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Zhou Y, Zhang L, Zheng T, Li H, Han Y, Meng W, Kuang H, Dong C, Yu ZL, Zhu X, Hu G, Dong GH, Yu Y. Metals link to diabetes: Insights from a national cross-sectional investigation. J Environ Sci (China) 2025; 155:720-729. [PMID: 40246503 DOI: 10.1016/j.jes.2024.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 07/26/2024] [Accepted: 07/29/2024] [Indexed: 04/19/2025]
Abstract
Diabetes and impaired fasting glucose (IFG) are significant global health concerns. However, the potential effects of mixed heavy metal exposure on these conditions remain underexplored. This study aims to investigate the combined effects of multiple metals on diabetes risk and explore the mediating role of Body Mass Index (BMI) in rural China. A cross-sectional analysis involved 2313 adults from 12 provinces in rural China. Urinary levels of zinc (Zn), chromium (Cr), nickel (Ni), cadmium (Cd), and lead (Pb) were quantified using inductively coupled plasma mass spectrometry. Fasting blood glucose (FBG) levels were measured with an automatic biochemical analyzer. Logistic regression models and the Bayesian Kernel Machine Regression (BKMR) model were used to examine associations and interactions. Mediation analysis was performed to assess the role of BMI. The results of our study indicate that there is a significant association between urinary Zn (OR = 2.38, 95 % CI: 1.57, 3.60), Cr (OR = 1.24, 95 % CI: 1.31, 1.61), and Ni (OR = 1.51, 95 % CI: 1.05, 2.18) and the diabetes risk. The study revealed that exposure to Ni amplified the associations between Zn, Cr and diabetes/IFG risk. Additionally, BMI was identified as a significant mediator in the relationship between metal exposure, particularly Cr/Cd, and diabetes risk. These findings reveal a complex link between multiple metals, such as Zn, Cr, and Ni, and diabetes risk, and emphasize the potential opposite mediating effects of BMI in different metal-induced diabetes mechanisms. Further investigation of these mechanisms is warranted.
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Affiliation(s)
- Yang Zhou
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Long Zhang
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Tong Zheng
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Hongyan Li
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Yajing Han
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Wenjie Meng
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Hongxuan Kuang
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Chenyin Dong
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Zi Ling Yu
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Xiaohui Zhu
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Guocheng Hu
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Yunjiang Yu
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China.
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He J, Chu N, Wan H, Ling J, Xue Y, Leung K, Yang A, Shen J, Chow E. Use of technology in prediabetes and precision prevention. J Diabetes Investig 2025. [PMID: 40317994 DOI: 10.1111/jdi.70057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2025] [Revised: 04/12/2025] [Accepted: 04/16/2025] [Indexed: 05/07/2025] Open
Abstract
Controlling the epidemic of diabetes is an urgent global healthcare challenge. The low uptake of diabetes prevention programs highlights difficulties in scalability, partly due to the need for intensive face-to-face contact and its impact on healthcare resource utilization. In this narrative review, we will summarize the latest evidence in technology-assisted lifestyle interventions. We will appraise evidence of digital diabetes prevention programs that use internet platforms or text messaging tools to support information delivery, lifestyle coaching, or peer support. We will also discuss the use of wearables, including physical activity trackers and continuous glucose monitoring (CGM) as part of lifestyle intervention. Experience from diabetes highlights the potential for CGM as a motivational tool to promote lifestyle change. The integration of digital data may facilitate earlier detection of prediabetes, sub-phenotyping, and personalized nutritional predictions. We will highlight major gaps in research and the need for rigorous clinical trials to evaluate the acceptability and cost-effectiveness of integrating technologies as part of a multicomponent strategy in diabetes prevention.
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Affiliation(s)
- Jie He
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | - Natural Chu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | - Heng Wan
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - James Ling
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | - Yincong Xue
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | - Kathy Leung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | - Aimin Yang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, SAR, China
| | - Jie Shen
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Elaine Chow
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, SAR, China
- Phase 1 Clinical Trial Centre, The Chinese University of Hong Kong, Hong Kong, SAR, China
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Song Q, Sui J, Yang Y, Zhang H, Ya L, Yang L. Fructose-1,6-bisphosphatase 1 in cancer: Dual roles, mechanistic insights, and therapeutic potential - A comprehensive review. Int J Biol Macromol 2025; 293:139273. [PMID: 39753180 DOI: 10.1016/j.ijbiomac.2024.139273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2024] [Revised: 12/22/2024] [Accepted: 12/26/2024] [Indexed: 01/07/2025]
Abstract
Fructose-1,6-bisphosphatase 1 (FBP1) is a key gluconeogenic enzyme that plays complex and context-dependent roles in cancer biology. This review comprehensively examines FBP1's dual functions as both a tumor suppressor and an oncogene across various cancer types. In many cancers, such as hepatocellular carcinoma, clear cell renal cell carcinoma, and lung cancer, downregulation of FBP1 contributes to tumor progression through metabolic reprogramming, promoting glycolysis, and altering the tumor microenvironment. Conversely, in certain contexts like breast and prostate cancers, FBP1 overexpression is associated with tumor promotion, indicating its oncogenic potential. The review explores FBP1's interactions with immune cells within the tumor microenvironment, influencing immune surveillance and tumor immune escape mechanisms. Additionally, FBP1 emerges as a promising diagnostic and prognostic biomarker, with expression levels correlating with patient outcomes in multiple cancers. Future therapeutic strategies targeting FBP1 are discussed, including inhibitors, activators, epigenetic modulation, and combination therapies, while addressing the challenges posed by its dual nature. Understanding the multifaceted roles of FBP1 offers valuable insights into cancer metabolism and opens avenues for personalized therapeutic interventions.
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Affiliation(s)
- Qinghang Song
- School of Basic Medicine, Qingdao University, Qingdao 266071, China
| | - Jiazhen Sui
- School of Basic Medicine, Qingdao University, Qingdao 266071, China
| | - Yuxuan Yang
- School of Basic Medicine, Qingdao University, Qingdao 266071, China
| | - Huhu Zhang
- School of Basic Medicine, Qingdao University, Qingdao 266071, China
| | - Li Ya
- School of Basic Medicine, Qingdao University, Qingdao 266071, China
| | - Lina Yang
- School of Basic Medicine, Qingdao University, Qingdao 266071, China.
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Yang C, Dai S, Luo Y, Lv Q, Zhu J, Yang A, Shi Z, Han Z, Yu R, Yang J, Liu L, Zhou JC. Vitamin E Intake Attenuated the Association Between Elevated Blood Heavy Metal (Pb, Cd, and Hg) Concentrations and Diabetes Risk in Adults Aged 18-65 Years: Findings from 2007-2018 NHANES. TOXICS 2024; 13:9. [PMID: 39853009 PMCID: PMC11769426 DOI: 10.3390/toxics13010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2024] [Revised: 12/19/2024] [Accepted: 12/23/2024] [Indexed: 01/26/2025]
Abstract
The association between heavy metal exposure and diabetes is controversial and vitamin E (VE) may reduce diabetes risk. We aimed to examine the associations between blood heavy metals (BHMs) and diabetes risk and VE's role in the relationship. From the 2007-2018 NHANES, 10,721 participants aged ≥ 18 were included for multiple statistical analyses, which revealed that BHMs and dietary VE intake were negatively associated with diabetes and fasting plasma glucose (FPG). The diabetes prevalence in each quartile (Q) of heavy metal exposure increased with age, but within age Q4, it generally decreased with exposure quartiles. Moreover, BHMs were positively associated with all-cause and diabetes-related mortalities with aging, which induced an age breakpoint of 65 years for age-stratified analyses on the associations between BHMs and diabetes risk. In those aged > 65, BHMs were negatively correlated with diabetes risk and its biomarkers; however, in adults aged 18-65, the correlation was positive. At higher VE intake levels, blood lead was associated with a lower diabetes risk and all three BHMs demonstrated lower FPG levels than those at lower VE intake levels. In conclusion, consuming sufficient VE and avoiding heavy metal exposure are highly recommended to reduce diabetes risk.
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Affiliation(s)
- Chenggang Yang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; (C.Y.); (S.D.); (Q.L.); (J.Z.); (A.Y.); (Z.S.); (Z.H.); (R.Y.); (J.Y.)
| | - Shimiao Dai
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; (C.Y.); (S.D.); (Q.L.); (J.Z.); (A.Y.); (Z.S.); (Z.H.); (R.Y.); (J.Y.)
| | - Yutian Luo
- School of Public Health, Columbia University, New York, NY 10025, USA;
| | - Qingqing Lv
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; (C.Y.); (S.D.); (Q.L.); (J.Z.); (A.Y.); (Z.S.); (Z.H.); (R.Y.); (J.Y.)
| | - Junying Zhu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; (C.Y.); (S.D.); (Q.L.); (J.Z.); (A.Y.); (Z.S.); (Z.H.); (R.Y.); (J.Y.)
| | - Aolin Yang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; (C.Y.); (S.D.); (Q.L.); (J.Z.); (A.Y.); (Z.S.); (Z.H.); (R.Y.); (J.Y.)
| | - Zhan Shi
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; (C.Y.); (S.D.); (Q.L.); (J.Z.); (A.Y.); (Z.S.); (Z.H.); (R.Y.); (J.Y.)
| | - Ziyu Han
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; (C.Y.); (S.D.); (Q.L.); (J.Z.); (A.Y.); (Z.S.); (Z.H.); (R.Y.); (J.Y.)
| | - Ruirui Yu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; (C.Y.); (S.D.); (Q.L.); (J.Z.); (A.Y.); (Z.S.); (Z.H.); (R.Y.); (J.Y.)
- The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China
| | - Jialei Yang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; (C.Y.); (S.D.); (Q.L.); (J.Z.); (A.Y.); (Z.S.); (Z.H.); (R.Y.); (J.Y.)
| | - Longjian Liu
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA
| | - Ji-Chang Zhou
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; (C.Y.); (S.D.); (Q.L.); (J.Z.); (A.Y.); (Z.S.); (Z.H.); (R.Y.); (J.Y.)
- Guangdong Province Engineering Laboratory for Nutrition Translation, Shenzhen 518107, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou 510080, China
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Li C, Lin K, Xiao L, Dilixiati Y, Huo Y, Zhang Z. Evaluation of cadmium effects on the glucose metabolism on insulin resistance HepG2 cells. Heliyon 2024; 10:e37325. [PMID: 39296152 PMCID: PMC11408151 DOI: 10.1016/j.heliyon.2024.e37325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 08/11/2024] [Accepted: 09/01/2024] [Indexed: 09/21/2024] Open
Abstract
Cadmium (Cd) is an environmental endocrine disruptor. Despite increasing research about the metabolic effects of Cd on HepG2 cells, information about the metabolic effects of Cd on insulin resistance HepG2 (IR-HepG2) cells is limited. Currently, most individuals with diabetes are exposed to Cd due to pollution. Previously, we reported that Cd exposure resulted in decreased blood glucose levels in diabetic mice, the underlying mechanism deserves further study. Therefore, we used palmitic acid (0.25 mM) to treat HepG2 cells to establish IR-HepG2 model. IR-HepG2 cells were exposed to CdCl2 (1 μM and 2 μM). Commercial kits were used to measure glucose production, glucose consumption, ROS and mitochondrial membrane potential. Western blot and qRT-PCR were used to measure the proteins and genes of glucose metabolism. In the current study setting, we found no significant changes in glucose metabolism in Cd-exposed HepG2 cells, but Cd enhanced glucose uptake, inhibited gluconeogenesis and activated the insulin signaling pathway in IR-HepG2 cells. Meanwhile, we observed that Cd caused oxidative stress and increased the intracellular calcium concentration and inhibited mitochondrial membrane potential in IR-HepG2 cells. Cd compensatingly increased glycolysis in IR-HepG2 cells. Collectively, we found Cd ameliorated glucose metabolism disorders in IR-HepG2 cells. Furthermore, Cd exacerbated mitochondrial damage and compensatory increased glycolysis in IR-HepG2 cells. These findings will provide novel insights for Cd exposure in insulin resistant individuals.
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Affiliation(s)
- Changhao Li
- School of Public Health, Soochow University, Suzhou, 215123, China
| | - Ke Lin
- Center for Disease Control and Prevention of Xishan District, Wuxi, 214000, Jiangsu, China
| | - Liang Xiao
- School of Public Health, Soochow University, Suzhou, 215123, China
| | | | - Yuan Huo
- School of Public Health, Soochow University, Suzhou, 215123, China
| | - Zengli Zhang
- School of Public Health, Soochow University, Suzhou, 215123, China
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Hsueh YM, Chen MC, Lin YC, Wu CY, Shiue HS, Hsu SL, Chen HH, Huang YL. Associations among global long interspersed nuclear element-1 DNA methylation, metal exposure, and chronic kidney disease. Arch Toxicol 2024; 98:3127-3135. [PMID: 38753188 DOI: 10.1007/s00204-024-03780-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 04/30/2024] [Indexed: 08/15/2024]
Abstract
Long interspersed nuclear element-1 (LINE-1) methylation serves as an indicator of global DNA methylation. This study explored the correlation between LINE-1 methylation and chronic kidney disease (CKD). We also evaluated whether LINE-1 methylation could modify the association between CKD and metal exposure. A total of 213 patients with clinically defined CKD, without hemodialysis and 416 age and sex matched controls were recruited. Levels of LINE-1 methylation, total urinary arsenic, blood lead, blood cadmium, and plasma selenium were assessed. The results reveal a positive association between LINE-1 methylation and CKD, with an odds ratio (OR) of 5.30 (95% confidence interval: 2.81 to 9.99). Total urinary arsenic and blood cadmium concentrations were positively related with LINE-1 methylation. This study was the first to observe that low plasma selenium, high blood cadmium, and high blood lead levels significantly and additively interact with increased LINE-1 methylation to increase the OR of CKD. Additionally, high LINE-1 methylation interacted multiplicatively with low plasma selenium to increase the OR of CKD (p < 0.001). This study highlighted the significant association between LINE-1 hypermethylation and CKD. Furthermore, the results demonstrate that LINE-1 methylation can interact with high blood cadmium or low plasma selenium to affect CKD risk.
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Affiliation(s)
- Yu-Mei Hsueh
- Department of Family Medicine, Wanfang Hospital, Taipei Medical University, Taipei City, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Zhonghe District, Taipei Medical University, No.301, Yuantong Road, New Taipei City, Taiwan
| | - Mei-Chieh Chen
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Ying-Chin Lin
- Department of Family Medicine, Wanfang Hospital, Taipei Medical University, Taipei City, Taiwan
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
- Department of Geriatric Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Chih-Yin Wu
- Department of Family Medicine, Wanfang Hospital, Taipei Medical University, Taipei City, Taiwan
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Horng-Sheng Shiue
- Department of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Sheng-Lun Hsu
- Department of Family Medicine, Wanfang Hospital, Taipei Medical University, Taipei City, Taiwan
| | - Hsi-Hsien Chen
- Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
- Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei City, Taiwan
| | - Ya-Li Huang
- Department of Public Health, School of Medicine, College of Medicine, Zhonghe District, Taipei Medical University, No.301, Yuantong Road, New Taipei City, Taiwan.
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Wang N, Dilixiati Y, Xiao L, Yang H, Zhang Z. Different Short-Chain Fatty Acids Unequally Modulate Intestinal Homeostasis and Reverse Obesity-Related Symptoms in Lead-Exposed High-Fat Diet Mice. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2024; 72:18971-18985. [PMID: 39146036 DOI: 10.1021/acs.jafc.4c04193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
Our previous study showed that heavy metal lead (Pb) exposure exacerbates high-fat-diet (HFD)-induced metabolic damage and significantly depletes the gut microbiota-derived metabolite short-chain fatty acid (SCFA) levels. However, it remains unclear whether SCFA is a key metabolite involved in accelerating adverse consequences after Pb exposure. In this study, we explored the effects of exogenous supplementation of acetate, propionate, and butyrate on a metabolic disorder model in Pb-exposed HFD mice. We found that three SCFA interventions attenuated glycolipid metabolism disorders and liver damage, with butyrate performing the best effects in improving obesity-related symptoms. All three SCFA promoted the abundance of Muribaculaceae and Muribaculum, acetate specifically enriched Christensenellaceae, Blautia, and Ruminococcus, and butyrate specifically enriched Parasutterella, Rikenella, Prevotellaceae_UCG-001, and Bacteroides, which contributed to the positive promotion of SCFA production forming a virtuous cycle. Besides, butyrate inhibited Gram-negative bacteria Escherichia-Shigella. All of these events alleviated the intestinal Th17/Treg imbalance and inflammatory response through crosstalk between the G protein-coupled receptor (GPR)/histone deacetylase 3 (HDAC3) and lipopolysaccharide (LPS)/toll-like receptors 4 (TLR4)/nuclear factor κ-B (NF-κB) pathways and ultimately improved the intestinal barrier function. SCFA further upregulated the monocarboxylate transporter 1 (MCT1) and GPR43/adenosine 5'-monophosphate-activated protein kinase (AMPK) pathways to inhibit hepatic lipid accumulation. Overall, SCFA, especially butyrate, is an effective modulator to improve metabolic disorders in obese individuals exposed to heavy metals by targeting gut microecology.
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Affiliation(s)
- Nana Wang
- School of Public Health, Soochow University, Suzhou 215123, China
| | | | - Liang Xiao
- School of Public Health, Soochow University, Suzhou 215123, China
| | - Hui Yang
- School of Public Health, Soochow University, Suzhou 215123, China
| | - Zengli Zhang
- School of Public Health, Soochow University, Suzhou 215123, China
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Numan AT, Jawad NK, Fawzi HA. Biochemical study of the effect of lead exposure in nonobese gasoline station workers and risk of hyperglycemia: A retrospective case-control study. Medicine (Baltimore) 2024; 103:e39152. [PMID: 39121307 PMCID: PMC11315521 DOI: 10.1097/md.0000000000039152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 07/10/2024] [Indexed: 08/11/2024] Open
Abstract
Evaluate the relationship between blood lead (Pb) levels and other biomedical markers and the risk of diabetes in gasoline station workers. The participants were separated into 2 groups: group A consisted of 26 workers from gasoline filling stations, while group B comprised 26 healthy individuals. Serum levels of malondialdehyde, IL-1β, visfatin, insulin, fasting blood sugar, and vitamin D were assessed. Mean Pb level was significantly higher in group A compared to group B (almost 2.9 times higher levels) (14.43 ± 1.01 vs 5.01 ± 1.41, µg/dL). The levels of visfatin (23.19 ± 0.96 vs 3.88 ± 0.58, ng/mL), insulin (22.14 ± 1.31 vs 11.26 ± 0.75, mU/L), fasting blood sugar (118.4 ± 26.1 vs 82.7 ± 9.2, gm/dL), malondialdehyde (6.40 ± 0.27 vs 1.62 ± 0.21, nmol/mL), and IL-1β (330.25 ± 10.34 vs 12.35 ± 1.43, pg/mL) were significantly higher in group A, meanwhile; vitamin D (11.99 ± 1.55 vs 35.41 ± 3.16, ng/mL) were significantly lower in group A. A positive association exists between blood Pb levels and increased inflammatory markers. Lead exposure increases serum insulin and fasting blood sugar, which suggests that it is diabetogenic and that increased inflammation is a possible cause.
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Affiliation(s)
- Ahmad Tarik Numan
- Department of Pharmacy, Al-Mustafa University College, Baghdad, Iraq
| | - Nada Kadum Jawad
- Department of Pharmacy, Al-Mustafa University College, Baghdad, Iraq
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Zheng X, Wang Q, Xu X, Huang X, Chen J, Huo X. Associations of insulin sensitivity and immune inflammatory responses with child blood lead (Pb) and PM 2.5 exposure at an e-waste recycling area during the COVID-19 lockdown. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2024; 46:296. [PMID: 38980420 DOI: 10.1007/s10653-024-02066-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 06/04/2024] [Indexed: 07/10/2024]
Abstract
Fine particular matter (PM2.5) and lead (Pb) exposure can induce insulin resistance, elevating the likelihood of diabetes onset. Nonetheless, the underlying mechanism remains ambiguous. Consequently, we assessed the association of PM2.5 and Pb exposure with insulin resistance and inflammation biomarkers in children. A total of 235 children aged 3-7 years in a kindergarten in e-waste recycling areas were enrolled before and during the Corona Virus Disease 2019 (COVID-19) lockdown. Daily PM2.5 data was collected and used to calculate the individual PM2.5 daily exposure dose (DED-PM2.5). Concentrations of whole blood Pb, fasting blood glucose, serum insulin, and high mobility group box 1 (HMGB1) in serum were measured. Compared with that before COVID-19, the COVID-19 lockdown group had lower DED-PM2.5 and blood Pb, higher serum HMGB1, and lower blood glucose and homeostasis model assessment of insulin resistance (HOMA-IR) index. Decreased DED-PM2.5 and blood Pb levels were linked to decreased levels of fasting blood glucose and increased serum HMGB1 in all children. Increased serum HMGB1 levels were linked to reduced levels of blood glucose and HOMA-IR. Due to the implementation of COVID-19 prevention and control measures, e-waste dismantling activities and exposure levels of PM2.5 and Pb declined, which probably reduced the association of PM2.5 and Pb on insulin sensitivity and diabetes risk, but a high level of risk of chronic low-grade inflammation remained. Our findings add new evidence for the associations among PM2.5 and Pb exposure, systemic inflammation and insulin resistance, which could be a possible explanation for diabetes related to environmental exposure.
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Affiliation(s)
- Xiangbin Zheng
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, 855 East Xingye Avenue, Guangzhou, 511443, Guangdong, China
- Center for Reproductive Medicine, Clinical Research Center, Shantou Central Hospital, Shantou, 515041, Guangdong, China
| | - Qihua Wang
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, 855 East Xingye Avenue, Guangzhou, 511443, Guangdong, China
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, 9713 GZ, Groningen, The Netherlands
| | - Xijin Xu
- Laboratory of Environmental Medicine and Developmental Toxicology, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Xiaofan Huang
- Center for Reproductive Medicine, Clinical Research Center, Shantou Central Hospital, Shantou, 515041, Guangdong, China
| | - Jiaxue Chen
- Laboratory of Environmental Medicine and Developmental Toxicology, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Xia Huo
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, 855 East Xingye Avenue, Guangzhou, 511443, Guangdong, China.
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Zhu M, Li P, Xu T, Zhang G, Xu Z, Wang X, Zhao L, Yang H. Combined exposure to lead and microplastics increased risk of glucose metabolism in mice via the Nrf2/NF-κB pathway. ENVIRONMENTAL TOXICOLOGY 2024; 39:2502-2511. [PMID: 38180308 DOI: 10.1002/tox.24125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/13/2023] [Accepted: 12/25/2023] [Indexed: 01/06/2024]
Abstract
The purpose of this study was to explore the effects of combined lead (Pb) and two types of microplastic (MP) (polyvinyl chloride [PVC] and polyethylene [PE]) exposure on glucose metabolism and investigate the role of the nuclear factor erythroid 2-related factor 2 (Nrf2)/nuclear factor-kappa B (NF-κB) signaling pathway in mediating these effects in mice. Adult C57BL/6J mice were randomly divided into four groups: control, Pb (100 mg/L), MPs (containing 10 mg/L PE and PVC), and Pb + MPs, each of which was treated with drinking water. Treatments were conducted for 6 weeks. Co-exposure to Pb + MPs exhibited increase glycosylated serum protein levels, insulin resistance, and damaged glucose tolerance compared with the control mice. Additionally, treatment with Pb + MPs caused more severe damage to hepatocytes than when exposed to them alone concomitantly, exposed to Pb + MPs exhibited improved the levels of interleukin-6, tumor necrosis factor-alpha, and malondialdehyde, but reduced superoxide dismutase, glutathione peroxidase, and catalase assay in livers. Furthermore, they increase the Kelch-like ECH-associated protein 1 (Keap1) and phosphorylated p-NF-κB protein levels but reduced the protein levels of heme oxygenase-1 and Nrf2, as well as increased Keap1 mRNA and Nrf2 mRNA. Co-exposure to Pb + MP impacts glucose metabolism via the Nrf2 /NF-κB pathway.
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Affiliation(s)
- Mengqiang Zhu
- Linyi Hedong District Maternal and Child Health Care Hospital, Linyi, China
| | - Peng Li
- Linyi Hedong District Maternal and Child Health Care Hospital, Linyi, China
| | | | - Guoyun Zhang
- Linyi Hedong District Maternal and Child Health Care Hospital, Linyi, China
| | - Zhuo Xu
- Linyi People's Hospital, Linyi, China
| | - Xiangrong Wang
- Linyi Hedong District Maternal and Child Health Care Hospital, Linyi, China
| | - Lulu Zhao
- Linyi Hedong District Maternal and Child Health Care Hospital, Linyi, China
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Xiao W, Zhang Y, Chen X, Sha A, Xiong Z, Luo Y, Peng L, Zou L, Zhao C, Li Q. The Diversity and Community Composition of Three Plants' Rhizosphere Fungi in Kaolin Mining Areas. J Fungi (Basel) 2024; 10:306. [PMID: 38786661 PMCID: PMC11121986 DOI: 10.3390/jof10050306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/10/2024] [Accepted: 04/17/2024] [Indexed: 05/25/2024] Open
Abstract
Mining activities in the kaolin mining area have led to the disruption of the ecological health of the mining area and nearby soils, but the effects on the fungal communities in the rhizosphere soils of the plants are not clear. Three common plants (Conyza bonariensis, Artemisia annua, and Dodonaea viscosa) in kaolin mining areas were selected and analyzed their rhizosphere soil fungal communities using ITS sequencing. The alpha diversity indices (Chao1, Shannon, Simpson, observed-species, pielou-e) of the fungal communities decreased to different extents in different plants compared to the non-kauri mining area. The β-diversity (PCoA, NMDS) analysis showed that the rhizosphere soil fungal communities of the three plants in the kaolin mine area were significantly differentiated from those of the control plants grown in the non-kaolin mine area, and the extent of this differentiation varied among the plants. The analysis of fungal community composition showed that the dominant fungi in the rhizosphere fungi of C. bonariensis and A. annua changed, with an increase in the proportion of Mycosphaerella (genus) by about 20% in C. bonariensis and A. annua. An increase in the proportion of Didymella (genus) by 40% in D. viscosa was observed. At the same time, three plant rhizosphere soils were affected by kaolin mining activities with the appearance of new fungal genera Ochrocladosporium and Plenodomus. Predictive functional potential analysis of the samples revealed that a significant decrease in the potential of functions such as biosynthesis and glycolysis occurred in the rhizosphere fungal communities of kaolin-mined plants compared to non-kaolin-mined areas. The results show that heavy metals and plant species are the key factors influencing these changes, which suggests that selecting plants that can bring more abundant fungi can adapt to heavy metal contamination to restore soil ecology in the kaolin mining area.
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Affiliation(s)
- Wenqi Xiao
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, Sichuan Engineering & Technology Research Center of Coarse Cereal Industrialization, School of Food and Biological Engineering, Chengdu University, Chengdu 610106, China; (W.X.); (Y.Z.); (X.C.); (A.S.); (Z.X.); (Y.L.); (L.P.); (L.Z.)
| | - Yunfeng Zhang
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, Sichuan Engineering & Technology Research Center of Coarse Cereal Industrialization, School of Food and Biological Engineering, Chengdu University, Chengdu 610106, China; (W.X.); (Y.Z.); (X.C.); (A.S.); (Z.X.); (Y.L.); (L.P.); (L.Z.)
| | - Xiaodie Chen
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, Sichuan Engineering & Technology Research Center of Coarse Cereal Industrialization, School of Food and Biological Engineering, Chengdu University, Chengdu 610106, China; (W.X.); (Y.Z.); (X.C.); (A.S.); (Z.X.); (Y.L.); (L.P.); (L.Z.)
| | - Ajia Sha
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, Sichuan Engineering & Technology Research Center of Coarse Cereal Industrialization, School of Food and Biological Engineering, Chengdu University, Chengdu 610106, China; (W.X.); (Y.Z.); (X.C.); (A.S.); (Z.X.); (Y.L.); (L.P.); (L.Z.)
| | - Zhuang Xiong
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, Sichuan Engineering & Technology Research Center of Coarse Cereal Industrialization, School of Food and Biological Engineering, Chengdu University, Chengdu 610106, China; (W.X.); (Y.Z.); (X.C.); (A.S.); (Z.X.); (Y.L.); (L.P.); (L.Z.)
| | - Yingyong Luo
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, Sichuan Engineering & Technology Research Center of Coarse Cereal Industrialization, School of Food and Biological Engineering, Chengdu University, Chengdu 610106, China; (W.X.); (Y.Z.); (X.C.); (A.S.); (Z.X.); (Y.L.); (L.P.); (L.Z.)
| | - Lianxin Peng
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, Sichuan Engineering & Technology Research Center of Coarse Cereal Industrialization, School of Food and Biological Engineering, Chengdu University, Chengdu 610106, China; (W.X.); (Y.Z.); (X.C.); (A.S.); (Z.X.); (Y.L.); (L.P.); (L.Z.)
| | - Liang Zou
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, Sichuan Engineering & Technology Research Center of Coarse Cereal Industrialization, School of Food and Biological Engineering, Chengdu University, Chengdu 610106, China; (W.X.); (Y.Z.); (X.C.); (A.S.); (Z.X.); (Y.L.); (L.P.); (L.Z.)
| | - Changsong Zhao
- School of Public Health, Chengdu Medical College, Chengdu 610500, China
| | - Qiang Li
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, Sichuan Engineering & Technology Research Center of Coarse Cereal Industrialization, School of Food and Biological Engineering, Chengdu University, Chengdu 610106, China; (W.X.); (Y.Z.); (X.C.); (A.S.); (Z.X.); (Y.L.); (L.P.); (L.Z.)
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12
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Друккер НА, Палиева НВ, Петров ЮА, Попова ВА. [The relationship of constitutional-exogenous obesity and hormonalmicroelement status in adolescent boys with delayed sexual development]. PROBLEMY ENDOKRINOLOGII 2024; 70:99-105. [PMID: 39868452 PMCID: PMC11775674 DOI: 10.14341/probl13155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 02/22/2024] [Accepted: 03/06/2024] [Indexed: 01/28/2025]
Abstract
BACKGROUND Childhood obesity and the rate of its spread is a serious threat to the reproductive health of the nation, especially among boys, being a background for delaying sexual development and further disrupting fertility. AIM To study the peculiarities of the ratio of the level of leptin and a number of toxic and essential chemical trace elements in biological environments in adolescent boys aged 13-14 years with obesity and delayed sexual development. MATERIALS AND METHODS Three groups of adolescents aged 13-14 years were studied and formed: the main ones - with constitutional exogenous obesity of 1-2 degrees (1-20 boys without secondary signs of puberty; 2 - 24 boys with 2-4 stages of puberty according to Tanner) and comparisons (3 - 15 boys with normal body weight and without deviations in puberty). The level of lead, zinc, selenium, chromium and manganese in the morning urine was determined by the absorption method; in the blood serum - leptin, by the method of enzyme immunoassay. Statistical analysis of the data was carried out in the MeoCape 11.4.2 Statistica environment, nonparametric Spearman correlation analysis and calculation of the Student's t-test for independent samples, the reliability of the results at p< 0.05. RESULTS It was found that adolescents with obesity are characterized by a certain shift in the content of toxic and essential trace elements, the vector of which is shifted towards the predominance of levels of toxic chemical elements, in particular, ead, and a decrease in essential toxic elements, such as zinc, selenium, chromium and manganese. However, a more pronounced shift in the values in the imbalance of trace elements already violates not only the metabolic processes in the body of adolescent children, but also leads to a violation of puberty - to a delay in sexual development. CONCLUSION In the body of adolescent boys with obesity and delayed sexual development, the processes of oxidative stress, tissue hypoxia are progressing against the background of excess leptin, accumulation of heavy metals and deficiency of essential trace elements. Less pronounced shifts in the content of leptin and trace elements in adolescent boys are determined by a failure in neuroendocrine regulation, but does not affect the level of puberty. The homeostasis of the hormonal-microelement composition ensures the harmonious development of adolescent boys.
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Affiliation(s)
| | | | - Ю. А. Петров
- Ростовский государственный медицинский университет
| | - В. А. Попова
- Ростовский государственный медицинский университет
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Chang Y, Zhou K, Yang T, Zhao X, Li R, Li J, Xu S, Feng Z, Ding X, Zhang L, Shi X, Su J, Li J, Wei Y. Bacillus licheniformis inoculation promoted humification process for kitchen waste composting: Organic components transformation and bacterial metabolic mechanism. ENVIRONMENTAL RESEARCH 2023; 237:117016. [PMID: 37657603 DOI: 10.1016/j.envres.2023.117016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/24/2023] [Accepted: 08/27/2023] [Indexed: 09/03/2023]
Abstract
Kitchen waste (KW) composting always has trouble with slow humification process and low humification degree. The objective of this study was to develop potentially efficient solutions to improve the humification of KW composting, accelerate the humus synthesis and produce HS with a high polymerization degree. The impact of Bacillus licheniformis inoculation on the transformation of organic components, humus synthesis, and bacterial metabolic pathways in kitchen waste composting, was investigated. Results revealed that microbial inoculation promoted the degradation of organic constituents, especially readily degradable carbohydrates during the heating phase and lignocellulose fractions during the cooling phase. Inoculation facilitated the production and conversion of polyphenol, reducing sugar, and amino acids, leading to an increase of 20% in the content of humic acid compared to the control. High-throughput sequencing and network analysis indicated inoculation enriched the presence of Bacillus, Lactobacillus, and Streptomyces during the heating phase, while suppressing the abundance of Pseudomonas and Oceanobacillus, enhancing positive microbial interactions. PICRUSt2 analysis suggested inoculation enhanced the metabolism of carbohydrates and amino acids, promoting the polyphenol humification pathway and facilitating the formation of humus. These findings provide insights for optimizing the humification process of kitchen waste composting by microbial inoculation.
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Affiliation(s)
- Yuan Chang
- College of Resources and Environmental Science, Beijing Key Laboratory of Biodiversity and Organic Farming, China Agricultural University, 100193, Beijing, China; Organic Recycling Institute (Suzhou) of China Agricultural University, Wuzhong District, Suzhou, 215128, China
| | - Kaiyun Zhou
- College of Resources and Environmental Science, Beijing Key Laboratory of Biodiversity and Organic Farming, China Agricultural University, 100193, Beijing, China; Organic Recycling Institute (Suzhou) of China Agricultural University, Wuzhong District, Suzhou, 215128, China
| | - Tianxue Yang
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, China
| | - Xinyu Zhao
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, China
| | - Ruoqi Li
- College of Resources and Environmental Science, Beijing Key Laboratory of Biodiversity and Organic Farming, China Agricultural University, 100193, Beijing, China; Organic Recycling Institute (Suzhou) of China Agricultural University, Wuzhong District, Suzhou, 215128, China
| | - Jun Li
- College of Resources and Environmental Science, Beijing Key Laboratory of Biodiversity and Organic Farming, China Agricultural University, 100193, Beijing, China; Organic Recycling Institute (Suzhou) of China Agricultural University, Wuzhong District, Suzhou, 215128, China
| | - Shaoqi Xu
- College of Resources and Environmental Science, Beijing Key Laboratory of Biodiversity and Organic Farming, China Agricultural University, 100193, Beijing, China
| | - Ziwei Feng
- College of Resources and Environmental Science, Beijing Key Laboratory of Biodiversity and Organic Farming, China Agricultural University, 100193, Beijing, China
| | - Xiaoyan Ding
- Organic Recycling Institute (Suzhou) of China Agricultural University, Wuzhong District, Suzhou, 215128, China
| | - Longli Zhang
- Beijing VOTO Biotech Co.,Ltd, 100193, Beijing, China
| | - Xiong Shi
- Yangtze Eco-Environment Engineering Research Center, China Three Gorges Corporation, Beijing, 100038, China
| | - Jing Su
- Nanjing Institute of Environmental Sciences, Ministry of Ecology and Environment, Nanjing, 210042, China.
| | - Ji Li
- College of Resources and Environmental Science, Beijing Key Laboratory of Biodiversity and Organic Farming, China Agricultural University, 100193, Beijing, China; Organic Recycling Institute (Suzhou) of China Agricultural University, Wuzhong District, Suzhou, 215128, China
| | - Yuquan Wei
- College of Resources and Environmental Science, Beijing Key Laboratory of Biodiversity and Organic Farming, China Agricultural University, 100193, Beijing, China; Organic Recycling Institute (Suzhou) of China Agricultural University, Wuzhong District, Suzhou, 215128, China.
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14
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Sun F, Pan XF, Hu Y, Xie J, Cui W, Ye YX, Wang Y, Yang X, Wu P, Yuan J, Yang Y, Pan A, Chen D. Metal Exposure during Early Pregnancy and Risk of Gestational Diabetes Mellitus: Mixture Effect and Mediation by Phospholipid Fatty Acids. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:13778-13792. [PMID: 37656932 DOI: 10.1021/acs.est.3c04065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
Despite existing studies exploring the association between metal exposure and gestational diabetes mellitus (GDM), most of them have focused on a single metal or a small mixture of metals. Our prospective work investigated the joint and independent effects of early gestational exposure to 17 essential and nonessential metals on the GDM risk and potential mediation by plasma phospholipid fatty acids (PLFAs) based on a nested case-control study established with 335 GDM cases and 670 randomly matched healthy controls. The Bayesian kernel machine regression (BKMR) and quantile g-computation analyses demonstrated a joint effect from metal co-exposure on GDM risk. BKMR with hierarchical variable selection indicated that the group of essential metals was more strongly associated with GDM than the group of nonessential metals with group posterior inclusion probabilities (PIPs) of 0.979 and 0.672, respectively. Cu (0.988) and Ga (0.570) had the largest conditional PIPs within each group. We also observed significant mediation effects of selected unsaturated PLFAs on Cu-GDM and Ga-GDM associations. KEGG enrichment analysis further revealed significant enrichment in the biosynthesis of unsaturated PLFAs. C18:1 n-7 exhibited the largest proportion of mediation in both associations (23.8 and 22.9%). Collectively, our work demonstrated the joint effect of early gestational metal exposure on GDM risk and identified Cu and Ga as the key species to the joint effect. The findings lay a solid ground for further validation through multicenter investigations and mechanism exploration via laboratory studies.
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Affiliation(s)
- Fengjiang Sun
- School of Environment, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, Guangdong, China
| | - Xiong-Fei Pan
- Section of Epidemiology and Population Health & Department of Gynecology and Obstetrics, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children, and National Medical Product Administration Key Laboratory for Technical Research on Drug Products in Vitro and in Vivo Correlation, West China Second University Hospital, Sichuan University and Shuangliu Institute of Women's and Children's Health, Shuangliu Maternal and Child Health Hospital, Chengdu 610041, Sichuan, China
| | - Yongxia Hu
- School of Environment, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, Guangdong, China
| | - Jinxin Xie
- School of Environment, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, Guangdong, China
| | - Wenxuan Cui
- School of Environment, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, Guangdong, China
| | - Yi-Xiang Ye
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Yi Wang
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Xue Yang
- Section of Epidemiology and Population Health & Department of Gynecology and Obstetrics, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children, and National Medical Product Administration Key Laboratory for Technical Research on Drug Products in Vitro and in Vivo Correlation, West China Second University Hospital, Sichuan University and Shuangliu Institute of Women's and Children's Health, Shuangliu Maternal and Child Health Hospital, Chengdu 610041, Sichuan, China
| | - Ping Wu
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Jiaying Yuan
- Department of Science and Education, Shuangliu Maternal and Child Health Hospital, Chengdu 610200, Sichuan, China
| | - Yan Yang
- School of Chemical Engineering and Light Industry, Guangdong University of Technology, Guangzhou 510006, Guangdong, China
- Synergy Innovation Institute of GDUT, Shantou 515041, Guangdong, China
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Da Chen
- School of Environment, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, Guangdong, China
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15
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Wang PP, Lei JY, Wang Y, Wang HL, Sun L, Hu B, Wang SF, Zhang DM, Chen GM, Liang CM, Tao FB, Yang LS, Wu QS. The association between the essential metal mixture and fasting plasma glucose in Chinese community-dwelling elderly people. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 263:115289. [PMID: 37499391 DOI: 10.1016/j.ecoenv.2023.115289] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Epidemiological studies about the effect of essential metal mixture on fasting plasma glucose (FPG) levels among elderly people are sparse. The object of this study was to examine the associations of single essential metals and essential metal mixture with FPG levels in Chinese community-dwelling elderly people. METHODS The study recruited 2348 community-dwelling elderly people in total. Inductively coupled plasma-mass spectrometry was adopted to detect the levels of vanadium (V), selenium (Se), magnesium (Mg), cobalt (Co), calcium (Ca), and molybdenum (Mo) in urine. The relationships between single essential metals and essential metal mixture and FPG levels were evaluated by linear regression and Bayesian kernel machine regression (BKMR) models, respectively. RESULTS In multiple-metal linear regression models, urine V and Mg were negatively related to the FPG levels (β = - 0.016, 95 % CI: - 0.030 to - 0.003 for V; β = - 0.021, 95 % CI: - 0.033 to - 0.009 for Mg), and urine Se was positively related to the FPG levels (β = 0.024, 95 % CI: 0.014-0.034). In BKMR model, the significant relationships of Se and Mg with the FPG levels were also found. The essential metal mixture was negatively associated with FPG levels in a dose-response pattern, and Mg had the maximum posterior inclusion probability (PIP) value (PIP = 1.0000), followed by Se (PIP = 0.9968). Besides, Co showed a significant association with decreased FPG levels in older adults without hyperlipemia and in women. CONCLUSIONS Both Mg and Se were associated with FPG levels, individually and as a mixture. The essential metal mixture displayed a linear dose-response relationship with reduced FPG levels, with Mg having the largest contribution to FPG levels, followed by Se. Further prospective investigations are necessary to validate these exploratory findings.
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Affiliation(s)
- Pan-Pan Wang
- School of Public Health, Department of Health Inspection and Quarantine, Anhui Medical University, Hefei 230032, Anhui, China
| | - Jing-Yuan Lei
- School of Public Health, Department of Health Inspection and Quarantine, Anhui Medical University, Hefei 230032, Anhui, China
| | - Yuan Wang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China
| | - Hong-Li Wang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China
| | - Liang Sun
- Fuyang Center for Diseases Prevention and Control, Fuyang 236069, Anhui, China
| | - Bing Hu
- Fuyang Center for Diseases Prevention and Control, Fuyang 236069, Anhui, China
| | - Su-Fang Wang
- School of Public Health, Department of Nutrition and Food Hygiene, Anhui Medical University, Hefei 230032, Anhui, China
| | - Dong-Mei Zhang
- School of Health Services Management, Anhui Medical University, Hefei 230032, Anhui, China
| | - Gui-Mei Chen
- School of Health Services Management, Anhui Medical University, Hefei 230032, Anhui, China
| | - Chun-Mei Liang
- School of Public Health, Department of Health Inspection and Quarantine, Anhui Medical University, Hefei 230032, Anhui, China
| | - Fang-Biao Tao
- MOE Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Lin-Sheng Yang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China.
| | - Qing-Si Wu
- Department of Blood Transfusion, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, China.
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16
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Ren M, Wang L, Wen L, Chen J, Quan S, Shi X. Association between female circulating heavy metal concentration and abortion: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1216507. [PMID: 37711903 PMCID: PMC10497972 DOI: 10.3389/fendo.2023.1216507] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/31/2023] [Indexed: 09/16/2023] Open
Abstract
Objective This study aimed to evaluate the association between blood heavy metal (zinc (Zn), copper (Cu), lead (Pb), and cadmium (Cd)) concentrations and spontaneous abortion (SA) and recurrent pregnancy loss (RPL) and explore the possible endocrine dysfunction associated with it. Methods A literature search was performed in the PubMed, Embase, Cochrane Library, and Web of Science databases up to April 2023. The overall effects were expressed as the standard mean difference (SMD). Subgroup analysis was performed according to the type of abortion (SA or RPL). Stata 16.0 was utilized for data analysis. Results Based on the integrated findings, abortion women showed significantly lower Zn (SMD = -1.05, 95% CI: -1.74 to -0.36, p = 0.003) and Cu concentrations (SMD = -1.42, 95% CI: -1.97 to -0.87, p <0.001) and higher Pb (SMD = 1.47, 95% CI: 0.89-2.05, p <0.001) and Cd concentrations (SMD = 1.15, 95% CI: 0.45-1.85, p = 0.001) than normal pregnant women. Subgroup analysis showed that Zn and Cu deficiency and Cd and Pb exposure were significantly (p <0.05) associated with RPL, whereas Cu deficiency and Cd and Pb exposure were significantly (p <0.05) associated with SA. Conclusion Zn and Cu deficiencies and Pb and Cd exposure were associated with abortion. Endocrine dysfunction, such as insulin resistance, vitamin D insufficiency, and abnormal thyroid and sex hormone concentrations, is thought to be involved in heavy metal-related abortion.
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Affiliation(s)
- Meiqi Ren
- Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, NanFang Hospital, Southern Medical University, Guangzhou, China
| | - Liantong Wang
- Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, NanFang Hospital, Southern Medical University, Guangzhou, China
| | - Liqin Wen
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Jinghua Chen
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Song Quan
- Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, NanFang Hospital, Southern Medical University, Guangzhou, China
| | - Xiao Shi
- Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, NanFang Hospital, Southern Medical University, Guangzhou, China
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Liu M, Liu R, Yang M, Ba Y, Deng Q, Zhang Y, Han L, Gao L, Huang H. Combined exposure to lead and high-fat diet induced neuronal deficits in rats: Anti-neuroinflammatory role of SIRT1. Food Chem Toxicol 2023; 177:113857. [PMID: 37244597 DOI: 10.1016/j.fct.2023.113857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/19/2023] [Accepted: 05/23/2023] [Indexed: 05/29/2023]
Abstract
INTRODUCTION Lead (Pb) exposure and high-fat diet (HFD) trigger neurotoxicity, which may involve neuroinflammation. However, the mechanism by which combined Pb and HFD exposure induces nucleotide oligomerization domain-like receptor family pyrin domain 3 (NLRP3) inflammasome activation has not been fully elucidated. MATERIAL AND METHODS The Sprague-Dawley (SD) rat model of exposure to Pb and HFD was established to reveal the influence of co-exposure on cognition and identify signaling clues that mediate neuroinflammation and synaptic dysregulation. PC12 cells was treated with Pb and PA in vitro. Silent information regulator 1 (SIRT1) agonist (SRT 1720) was employed as intervention agent. RESULTS Our results showed that Pb and HFD exposure induced cognitive impairment and lead to neurological damage in rats. Meanwhile, Pb and HFD could stimulate the NLRP3 inflammasome assembly and activate caspase 1, releasing proinflammatory cytokines interleukin-1β (IL-1β) and interleukin-18 (IL-18), further promoting neuronal cell activation and amplifying neuroinflammatory responses. Additionally, our findings suggest that SIRT1 plays a role in Pb and HFD induced neuroinflammation. However, the use of SRT 1720 agonists showed some potential in alleviating these impairments. CONCLUSION Pb exposure and HFD intake could induce neuronal damage through activation of the NLRP3 inflammasome pathway and synaptic dysregulation, while the NLRP3 inflammasome pathway may be rescued via activating SIRT1.
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Affiliation(s)
- Mengchen Liu
- Department of Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan province, 450001, China.
| | - Rundong Liu
- Department of Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan province, 450001, China.
| | - Mingzhi Yang
- Department of Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan province, 450001, China.
| | - Yue Ba
- Department of Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan province, 450001, China.
| | - Qihong Deng
- Department of Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan province, 450001, China.
| | - Yu Zhang
- State Key Laboratory of Microbial Technology, Qingdao, Shandong, 266000, China; Shandong Engineering Research Center of Biomarker and Artificial Intelligence Application, Jinan, Shandong, 250100, China; Institute of Marine Science and Technology, Shandong University, Qingdao, Shandong, 266000, China.
| | - Lin Han
- Shandong Engineering Research Center of Biomarker and Artificial Intelligence Application, Jinan, Shandong, 250100, China; Institute of Marine Science and Technology, Shandong University, Qingdao, Shandong, 266000, China.
| | - Lihua Gao
- Zhengzhou Center for Disease Control and Prevention, Zhengzhou, Henan, 450052, China.
| | - Hui Huang
- Department of Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan province, 450001, China.
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Xu T, Lin K, Cao M, Miao X, Guo H, Rui D, Hu Y, Yan Y. Patterns of global burden of 13 diseases attributable to lead exposure, 1990-2019. BMC Public Health 2023; 23:1121. [PMID: 37308890 DOI: 10.1186/s12889-023-15874-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/11/2023] [Indexed: 06/14/2023] Open
Abstract
OBJECTIVES Understanding the spatio-temporal patterns of the global burden of various diseases resulting from lead exposure is critical for controlling lead pollution and disease prevention. METHODS Based on the 2019 Global Burden of Disease (GBD) framework and methodology, the global, regional, and national burden of 13 level-three diseases attributable to lead exposure were analyzed by disease type, patient age and sex, and year of occurrence. Population attributable fraction (PAF), deaths and disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) obtained from the GBD 2019 database were used as descriptive indicators, and the average annual percentage change (AAPC) was estimated by a log-linear regression model to reflect the time trend. RESULTS AND CONCLUSIONS From 1990 to 2019, the number of deaths and DALYs resulting from lead exposure increased by 70.19% and 35.26%, respectively; however, the ASMR and ASDR decreased by 20.66% and 29.23%, respectively. Ischemic heart disease (IHD), stroke, and hypertensive heart disease (HHD) showed the highest increases in deaths; IHD, stroke, and diabetes and kidney disease (DKD) had the fastest-growing DALYs. The fastest decline in ASMR and ASDR was seen in stroke, with AAPCs of -1.25 (95% CI [95% confidence interval]: -1.36, -1.14) and -1.66 (95% CI: -1.76, -1.57), respectively. High PAFs occurred mainly in South Asia, East Asia, the Middle East, and North Africa. Age-specific PAFs of DKD resulting from lead exposure were positively correlated with age, whereas the opposite was true for mental disorders (MD), with the burden of lead-induced MD concentrated in children aged 0-6 years. The AAPCs of ASMR and ASDR showed a strong negative correlation with the socio-demographic index. Our findings showed that the global impact of lead exposure and its burden increased from 1990 to 2019 and varied significantly according to age, sex, region, and resulting disease. Effective public health measures and policies should be adopted to prevent and control lead exposure.
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Affiliation(s)
- Tongtong Xu
- Department of Preventive Medicine, School of Medicine, Shihezi University, No. 59, North 2nd Rd, Hong-Shan District, Shihezi, 832003, Xinjiang, China
| | - Kangqian Lin
- Department of Preventive Medicine, School of Medicine, Shihezi University, No. 59, North 2nd Rd, Hong-Shan District, Shihezi, 832003, Xinjiang, China
| | - Miao Cao
- Department of Preventive Medicine, School of Medicine, Shihezi University, No. 59, North 2nd Rd, Hong-Shan District, Shihezi, 832003, Xinjiang, China
| | - Xinlu Miao
- Department of Preventive Medicine, School of Medicine, Shihezi University, No. 59, North 2nd Rd, Hong-Shan District, Shihezi, 832003, Xinjiang, China
| | - Heng Guo
- Department of Preventive Medicine, School of Medicine, Shihezi University, No. 59, North 2nd Rd, Hong-Shan District, Shihezi, 832003, Xinjiang, China
- Key Laboratory of Preventive Medicine, Shihezi University, Shihezi, Xinjiang, China
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), School of Medicine, Shihezi University, Shihezi, Xinjiang, China
- Key Laboratory for Prevention and Control of Crucial Emerging Infectious Diseases and Public, Health Security of The Xinjiang Production and Construction Corps, Shihezi, Xinjiang, China
| | - Dongsheng Rui
- Department of Preventive Medicine, School of Medicine, Shihezi University, No. 59, North 2nd Rd, Hong-Shan District, Shihezi, 832003, Xinjiang, China
- Key Laboratory of Preventive Medicine, Shihezi University, Shihezi, Xinjiang, China
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), School of Medicine, Shihezi University, Shihezi, Xinjiang, China
- Key Laboratory for Prevention and Control of Crucial Emerging Infectious Diseases and Public, Health Security of The Xinjiang Production and Construction Corps, Shihezi, Xinjiang, China
| | - Yunhua Hu
- Department of Preventive Medicine, School of Medicine, Shihezi University, No. 59, North 2nd Rd, Hong-Shan District, Shihezi, 832003, Xinjiang, China.
- Key Laboratory of Preventive Medicine, Shihezi University, Shihezi, Xinjiang, China.
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), School of Medicine, Shihezi University, Shihezi, Xinjiang, China.
- Key Laboratory for Prevention and Control of Crucial Emerging Infectious Diseases and Public, Health Security of The Xinjiang Production and Construction Corps, Shihezi, Xinjiang, China.
| | - Yizhong Yan
- Department of Preventive Medicine, School of Medicine, Shihezi University, No. 59, North 2nd Rd, Hong-Shan District, Shihezi, 832003, Xinjiang, China.
- Key Laboratory of Preventive Medicine, Shihezi University, Shihezi, Xinjiang, China.
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), School of Medicine, Shihezi University, Shihezi, Xinjiang, China.
- Key Laboratory for Prevention and Control of Crucial Emerging Infectious Diseases and Public, Health Security of The Xinjiang Production and Construction Corps, Shihezi, Xinjiang, China.
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Tagorti G, Yalçın B, Güneş M, Burgazlı AY, Kaya B. Computational assessment of the biological response of curcumin to type 2 diabetes mellitus induced by metal exposure. Toxicology 2023; 491:153531. [PMID: 37121082 DOI: 10.1016/j.tox.2023.153531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/20/2023] [Accepted: 04/27/2023] [Indexed: 05/02/2023]
Abstract
The current study aimed to identify the molecular mechanisms of a metal mixture (cadmium, nickel, and lead) involved in type 2 diabetes mellitus (T2DM) development and the therapeutic effect of curcumin in this metal mixture-induced T2DM. To accomplish this, SwissADME assessed the physicochemical and pharmacokinetic properties of curcumin and the Prediction of Activity Spectra for Substances evaluates its biological activities. The Comparative Toxicogenomics Database, Cytoscape, AutoDock Vina, and MicroRNA ENrichment TURned NETwork were used as tools to perform data-mining approaches and molecular docking. Curcumin properties were fitted within the acceptable range to be a promising drug candidate. The mixed metal altered 23 genes linked to T2DM development and targeted by curcumin. Curcumin had a dual-natured effect or antagonistic effect for most of the involved genes in T2DM and metal mixture. The most prominent biological processes were identified as ''response to external stimulus'', ''regulation of programmed cell death'', ''programmed cell death'', ''cell death'', and ''response to stress''. Three highly interacted miRNAs related to metal mixture-induced T2DM and targeted by curcumin (hsa-miR-98-5p, hsa-miR-34a-5p, and hsa-miR-155-5p) were identified. These findings could pave the way for further studies to evaluate the link between these genes and T2DM.
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Affiliation(s)
- Ghada Tagorti
- Akdeniz University, Faculty of Sciences, Department of Biology, Campus, Antalya 07058, Turkey
| | - Burçin Yalçın
- Akdeniz University, Faculty of Sciences, Department of Biology, Campus, Antalya 07058, Turkey
| | - Merve Güneş
- Akdeniz University, Faculty of Sciences, Department of Biology, Campus, Antalya 07058, Turkey
| | - Ayşen Yağmur Burgazlı
- Akdeniz University, Faculty of Sciences, Department of Biology, Campus, Antalya 07058, Turkey
| | - Bülent Kaya
- Akdeniz University, Faculty of Sciences, Department of Biology, Campus, Antalya 07058, Turkey.
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20
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Wan H, Wang D, Liang Y, He Y, Ma Q, Li T, He Y, Guo H, Wang J, Li Z, Lin X, Liu L, Shen J. Single and combined associations of blood lead and essential metals with serum lipid profiles in community-dwelling adults. Front Nutr 2023; 10:1129169. [PMID: 37125027 PMCID: PMC10140323 DOI: 10.3389/fnut.2023.1129169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/23/2023] [Indexed: 05/02/2023] Open
Abstract
Background Although several studies have examined the relationships between lead (Pb) exposure and serum lipid profiles, the associations of the metal mixture, including lead (Pb) and essential metals with lipid profiles, remain unclear. Objective To investigate the associations of the metal mixture including Pb and essential metals [magnesium (Mg), manganese (Mn), copper (Cu), iron (Fe), zinc (Zn), and calcium (Ca)] with serum lipid profiles [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C)], as well as the potential interactions among the metals. Methods Nine hundred and ninety-eight Chinese community-dwelling adults completed a questionnaire and underwent checkups of anthropometric parameters, serum lipid profile levels (TC, TG, LDL-C, and HDL-C), and blood metal concentrations (Pb, Mg, Mn, Cu, Fe, Zn, and Ca). The multivariable linear regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) were applied to evaluate the single and combined associations of blood Pb and essential metals with serum lipid profiles. Results In the multivariable linear regression model, the blood Pb was positively associated with TC, LDL-C, and HDL-C (p < 0.05, all), and the blood Mg were positively associated with serum TC, LDL-C, and Ln TG (p < 0.05, all). In the WQS regression and BKMR models, the metal mixture of blood Pb and the essential metals was positively associated with all of the serum lipid profiles. In addition, an inverse U-shaped association of Pb with Ln TG and the positive interactive effect between blood Pb and Mg levels on TC and LDL-C were found. Conclusion The levels of blood Pb, together with the essential metals, especially Mg levels, are suggested to be considered when assessing dyslipidemia risk. However, more evidence is still needed to validate the conclusions.
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Affiliation(s)
- Heng Wan
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Dongmei Wang
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Yongqian Liang
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Yajun He
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Qintao Ma
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Tingting Li
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Yingbo He
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Hanquan Guo
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiachen Wang
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhao Li
- Department of Business Development, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Xu Lin
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Lan Liu
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
- Lan Liu,
| | - Jie Shen
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
- *Correspondence: Jie Shen,
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21
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Avicularin Attenuates Lead-Induced Impairment of Hepatic Glucose Metabolism by Inhibiting the ER Stress-Mediated Inflammatory Pathway. Nutrients 2022; 14:nu14224806. [PMID: 36432494 PMCID: PMC9697143 DOI: 10.3390/nu14224806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/05/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022] Open
Abstract
Lead (Pb), an environmental hazard, causes several human diseases. Avicularin (Avi), a main dietary flavonoid found in several plants and fruits, exhibits potential protective properties on organs. However, the molecular mechanisms of Avi's protective effects against Pb-induced damage are not clear. In our study, the effects of Avi on Pb-induced hepatotoxicity were evaluated using ICR mice. We have revealed for the first time that treatment with Avi significantly reduced hepatic inflammation, endoplasmic reticulum stress (ERS) and glucose metabolism disorder induced by Pb. Avi decreased the serum biochemical indicators of glucose metabolism. Avi increased the activities of glycogenolysis rate-limiting enzyme hexokinase (HK), pyruvate kinase (PK), glucokinase (GK) and glycogen phosphorylase (PYG) and inhibited the activities of gluconeogenesis rate-limiting enzyme phosphoenolpyruvate carboxy kinase (PEPCK) and glucose-6-phosphate dehydrogenase (G6PD). Avi decreased the protein expression levels of glucose-regulated protein 78 (GRP78), phosphorylated inositol requiring enzyme 1 (p-IRE1), phosphorylated RNA-dependent protein kinase-like ER kinase (p-PERK) and phosphorylated eukaryotic initiation factor 2α (p-eIF2α). The levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) were decreased in the liver as a result of Avi suppression Pb-induced inflammation. These results indicated that Avi attenuated Pb-induced impairment of hepatic glucose metabolism by the ERS and inflammation pathway.
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22
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Zhu K, Zhang Y, Lu Q, Geng T, Li R, Wan Z, Zhang X, Liu Y, Li L, Qiu Z, He M, Liu L, Pan A, Liu G. Associations of exposure to lead and cadmium with risk of all-cause and cardiovascular disease mortality among patients with type 2 diabetes. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:76805-76815. [PMID: 35670945 DOI: 10.1007/s11356-022-21273-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
The aim of this paper is to investigate the associations of lead and cadmium exposure with all-cause and cardiovascular disease (CVD) mortality among adults with type 2 diabetes (T2D). The prospective cohort study included participants with T2D (n = 7420 for blood lead; n = 5113 for blood cadmium) from the National Health and Nutrition Examination Survey (NHANES) III and NHANES 1999-2014. Death outcomes were ascertained through linkage with the National Death Index records. The geometric mean (interquartile range) concentrations of blood lead and cadmium were 19.6 (11.8, 35.0) μg/L and 0.39 (0.21, 0.60) μg/L, respectively. During 72,279 and 37,017 person-years of followup, 2818 all-cause deaths (including 832 CVD deaths) for blood lead and 1237 all-cause deaths (including 319 CVD deaths) for blood cadmium were documented, respectively. Comparing extreme quartiles, the multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause mortality were 1.51 (1.25, 1.82) for blood lead (Ptrend < 0.001) and 1.58 (1.22, 2.03) for blood cadmium (Ptrend < 0.001); and the HRs (95% CIs) of CVD mortality were 2.27 (1.54, 3.34) for blood lead (Ptrend < 0.001) and 1.78 (1.04, 3.03) for blood cadmium (Ptrend = 0.07). In the joint analysis, compared with participants in the lowest tertiles of blood lead and cadmium, participants in the highest tertiles had a HR (95% CI) of 2.09 (1.35, 3.24) for all-cause mortality. Exposure to lead and cadmium alone or in combination was significantly associated with higher risk of mortality among patients with T2D. These findings imply that minimizing exposure to lead and cadmium may aid in the prevention of premature death among individuals with diabetes.
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Affiliation(s)
- Kai Zhu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Yuge Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Qi Lu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Tingting Geng
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rui Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Zhenzhen Wan
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Xuena Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Yujie Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Lin Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Zixin Qiu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Meian He
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liegang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - An Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China.
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Wang Z, Huang X, Li J, Liu N, Wei Q. Lead exposure is non-linearly associated with subclinical myocardial injury in the general population without cardiovascular disease. Front Public Health 2022; 10:975413. [PMID: 36339197 PMCID: PMC9633844 DOI: 10.3389/fpubh.2022.975413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 10/10/2022] [Indexed: 01/25/2023] Open
Abstract
Background and aims Growing studies have focused on the effect of lead exposure on human circulatory system, while the relationship between lead exposure and subclinical myocardial injury (SC-MI) is still poorly known. Therefore, this study was to explore the effect of lead exposure on SC-MI. Methods The study included 6,272 individuals aged 40 and older without cardiovascular disease (CVD) from the third National Health and Nutrition Examination Survey. Blood lead was used as an alternative marker of lead exposure. Multivariable logistic regression models, restricted cubic spline and threshold effect analyses were performed to investigate the effect of blood lead on SC-MI. Results After adjusting for age, sex, race, diabetes, hypertension, systolic blood pressure, body mass index, waist-to-hip ratio, triglycerides, total cholesterol, creatinine, fasting plasma glucose and hemoglobin Alc, higher blood lead level was independently related to higher risk of SC-MI (OR 1.047, 95% CI [1.018, 1.077]; P = 0.003). Restricted cubic spline curve showed that there was a non-linear correlation between blood lead and SC-MI. Threshold effect analysis determined that the inflection point of blood lead was 3.8 ug/dl. When the blood lead level was higher than 3.8 ug/dl, there was an independent positive correlation between blood lead level and the risk of SC-MI (OR 1.031, 95% CI [1.009, 1.053]; P < 0.01). And similar associations were also observed among subgroups of male, ≤60 years, >60 years, never smoker, non-Hispanic White, non-Hispanic Black or without hypertension and diabetes. Conclusions Blood lead was non-linearly related to SC-MI in population free from CVD.
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Affiliation(s)
- Zhenwei Wang
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Xu Huang
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Jingjie Li
- Department of Hematology and Oncology, Affiliated Xuchang People's Hospital of Xinxiang Medical College, Xuchang, China
| | - Naifeng Liu
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China,*Correspondence: Naifeng Liu
| | - Qin Wei
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China,Qin Wei
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Chronic lead exposure exacerbates hepatic glucolipid metabolism disorder and gut microbiota dysbiosis in high-fat-diet mice. Food Chem Toxicol 2022; 170:113451. [PMID: 36198340 DOI: 10.1016/j.fct.2022.113451] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/15/2022] [Accepted: 09/28/2022] [Indexed: 11/21/2022]
Abstract
Lead (Pb) and obesity are co-occurring risk factors for metabolic disorders. However, there is still a lack of study on the combined effects of both stressors on metabolism. C57BL/6J mice were exposed to 200 mg/L Pb or/and HFD for 24 weeks and were used to investigate the effects and underlying mechanisms of chronic Pb exposure on obese mice. The results showed that Pb significantly increased body weight, visceral obesity, fasting blood glucose levels, and insulin resistance, and aggravated liver damage, hepatic lipid accumulation and steatosis in HFD-fed mice. Further analysis showed that Pb significantly inhibited insulin signaling pathway PI3K/AKT and fatty acid β-oxidation, and accelerated fatty acid synthesis. Moreover, Pb exacerbated HFD-induced disruption of gut microbiota homeostasis, manifested by increased proportions of pathogenic genera such as Desulfovibrio, Alistipes and Helicobacter, and decreased proportions of beneficial microbes Akkermansia and Barnesiella, which were negatively associated with obesity. These results indicated that Pb exposure exacerbated the disruption of liver glucolipid metabolism in HFD mice possibly by disrupting gut microbiota.
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Wang B, Zhang W, Chen C, Chen Y, Xia F, Wang N, Lu Y. Lead exposure and impaired glucose homeostasis in Chinese adults: A repeated measures study with 5 years of follow-up. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 243:113953. [PMID: 35961200 DOI: 10.1016/j.ecoenv.2022.113953] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
Experimental studies suggest the diabetogenic effects of lead, but relevant data in humans are limited and have been primarily based on cross-sectional study design. We aimed to prospectively examine the association between lead exposure and glucose homeostasis in general population using repeated measurements. This cohort study included 5505 Chinese adults free of glucose-lowering medication use at baseline in 2014 and followed up 5 years later. Blood lead and glucose metabolic traits including fasting plasma glucose (FPG), fasting serum insulin, the homeostasis model assessment of insulin resistance (HOMA-IR), and HOMA of beta-cell function (HOMA-B) were measured at baseline and follow-up. Linear mixed models and linear regression models were performed to evaluate the associations between blood lead and markers of glucose homeostasis. After full adjustment for confounders including BMI, an interquartile range (IQR) increase in blood lead levels was associated with a 2.26 % increase in FPG (95 % CI: 0.16 %, 4.39 %) and an 11.3 % decrease in HOMA-B (95 % CI: - 19.1 %, - 2.71 %) in women. The odds ratios of hyperglycemia and beta-cell dysfunction corresponding to an IQR increase in blood lead levels were 1.39 (95 % CI: 0.99, 1.95) and 1.74 (95 % CI: 1.00, 3.03), respectively. Similar results were found for 5-year changes of glucose metabolic markers. Compared with the first quartile of baseline lead levels, the highest lead quartile was associated with an additional 3.03 % increase in FPG (95 % CI: 0.84 %, 5.26 %) and an additional 13.3 % decrease in HOMA-B (95 % CI: - 20.4 %, - 5.53 %) in women during follow-up. We observed no overall associations between blood lead levels and glucose metabolic markers in men. Our findings provide suggestive evidence that environmental exposure to lead might contribute to sex-dependent disruption of glucose homeostasis in general adult population.
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Affiliation(s)
- Bin Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fangzhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ningjian Wang
- Department of Endocrinology and Metabolism, Huangpu Branch, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Endocrinology and Metabolism, Huangpu Branch, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Wan H, Wang Y, Zhang H, Zhang K, Chen Y, Chen C, Zhang W, Xia F, Wang N, Lu Y. Chronic lead exposure induces fatty liver disease associated with the variations of gut microbiota. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 232:113257. [PMID: 35104782 DOI: 10.1016/j.ecoenv.2022.113257] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/06/2022] [Accepted: 01/26/2022] [Indexed: 05/02/2023]
Abstract
BACKGROUND Lead (Pb) has been suggested as an endocrine-disrupting chemical. However, few studies have investigated the association between chronic Pb exposure and fatty liver disease. OBJECTIVES We aimed to investigate the association of chronic Pb exposure with fatty liver disease and whether the variations of the gut microbiota involve in the mechanism of the fatty liver disease induced by chronic Pb exposure. METHODS We conducted a cross-sectional study of 3066 rural participants in East China. Blood lead level (BLL) was detected, and abdominal ultrasonography was used to diagnose hepatic steatosis. Both the definition of non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD) were used. Wistar rats were randomly divided into two groups and each group was exposed to 0 or 0.05% w/v Pb through drinking water for 28 weeks. The relevant parameters of hepatic lipid metabolism and gut microbiota were analyzed. RESULTS In humans, after adjusting for potential confounders, the odds of having NAFLD and MAFLD were significantly increased by 54% and 52% in the participants in the fourth BLL quartile (OR 1.54, 95% CI 1.24, 1.91 and OR 1.52, 95% CI 1.22, 1.89). In the rats, chronic Pb exposure induced the increased visceral fat, hepatic steatosis, and dysbiosis of the gut microbiota, including the decrease of richness, diversity, evenness and phylogenetic diversity of the gut microbiota and the significant alternations of the gut microbiota composition, particularly, the decrease of the relative abundance of Coprococcus and Oscillospira at the genus level. CONCLUSIONS Chronic Pb exposure could induce fatty liver disease, which may be associated with the variations of the gut microbiota.
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Affiliation(s)
- Heng Wan
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China; Institute and Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Yuying Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Haojie Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Kun Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Chi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Wen Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Fangzhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China; Institute and Department of Endocrinology and Metabolism, Huangpu Branch, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China; Institute and Department of Endocrinology and Metabolism, Huangpu Branch, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
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