Independent and combined associations of urinary arsenic exposure and serum sex steroid hormones among 6-19-year old children and adolescents in NHANES 2013-2016

Associations of exposure to arsenic species and endogenous sex hormones with oral cancer: a hospital-based study in Southeastern China

The effects of arsenic species and endogenous sex hormones on oral cancer risk, particularly their molecular interactions, have been infrequently reported. This study aimed to assess the individual and combined effects of arsenic species and endogenous sex hormones on oral cancer risk and elucidate the association between hormones, arsenic species, and arsenic metabolism. A case-control study (comprising 144 cases and 144 controls) was conducted from January 2020 to January 2024 in Southeastern China. Serum levels of six arsenic species and nine endogenous sex hormones were measured using High-Performance Liquid Chromatography Inductively Coupled Plasma Mass Spectrometry (HPLC-ICP-MS) and ultra-high performance liquid chromatography-high resolution mass spectrometry (UPLC-HRMS), respectively. After adjusting for potential confounders, Logistic regression showed that high exposure levels of inorganic arsenic (IAs) (adjusted OR [aOR] and 95 %CI: 0.00[0.00,0.44] and 0.45[0.25,0.78]) and Cortisone (aOR and 95 %CI: 0.16[0.07,0.35] and 0.19[0.10,0.37]) were associated with reduced oral cancer risk, both as continuous and categorical variables. Serum Melatonin, Cortisone, and Testosterone levels correlated with partial arsenic species, while Cortisone and Melatonin were linked to arsenic methylation metabolic indexes (spearman's test P < 0.05). Quantile g-computation analysis revealed that Corticosterone and Cortisone had the largest positive and negative weights on oral cancer risk, respectively (weights = 0.640 and 0.525). The combined effect of arsenic species and hormones on oral cancer was protective (β and 95 %CI: 0.36(-0.05,-0.67)), with slight gender differences. Independent of other arsenic species and hormone levels, Cortisone exhibited a protective effect against oral cancer in BKMR analysis. Additionally, an interaction effect between Melatonin and other arsenic species was also observed. In summary, Serum IAs and Cortisone were negatively associated with oral cancer, while Corticosterone showed a positive association. Further cohort studies are needed to confirm and elucidate these mechanisms.

Association between urinary arsenic and the prevalence of endometriosis in women in the United States

Background

Endometriosis affects up to 15% of women of reproductive age and can lead to various symptoms. More than 200 million people worldwide are at risk of higher than safe levels of arsenic exposure through drinking water. Studies investigating the relationship between arsenic and endometriosis are very limited and have yielded inconsistent results. This study aimed to explore the relationship between total urinary arsenic, arsenic species (Urinary arsenous acid, Urinary Arsenic acid, Urinary Arsenobetaine, Urinary Arsenocholine, Urinary Dimethylarsinic acid, Urinary Monomethylarsonic acid) and endometriosis.

Methods

We utilized a nationally representative dataset from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2006. A total of 650 participants were included. We examined the association between total urinary arsenic and different arsenic species with endometriosis using weighted multivariate logistic regression models.

Results

Urinary arsenous acid and urinary monomethylarsonic acid (MMA) were positively correlated with endometriosis (p < 0.05). After adjusting for potential confounding factors, the positive correlation of urinary MMA remained significant (OR: 1.317, 95%CI: 1.074-1.615). Subgroup analyses and interaction tests indicated that this association was not dependent.

Conclusion

Our research underscores a significant positive association observed between factors urinary MMA and endometriosis. Future research is needed to elucidate the specific mechanisms behind this association.

Mechanism of arsenic-induced liver injury in rats revealed by metabolomics and ionomics based approach

Arsenic (As) is an environmental toxicant and human carcinogen, long-term exposure to As can lead to varying degrees of liver injury. In this study, the liver injury model of As poisoned Sprague-Dawley (SD) rats was established, and the potential mechanism was investigated by metabonomics and ionomics. A total of 164 differential expressed metabolites (DEMs) were identified between the As poisoned group and the control group, which mainly involved in nicotinate and nicotinamide metabolism, steroid hormone biosynthesis, taurine and hypotaurine metabolism, and porphyrin metabolism. The levels of 10 ions were significantly increased in As poisoned group, including As, bismuth (Bi), cadmium (Cd), mercury (Hg), manganese (Mn), rubidium (Rb), antimony (Sb), strontium (Sr), uranium(U), and zinc (Zn), in contrast, the levels of lead (Pb) and thallium (TI) were significantly decreased. Spearman correlation analysis showed that As, Cd, Hg and Pb were negatively correlated with androstenedione, protoporphyrinogen IX and estriol, whereas As and Mn was positively correlated with progesterone (PROG), Cd was positively correlated with NAD+ and 3-Sulfino-L-alanine. There are sex differences in changes in metabolites and ions levels. Male and female rats shared 60 DEMs and 2 pathways (steroid hormone biosynthesis and porphyrin metabolism pathway). The levels of As, Cd, Hg, and Sr were significantly changed in both male and female rats. In both female and male rats, As was positively correlated with PROG, and Cd was positively correlated with coproporphyrin III. The results of this study provide new insights to elucidate the mechanism of As-induced liver injury in rats.

Machine learning prediction of glaucoma by heavy metal exposure: results from the National Health and Nutrition Examination Survey 2005 to 2008

Using follow-up data from the National Health and Nutrition Examination Survey (NHANES) database, we have collected information on 2572 subjects and used generalized linear model to investigate the association between urinary heavy metal levels and glaucoma risk. In addition, we have developed an individualized risk prediction model using machine learning algorithms and further interpreted the model results through feature importance analysis, local cumulative analysis, and interaction effects. In this study, we found significant association between logarithmically calculated arsenic (As) metabolites, especially arsenochlorine (AC), and glaucoma after adjusting for a series of confounders, including urinary creatinine (β = 1.090, 95% CI: 0.313-1.835). The Shapley Additive Explanations (SHAP) analysis results and clinical risk scores also indicated that As metabolites promoted glaucoma more severely than other variables. This study applied machine learning for the first time to explore the relationship between heavy metals and glaucoma while analyzing the effects of multiple heavy metal exposures on the disease, improving the predictive power compared to conventional models. Our results provided important insights into the potential role of heavy metals in the pathogenesis of glaucoma, facilitated the discovery of new biomarkers for early diagnosis, risk assessment, and timely treatment of glaucoma, and guided public health measures to reduce heavy metal exposure.

Sex steroid hormones mediate the association between neonicotinoids and obesity among children and adolescents

BACKGROUND

Neonicotinoids are the most widely used insecticide worldwide. Toxicological and epidemiological studies suggest that exposure to neonicotinoid may be linked to the development of childhood obesity. However, the evidence is limited.

OBJECTIVE

To investigate the association between neonicotinoid exposure and obesity among U.S. children and adolescents and to explore underlying mechanism mediated by serum sex steroid hormones in these associations.

METHODS

Data from the 2015-2016 National Health and Nutrition Examination Survey were used for the analysis. Generalized linear regression was used to investigate the association between detectable neonicotinoids and ten measures of obesity. The interaction effects of multiple neonicotinoids were determined by Chi-squared Automatic Interaction Detection method. Mediation analysis was used to assess potential mediators of sex steroid hormones, including testosterone (T), estradiol (E2), T/E2, sex hormone-binding globulin (SHBG), and free androgen index (FAI).

RESULTS

Clothianidin (β = -0.29, 95 % CI: -0.57, -0.01) and N-desmethyl-acetamiprid (β = -0.19, 95 % CI: -0.35, -0.03) were associated with reduced VFI z-score. After stratification, 5-hydroxy-imidacloprid was positively associated with the risk of general obesity in males (OR=2.24, 95 % CI: 1.20, 4.20) with a probability of 52.5 %. FAI mediated 15 % of the association between neonicotinoid exposure and reduced risk of obesity, and SHBG mediated 30 % of the association between neonicotinoid exposure and increased risk of obesity.

CONCLUSION

Neonicotinoids showed associations with obesity, but the results were mixed and sex-specific. Sex steroid hormones may play a role in mediating the effects of neonicotinoids on obesity.

Heavy-metal associated breast cancer and colorectal cancer hot spots and their demographic and socioeconomic characteristics

PURPOSE

Cancer registries offer an avenue to identify cancer clusters across large populations and efficiently examine potential environmental harms affecting cancer. The role of known metal carcinogens (i.e., cadmium, arsenic, nickel, chromium(VI)) in breast and colorectal carcinogenesis is largely unknown. Historically marginalized communities are disproportionately exposed to metals, which could explain cancer disparities. We examined area-based metal exposures and odds of residing in breast and colorectal cancer hotspots utilizing state tumor registry data and described the characteristics of those living in heavy metal-associated cancer hotspots.

METHODS

Breast and colorectal cancer hotspots were mapped across Kentucky, and area-based ambient metal exposure to cadmium, arsenic, nickel, and chromium(VI) were extracted from the 2014 National Air Toxics Assessment for Kentucky census tracts. Among colorectal cancer (n = 56,598) and female breast cancer (n = 77,637) diagnoses in Kentucky, we used logistic regression models to estimate Odds Ratios (ORs) and 95% Confidence Intervals to examine the association between ambient metal concentrations and odds of residing in cancer hotspots, independent of individual-level and neighborhood risk factors.

RESULTS

Higher ambient metal exposures were associated with higher odds of residing in breast and colorectal cancer hotspots. Populations in breast and colorectal cancer hotspots were disproportionately Black and had markers of lower socioeconomic status. Furthermore, adjusting for age, race, tobacco and neighborhood factors did not significantly change cancer hotspot ORs for ambient metal exposures analyzed.

CONCLUSION

Ambient metal exposures contribute to higher cancer rates in certain geographic areas that are largely composed of marginalized populations. Individual-level assessments of metal exposures and cancer disparities are needed.

Conditional associations of sex steroid hormones with C-reactive protein levels in American children and adolescents: evidence from NHANES 2015-2016

Background

The relationship between sex steroid hormones and high-sensitivity C-reactive protein(hs-CRP) levels in American children and adolescents is understudied. This research will examine this association.

Methods

The study conducted a data analysis from the National Health and Nutrition Examination Survey (NHANES) 2015-2016, adjusting multiple linear regression models with R 4.2.2 and EmpowerStats. A total of 1,768 children and adolescents were surveyed. Data collection involved measurements of serum levels of testosterone, estradiol, sex hormone-binding globulin (SHBG) and hs-CRP.

Results

With the increase in testosterone, a brief rise (β=0.082, P=0.047) followed by an overall decline (β=-0.028, P=0.023) in hs-CRP was observed in the Male Prepubertal population, while a continuous decline (β=-0.002, P<0.05) was seen in the Male Pubertal group. A positive correlation (β=0.047, P<0.05) was found between testosterone and hs-CRP in the Female Prepubertal population, whereas no significant association (β=0.002, P>0.05) was detected in the Female Pubertal group. A significant inverse correlation was observed between estradiol and hs-CRP solely in the Female Pubertal group (β=-0.002, P<0.05), while no association was found in other populations. An inverse relationship between SHBG and hs-CRP was consistently noted across all groups: Male Prepubertal, Male Pubertal, Female Prepubertal, and Female Pubertal.

Conclusions

The association between sex steroid hormones and high-sensitivity C-reactive protein (hs-CRP) levels among American children and adolescents is conditional and influenced by multiple factors.

Associations of Urinary Total Arsenic and Arsenic Species and Periodontitis

AIMS

Arsenic exposure is a significant global public health concern and has been implicated in endocrine disruption and increased oxidative stress, both of which are crucial pathogenic mechanisms of periodontitis. This study aimed to investigate the association of urinary total arsenic and arsenic species with periodontitis and to further explore the potential mediating roles of sex hormones and oxidative stress indicators.

METHODS

Data used in this study were derived from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) in the US population. In all, 1063 participants with complete data were included in this study. Weighted logistic regression analyses were used to evaluate the relationship between urinary arsenic and periodontitis. Mediation analyses were used to explore the effects of potential mediators on these associations.

RESULTS

High concentrations of urinary dimethylarsinic acid (DMA), monomethylarsonic acid (MMA), 2 types of toxic urinary arsenic (TUA2), and 4 types of toxic urinary arsenic (TUA4) were positively related to periodontitis (P < .05). After adjusting for potential confounders, the positive association remained significant (odds ratio, 1.32; 95% confidence interval, 1.01-1.71). Testosterone may partially mediate the relationship between MMA and periodontitis, with mediating effects of 21.78% and 39.73% of the total effect. No significant mediation effect of oxidative stress indicators was found for this relationship.

CONCLUSIONS

This study reports a positive association between urinary MMA and periodontitis, and testosterone may mediate this relationship. Our findings serve as a call for action to avoid the deployment of arsenic-containing therapeutic agents as treatment modalities for oral afflictions.

Arsenic exposure at environmentally relevant levels induced metabolic toxicity in development mice: Mechanistic insights from integrated transcriptome and metabolome

Emerging evidence has linked arsenic exposure and metabolic homeostasis, but the mechanism is incompletely understood, especially at relatively low concentrations. In this study, we used a mouse model to evaluate the health impacts and metabolic toxicity of arsenic exposure in drinking water at environmentally relevant levels (0.25 and 1.0 ppm). Our results indicated that arsenic damaged intestinal barrier and induced arsenic accumulation, oxidative stress, and pathological changes in the liver and illum. Interestingly, arsenic increased the hepatic triglyceride (TG) and total cholesterol (TC), while reduced serum TG and TC levels. The liver transcriptome found that arsenic exposure caused transcriptome perturbation and promoted hepatic lipid accumulation by regulating the exogenous fatty acids degradation and apolipoproteins related genes. The serum metabolomics identified 74 and 88 differential metabolites in 0.25 and 1.0 ppm, respectively. The KEGG disease and subcellular location analysis indicated that arsenic induced liver and intestinal diseases, and the mitochondrion might be the target organelle for arsenic-induced toxicity. Co-enrichment of transcriptome and metabolome identified 24 metabolites and 9 genes as metabolic toxicity biomarkers. Moreover, 40 male (20 nonalcoholic fatty liver disease (NAFLD) cases and 20 healthy controls) was further selected to validate our findings. Importantly, the significantly changed L-palmitoylcarnitine, 3-hydroxybutyric acid, 2-hydroxycaproic acid and 6 genes of Hadha, Acadl, Aldh3a2, Cpt1a, Cpt2, and Acox1 were found in the NAFLD cases. The results from integrated multi-omics and chemical-protein network analysis indicated that L-palmitoylcarnitine played a critical role in metabolic toxicity by regulating mitochondrial fatty acids β-oxidation genes (Cpt1a, Cpt2). In conclusion, these findings provided new clues for the metabolic toxicity of arsenic exposure at environmentally relevant levels, which involved in the late-life NAFLD development. Our results also contribute to understanding the human responses and phenotypic changes to this hazardous material exposure in the environment.

Association between exposure to per- and polyfluoroalkyl substance and liver injury in American adults

Epidemiological data is scarce regarding the association between exposure to mixtures of per- and polyfluoroalkyl substances (PFASs) and liver injury in the general populace. The current research used data from the National Health and Nutrition Examination Survey (2009-2018). The PFAS exposure levels were defined by the serum concentrations of PFASs with > 70% detection in samples, namely perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorohexane sulfonic acid (PFHxS), perfluorodecanoic acid (PFDeA), and perfluorooctane sulfonic acid (PFOS). Liver injury was assessed from two aspects: first, the degree of liver inflammation was determined based on serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamyltransferase (GGT), and total bilirubin (TBIL) levels; second, the degree of liver fibrosis was determined based on fibrosis-4 (FIB-4) index. We assessed the associations between individual or total PFAS exposure and these outcomes using multivariable linear regression models and logistic regression models, restricted cubic splines, and weighted quantile sum regression. Among the samples of 7484 American adults, the median concentration of PFOS was the highest, followed by PFOA and PFHxS. Using multivariable linear regression, a positive correlation was observed between all PFASs and liver enzymes such as ALT, AST, and TBIL. Additionally, the weighted quantile sum model indicated an overall positive association between the five PFASs and liver injury indicators. For liver function biomarkers and liver fibrosis, PFNA and PFOS were the most heavily weighting chemicals, respectively. Our findings provide new epidemiological evidence indicating a potential association between PFAS exposure and adverse effects on liver injury biomarkers, highlighting the potentially harmful effects of PFAS exposure on liver health.

Association between carotenoids and the prevalence of chronic obstructive pulmonary disease in the United States

BACKGROUND

Previous studies mainly concentrated on examining the correlation between single carotenoids and Chronic obstructive pulmonary disease (COPD). However, these findings have been inconsistent.

OBJECTIVES

This study aimed to evaluate both the individual and overall associations of carotenoids with the prevalence of COPD.

METHODS

This study comprised 2,939 participants chosen from the National Health and Nutrition Examination Survey (NHANES) 2017-2018. The logistic regression, quantile-based G-computation regression (qgcomp), and Bayesian kernel machine regression (BKMR) models were employed to explore the association between carotenoids and the prevalence of COPD. Mediation analyses were also conducted to explore the underlying mechanism of carotenoids on COPD.

RESULTS

Individuals diagnosed with COPD had significantly lower serum carotenoid concentrations than those without COPD. We found a negative relationship between combined carotenoids and the prevalence of COPD, and lutein and zeaxanthin and alpha cryptoxanthin were identified as the main contributors to this negative association. Moreover, eosinophil acted as a mediator in the relationship between lutein and zeaxanthin, alpha cryptoxanthin, and the prevalence of COPD, with mediating proportions of 2.75 % and 3.67 %.

CONCLUSION

A negative association was observed between combined carotenoids and COPD prevalence, with lutein and zeaxanthin, and alpha cryptoxanthin identified as the main contributors. Eosinophils could potentially mediate the association between carotenoids and COPD.

Serum albumin mediates the associations between heavy metals and two novel systemic inflammation indexes among U.S. adults

BACKGROUND

The effects of heavy metal exposure on immunological function have sparked widespread concern, but unequivocal evidence on the association between mixed metal exposure and novel systemic inflammatory indexes remains scarce.

OBJECTIVES

This study aimed to analyze the associations of heavy metals with two novel systemic inflammation indexes and the mediated effects of serum albumin.

METHODS

Nineteen metals were detected among 4082 U.S. adults based on the NHANES. A linear regression, restricted cubic splines (RCS) regression, weighted quantile sum (WQS), Quantile-based Gcomputation (qgcomp), and Bayesian kernel machine regression (BKMR) were conducted to evaluate the associations of single metal and mixed metals with systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) levels, respectively. A series of subgroup analyses were used to identify potentially vulnerable populations. Furthermore, we conducted mediation analyses to investigate the mediated effects of serum albumin on the associations of metals with SII and SIRI.

RESULTS

In the single-exposure model, exposure to various metals such as urinary Co, As, and serum Zn, Cu was associated with SII and SIRI (PFDR<0.05). Simultaneously, the above metals were linear positively correlated with SII and SIRI. Mixed-exposure analyses consistently showed that overall mixed urinary metal levels were positively pertinent for SII and SIRI levels, and the metal Co played a significant role in the urinary metal mixtures. Subgroup analyses showed that exposure to urinary Cd in men and elderly people increased SII and SIRI levels. The results of mediation analyses suggested the association of urinary metal mixture with SII and SIRI was mediated by albumin, and the proportion of mediation was 14.45% and 9.49%, respectively.

CONCLUSIONS

Our findings suggested that metal exposure is strongly associated with the levels of system inflammation indexes and that serum albumin is, in part, a mediator of this association.

Associations between blood essential metal mixture and serum uric acid: a cross-sectional study

Introduction

Although several studies have explored the associations between single essential metals and serum uric acid (SUA), the study about the essential metal mixture and the interactions of metals for hyperuricemia remains unclear.

Methods

We performed a cross-sectional study to explore the association of the SUA levels with the blood essential metal mixture, including magnesium (Mg), calcium (Ca), iron (Fe), copper (Cu), zinc (Zn), manganese (Mn) in Chinese community-dwelling adults (n=1039). The multivariable linear regression, the weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) were conducted to estimate the associations of blood essential metals with SUA levels and the BKMR model was also conducted to estimate the interactions of the essential metals on SUA.

Results

In the multivariable linear regression, the association of blood Mg, Mn, and Cu with SUA was statistically significant, both in considering multiple metals and a single metal. In WQS regression [β=13.59 (95%CI: 5.57, 21.60)] and BKMR models, a positive association was found between the mixture of essential metals in blood and SUA. Specifically, blood Mg and Cu showed a positive association with SUA, while blood Mn showed a negative association. Additionally, no interactions between individual metals on SUA were observed.

Discussion

In conclusion, further attention should be paid to the relationship between the mixture of essential metals in blood and SUA. However, more studies are needed to confirm these findings.

Association of perfluoroalkyl and polyfluoroalkyl substances with sex hormones in children and adolescents 6-19 Years of age

Perfluoroalkyl and polyfluoroalkyl substances (PFAS) have raised concerns regarding sex hormones homeostasis disruption in critical windows including childhood and adolescence, but epidemiological evidence is limited. We aimed to explore the associations of total testosterone (TT), estradiol (E₂), and sex hormone binding globulin (SHBG) in children and adolescents with PFAS in 921 participants 6-19 years of age from NHANES 2013 to 2016. Multiple linear regression models and Bayesian Kernel Machine Regression (BKMR) models stratified by sex-age and sex-puberty-status groups were performed to explore the associations of the associations of individual or mixture of PFAS with sex hormone levels, respectively. Inverse associations were observed between n-PFOA and SHBG in female adolescents when the exposure was modeled as continuous (β = -0.20, 95% CI -0.33, -0.07) or categorized variable (P for trend = 0.005). In children, inverse associations were observed by BKMR in 6-11-year-old girls of high concentration, and in boys of low concentration of the PFAS mixture with TT. A positive association of PFAS mixture with SHBG was observed in boys. PFOS and PFNA were identified as major contributors to the associations in girls and boys, respectively. Although the 95% credible intervals included the null in adolescents, suggestive negative associations of PFAS mixture with TT and SHBG levels in adolescents aged 12-19 years were found by BKMR. Results by sex-puberty status presented a similar pattern, where significantly inverse associations between PFAS mixture and E₂ were observed in the pubertal. Our findings suggested the associations of either individual or mixture PFAS with decreased TT levels, and increased SHBG levels in U.S. children and adolescents, and with decreased E₂ levels in pubertal individuals. The associations were evident in children.