. After adjusting for covariates and arsenobetaine, creatinine-adjusted arsenic was positively associated with HDL levels (β = 0.063; 95% CI: 0.007, 0.119). Upon further adjustment for DMA, creatinine-adjusted arsenic was positively associated with HDL levels (β = 0.079; 95% CI: 0.015, 0.143) and TC levels (β = 0.258; 95% CI: 0.002, 0.515). No effect modification by weight status was observed.

CONCLUSIONS

We found a positive association of approximated unmethylated inorganic arsenic exposure with TC, and contrary to our expectation, with HDL. There was no effect modification by weight status. Our findings should be confirmed by conducting longitudinal studies among adolescents exposed to low-level arsenic and focusing specifically on urinary inorganic arsenic concentrations.

Clinical relevance of environmental manganese exposure with liver stiffness and steatosis detected by transient elastography in adults

Global manganese pollution to air and water is a significant threat to human health. The associations between manganese and liver stiffness and steatosis have not been reported in epidemiological studies. This study aimed to explore the clinical relevance of blood manganese with liver stiffness and steatosis in adults from the 2017-2018 National Health and Nutrition Examination Survey (N = 4,192). Subjects with excessive alcohol consumption and hepatitis B or C infection were excluded. Liver stiffness and steatosis were detected by transient elastography. Logistic regression and restricted cubic splines were adopted to explore the non-linear dose-response relationships. In multivariate analysis, while higher blood manganese concentrations were not associated with liver stiffness in the total sample and in males, an increased odds of significant liver fibrosis was found with higher blood manganese concentrations (tertile 3 vs. tertile 1) in females [odds ratios (95% confidence intervals): 2.34 (1.32-4.14), P trend < 0.01] and in other races [1.47 (1.05-2.05), P trend = 0.03]. Higher blood manganese concentrations were associated with liver steatosis in the total sample [1.33 (1.04-1.70), P trend = 0.03], in females [1.58 (1.02-2.44), P trend = 0.04], in other races [1.91 (1.50-2.43), P trend < 0.01], and in obese subjects [2.29 (1.13-4.65), P trend = 0.02]. Dose-response analysis showed that the departures from non-linear relationships between blood manganese concentrations and significant liver fibrosis (Pnon-linearity = 0.30) and steatosis (Pnon-linearity = 0.47) were not significant, suggesting that the observed associations were linear. In conclusion, higher blood manganese concentrations were positively associated with liver stiffness and steatosis, and the associations were mainly observed in females, in races other than Non-Hispanic White, and in obese subjects.

Associations of multiple plasma metals with the risk of metabolic syndrome: A cross-sectional study in the mid-aged and older population of China

BACKGROUND

Metal exposures have been reported to be related to the progress of metabolic syndrome (MetS), however, the currents results were still controversial, and the evidence about the effect of multi-metal exposure on MetS were limited. In this study, we intended to evaluate the relationships between metal mixture exposure and the prevalence of MetS in a mid-aged and older population of China.

METHODS

The plasma levels of 13 metals (aluminum, magnesium, calcium, iron, manganese, cobalt, copper, arsenic, zinc, selenium, cadmium, molybdenum and thallium) were detected by inductively coupled plasma mass spectrometry (ICP-MS) in 1277 adults recruited from the Eighth Affiliated Hospital of Sun Yat-Sen University (Shenzhen, China). Logistic regression, the adaptive least absolute shrinkage and selectionator operator (LASSO) penalized regression analysis and restricted cubic spline (RCS) analysis were used to explore the associations and dose-response relationships of plasma metals with MetS. To evaluate the cumulative effect of metals, the Bayesian Kernel Machine Regression (BKMR) model was applied.

RESULTS

The concentrations of magnesium and molybdenum were lower in the MetS group (p < 0.05). In the single-metal model, the adjusted ORs (95%CI) in the highest quartiles were 0.44 (0.35, 0.76) for magnesium and 0.30 (0.17, 0.51) for molybdenum compared with the lowest quartile. The negative associations and dose-dependent relationships of magnesium and molybdenum with MetS were further validated by the stepwise model, adaptive LASSO penalized regression and RCS analysis. The BKMR models showed that the metal mixture were associated with decreased MetS when the chemical mixtures were≥ 25th percentile compared to their medians, and Mg, Mo were the major contributors to the combined effect. Moreover, concentrations of magnesium were significantly related to blood glucose, and molybdenum was related with BMI, blood glucose and blood pressure.

CONCLUSIONS

Elevated levels of plasma magnesium and molybdenum were associated with decreased prevalence of MetS. Further investigations in larger perspective cohorts are needed to confirm our findings.

Relationships Between Indicators of Metabolic Disorders and Selected Concentrations of Bioelements and Lead in Serum and Bone Tissue in Aging Men

BACKGROUND

The aim of this study was to investigate the relationships between serum and bone concentrations of selected bioelements, ie, zinc (Zn), copper (Cu), iron (Fe), chrome (Cr), magnesium (Mg), and selenium (Se), and a heavy metal, ie, lead (Pb), and the selected indicators of metabolic disorders - Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP) and Body Mass Index (BMI).

MATERIAL AND METHODS

The study comprised 151 men aged 60 to 75 years who were scheduled for hip replacement surgery due to osteoarthritis. The concentrations of elements in the serum and bone tissue were measured using inductively coupled plasma optical emission spectrometry (Mg, Zn, Cu, Cr, Fe, and Pb) and the spectrofluorometric method (Se). Fasting plasma glucose (FPG), high-density cholesterol (HDL-Ch), and triacylglycerols (TAG) were determined. Lipid accumulation product (LAP) and visceral adiposity index (VAI) were calculated.

RESULTS

There was no relationship between serum and bone concentrations of bioelements and lead and the BMI index. Bone Mg was significantly higher in men with higher VAI, but no such relation was observed in the serum. Similarly, bone Mg and Zn were higher in patients with higher LAP, which was not observed in the serum. Multivariate logistic regression analysis with adjustment for age was performed. There was a correlation between serum Zn concentration and the cut-off point for VAI. The cut-off point for LAP was related to the bone tissue concentrations of Mg, Zn, and Cu.

CONCLUSION

We found some relationships between the concentrations of selected bioelements and Pb and VAI, LAP, and BMI in bone but not in the serum. VAI positively correlated with bone Mg, while LAP positively correlated with bone Cu, Zn, and Mg.

Mercury Exposure and Risk of Type 2 Diabetes: A Systematic Review and Meta-Analysis

METHODS

Scopus and PubMed databases were systematically searched from their inception to November 2021 to obtain pertinent studies. Standardized mean differences (SMDs) with corresponding 95% confidence intervals (CIs) were calculated to evaluate the difference in Hg levels between people with and without T2DM. The association of the Hg exposure with T2DM was assessed using a random-effects model by pooling the odds ratios (ORs) and 95% CIs.

RESULTS

A total of 17 studies, with 42,917 participants, aged ≥18 years, were analyzed. Overall, Hg levels were significantly higher in T2DM patients compared with non-T2DM controls (SMD = 1.07; 95%CI = 0.59 to 1.55, P ≤ 0.001), with significant heterogeneity across studies (I² = 96.1%; P=≤0.001). No significant association was found between Hg exposure and risk of T2DM in the overall analysis and subgroup analysis based on the source of sample and study design. However, higher exposure to Hg was related to reduced risk of T2DM in men (OR = 0.71; 95%CI = 0.57 to 0.88), but not in women. No significant evidence for publication bias was detected.

CONCLUSIONS

Although the Hg level in T2DM is significantly higher than that of nondiabetics, there was no association between Hg exposure and the overall risk of T2DM. Nevertheless, our study shows that higher exposure to Hg might reduce the risk of T2DM in men.

Relationship Analysis of Inorganic Arsenic Exposure and Metabolic Syndrome Based on Propensity Score Matching in Xinjiang, China

PURPOSE

The role of inorganic arsenic (iAs) in the risk of metabolic syndrome (MetS) remains unclear. This investigation focused on the effect of iAs exposure on MetS and whether the results are consistent in different subgroups.

PATIENTS AND METHODS

The present study was conducted on 629 men and 616 women aged 35-70 years and living in Xinjiang Uygur Autonomous Region, China. The 1:1 propensity score matching (PSM) was adopted to regulate the confounding factors, and the multivariate logistic regression was performed to assess the relationship between urinary iAs and MetS.

RESULTS

The median content of urinary iAs was examined as 2.20 μg/dL (interquartile range: 1.30-3.20 μg/dL), and the MetS prevalence reached 23.69% (295 cases/950 participants). After the confounding factors were adjusted, the ORs (95% CIs) for MetS from the minimal to the maximum urinary iAs quartiles reached 1.171 (0.736,1.863), 1.568 (1.008, 2.440) and 2.011 (1.296, 3.120), respectively (referencing 1.00) (P for trend=0.001). After the PSM, the urinary iAs content still plays a potential prediction role in MetS (P for trend=0.011). In addition, as revealed from the subgroup analysis, the urinary iAs content was a predictor of MetS in the female patients, whereas it did not serve as a significant predictor of MetS in the male patients (P for interaction<0.05).

CONCLUSION

The increased urinary iAs content was associated with the increased prevalence of MetS in Chinese population. More attention should be paid to female urinary iAs content to avoid the high prevalence of MetS.

Inverse Association of Plasma Molybdenum with Metabolic Syndrome in a Chinese Adult Population: A Case-Control Study

Molybdenum has been found to be associated with metabolic disorders. However, the relationship between molybdenum and metabolic syndrome (MetS) is still unclear. A large case-control study was conducted in a Chinese population from the baseline of Ezhou-Shenzhen cohort. A total of 5356 subjects were included with 2678 MetS and 2678 controls matched by sex and age (±2 years). Medians (IQRs) of plasma molybdenum concentrations were 1.24 μg/L for MetS cases and 1.46 μg/L for controls. After adjustment for multiple covariates, the odds ratio (OR) and 95% confidence intervals (CIs) for MetS were 1.00 (reference), 0.71 (0.59-0.84), 0.56 (0.46-0.68), and 0.47 (0.39-0.58) across quartiles of plasma molybdenum, and per SD increment of log-transformed molybdenum was associated with a 23% lower risk of MetS. In the spline analysis, the risk of MetS and its components decreased steeply with increasing molybdenum and followed by a plateau when the cutoff point was observed around 2.0 μg/L. The dose-dependent relationship of molybdenum with MetS remained consistent when considering other essential elements in the Bayesian kernel machine regression (BKMR) model. In our study, higher plasma molybdenum was significantly associated with a lower risk of MetS, as well as its components, in a dose-response manner.

Associations of total blood mercury and blood methylmercury concentrations with diabetes in adults: An exposure-response analysis of 2005-2018 NHANES

OBJECTIVE

To examine the exposure-response relationship between mercury exposure and diabetes in adults, and to explore the possible effect modifications by selenium and omega-3 fatty acids.

METHODS

Biomarker data (total blood mercury and blood methylmercury) from individuals ≥20 years of age were obtained from the 2005-2018 NHANES. Diabetes was defined through questionnaires, fasting plasma glucose, 2 -h plasma glucose and hemoglobin A_1c levels. The exposure-response relationship between mercury exposure and diabetes was assessed with logistic regression and restricted cubic splines.

RESULTS

Comparing the highest to lowest quartile of exposure, the multivariable-adjusted odds ratio (95 % CI) of diabetes was 0.76 (0.63-0.92) with total blood mercury and 0.82 (0.66-1.00) with blood methylmercury. The inverse associations between total blood mercury [0.55 (0.40-0.77)] and blood methylmercury [0.61 (0.38-0.97)] and diabetes were observed among individuals having higher intakes of selenium (P_{for interaction}<0.05). Trends toward lower odds of diabetes with mercury exposure were mainly confined to individuals having higher intakes of omega-3 fatty acid, but the interactions were not significant. The inverse associations between total blood mercury and blood methylmercury and diabetes remained in sensitivity analyses after excluding patients with hypertension that may change their dietary intake of fish. Exposure-response analyses showed an initial decrease in odds of diabetes followed by a platform or a weaker decrease beyond 3 μg/L of total blood mercury and methylmercury concentrations, respectively.

CONCLUSIONS

Total blood mercury and blood methylmercury concentrations were inversely associated with diabetes in adults, and the associations were modified by selenium.

The Relationship between Metabolic Syndrome and Plasma Metals Modified by EGFR and TNF-α Gene Polymorphisms

With the escalating global prevalence of metabolic syndrome (MetS), it is crucial to detect the high-risk population early and to prevent chronic diseases. Exposure to various metals has been indicated to promote MetS, but the findings were controversial, and the effect of genetic modification was not considered. Epidermal growth factor receptor (EGFR) was proposed to be involved in the pathway of metabolic disorders, and tumor necrotic factor-α (TNF-α) was regarded as an early inflammatory biomarker for MetS. This research aimed to analyze the impact of EGFR and TNF-α gene polymorphisms on the prevalence of MetS under environmental or occupational exposure to metals. We gathered data from 376 metal industrial workers and 639 non-metal workers, including physical parameters, biochemical data, and plasma concentrations of six metals. According to the genomic database of Taiwan Biobank, 23 single nucleotide polymorphisms (SNPs) on EGFR gene and 6 SNPs on TNF-α gene were incorporated in our research. We applied multivariable logistic regression to analyze the probability of MetS with various SNPs and metals. Our study revealed some susceptible and protective EGFR and TNF-α genotypes under excessive exposure to cobalt, zinc, selenium, and lead. Thus, we remind the high-risk population of taking measures to prevent MetS.

Multiple metal exposure and obesity: A prospective cohort study of adults living along the Yangtze River, China

Association between long-term exposure to multiple metals and obesity remains inconclusive, and prospective evidence on the region along the Yangtze River was limited. Thus, our study aimed to examine the association of multiple metal exposure and obesity. We measured baseline urine levels of 22 metals of 982 adults living along the Yangtze River, incidence of obesity was calculated from body mass index (BMI) and waist circumference (WC) measured at follow-up survey. Cox proportional hazards models were used to examine the hazard ratios (HR) and 95% confidence interval (CI) for the association between urinary metals and obesity, and the mixing effect of metals on obesity was estimated by using quantile g-computation. In multiple-metal models, arsenic was significantly associated with BMI/obesity, with the HR in the highest quartiles of 0.33 (95% CI: 0.16, 0.69; p-trend = 0.004). The HRs for WC/obesity of arsenic and molybdenum were 0.49 (95% CI: 0.32, 0.75 for the fourth vs. first quartile; p-trend = 0.002) and 1.83 (95% CI: 1.25, 2.70; p-trend = 0.001), respectively. Quantile g-computation mixtures approach showed a significantly negative joint effect of multiple metals on WC/obesity, with the HR of 0.26 (95% CI: 0.14, 0.47; p < 0.001) when increasing all seventeen metals by one quartile. Our study suggests that all seventeen metal mixed exposure may be negatively associated with obesity. Further cohort studies are needed to confirm these findings and clarify the underlying biological mechanisms.

Impact of environmental mercury exposure on the blood cells oxidative status of fishermen living around Mundaú lagoon in Maceió - Alagoas (AL), Brazil

Mercury in the aquatic environment can lead to exposure of the human population and is a known toxic metal due to its capacity for accumulation in organs. We aimed to evaluate the mercury level in the blood and urine of fishermen and correlate it with the level of oxidative stress in blood cells. We show in this case-control study that the fishermen of the exposed group (case) of Mundaú Lagoon (Maceió - Alagoas, Brazil) have higher concentrations of total mercury in the blood (0.73-48.38 μg L^-1) and urine (0.430-10.2 μg L^-1) than the total mercury concentrations in blood (0.29-17.30 μg L^-1) and urine (0.210-2.65 μg L^-1) of the control group. In the blood cells of fishermen, we observed that the lymphomononuclear cells produced high levels of reactive oxygen species (61.7%), and the erythrocytes presented increased lipid peroxidation (151%) and protein oxidation (41.0%) and a decrease in total thiol (36.5%), GSH and the REDOX state (16.5%). The activity of antioxidant system enzymes (SOD, GPx, and GST) was also reduced in the exposed group by 26.9%, 28.3%, and 19.0%, respectively. Furthermore, hemoglobin oxygen uptake was decreased in the exposed group (40.0%), and the membrane of cells presented increased osmotic fragility (154%) compared to those in the control group. These results suggest that mercury in the blood of fishermen can be responsible for causing impairments in the oxidative status of blood cells and is probably the cause of the reduction in oxygen uptake capacity and damage to the membranes of erythrocytes.

Associations between blood and urinary manganese with metabolic syndrome and its components: Cross-sectional analysis of National Health and Nutrition Examination Survey 2011-2016

Manganese (Mn) may improve cardiometabolic health with its anti-oxidative ability. However, epidemiological evidence on the overall and sex-specific relationship between Mn exposure and metabolic syndrome (MetS) has been inconclusive. We evaluated the associations of urinary (n = 1713) and blood (n = 3335) Mn levels with the prevalence of MetS, its components (elevated waist circumference, impaired glucose metabolism, elevated blood pressure and dyslipidemia) and sex-dependent heterogeneities among participants in the United States National Health and Nutrition Examination Survey 2011-2016. After adjusting for multiple covariates and the levels of other metals (Arsenic, Barium, Cadmium, Mercury, Molybdenum, Tin and Uranium), urinary Mn at the third quartile associated with a lower odd of MetS (odds ratio [OR] = 0.55, 95% confidence interval [C.I.] = 0.32-0.97), elevated waist circumference (OR = 0.56, 95% C.I. = 0.36-0.86) and elevated fasting plasma glucose (OR = 0.46, 95% C.I. = 0.27-0.76) among overall participants, and lower odds of MetS (OR = 0.40, 95% C.I. = 0.16-0.99), elevated waist circumference (OR = 0.39, 95% C.I. = 0.19-0.81) and elevated fasting plasma glucose (OR = 0.44, 95% C.I. = 0.22-0.90) among men. The U-shaped dose-response relationship between urinary Mn and MetS (P non-linear = 0.008) was observed among all participants. We did not observe the significant associations of blood Mn with the prevalence of MetS. Compared with other metals, urinary Mn played a less important role in development of MetS (posterior inclusion probabilities [PIP] = 0.49 for Mn versus 0.54 to 0.91 for other metals), but the contribution of blood Mn (PIP = 0.59 versus 0.60 to 0.61) was similar to other blood metals (Cadmium, Lead, Mercury and Selenium). These findings have provided new evidence of the potential roles of Mn in cardiometabolic health, and the needs to explore how Mn interacts with multiple metals in sex-specific manner.

Effects of heavy metal, vitamin, and curry consumption on metabolic syndrome during menopause: a Korean community-based cross-sectional study

OBJECTIVE

To determine the associations between metabolic syndrome (MetS) during menopause and serum heavy metal levels and vitamin and curry consumption.

METHODS

A data set of 7,131 pre- and postmenopausal women aged ≥ 20 years collected between 2009 and 2017 was used to obtain information on sociodemographic, lifestyles, family histories, food intakes, and serum heavy metal levels and MetS. Logistic regression was used to identify associations between the presence of MetS and risk factors and to predict risks of MetS based on marginal effects.

RESULTS

Our results show that postmenopausal women had a higher risk of MetS than premenopausal women. During postmenopause elevations in the levels of serum cadmium by one unit increased the risk of MetS by 33% (OR 1.33; 95% CI, 1.03-1.72, P = 0.028). Risks of MetS in pre- and postmenopausal women, when serum Hb levels increased by 1 unit increased 21% (OR 1.21; 95% CI, 1.09-1.33, P < 0.001) and 26% (OR 1.26; 95% CI, 1.16-1.38, P < 0.001), respectively. Furthermore, the risk of MetS risk in pre- and postmenopausal women was increased 2.49-fold and 2.79-fold by a 1% increase in HbA1c level (OR 2.49; 95% CI, 1.97-3.16, P < 0.001) and (OR 2.79; 95% CI, 2.30-3.38, P < 0.001), respectively. High curry consumption reduced the risk of MetS significantly more than low curry consumption (OR 0.60; 95% CI, 0.39-0.91, P = 0.017) in premenopausal women. Furthermore, an increase in daily vitamin B2 intake by 1 mg reduced the risk of MetS by 45% (OR 0.55; 95% CI, 0.32-0.94, P = 0.028) in postmenopausal women.

CONCLUSION

Vitamin B2 and curry supplementation may protect against MetS. Further work is needed to reduce risk factors associated with heavy metals and determine the effects of vitamins and curry consumption on MetS during menopause.