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Migliorini F, Pilone M, Bell A, Merfort R, Giorgino R, Maffulli N. Serum cobalt and chromium concentration following total hip arthroplasty: a Bayesian network meta-analysis. Sci Rep 2023; 13:6918. [PMID: 37106086 PMCID: PMC10140036 DOI: 10.1038/s41598-023-34177-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/25/2023] [Indexed: 04/29/2023] Open
Abstract
The present systematic review investigated the concentration of chromium (Cr) and cobalt (Co) in serum in patients who have undergone total hip arthroplasty (THA). The first outcome of interest was to investigate the mean concentration in serum of Cr and Co using different material combinations and to verify whether their concentrations change significantly using different patterns of head and liner in THA. The second outcome of interest was to investigate whether the time elapsed from the index surgery to the follow-up, BMI, sex, and side exert an influence on the mean concentration of Cr and Co in serum in patients who have undergone THA. The following material combinations were investigated (head-liner): Ceramic-Co Cr (CoCr), CoCr-CoCr, CoCr-Polyethylene, CoCr high carbide-CoCr high carbide. Data from 2756 procedures were retrieved. The mean length of follow-up was 69.3 ± 47.7 months. The ANOVA test evidenced good comparability in age, length of follow-up, BMI, and sex (P > 0.1). In patients who have undergone THA, the mean concentration in the serum of Co ranged between 0.5 µg/L and 3.5 µg/L, and the mean concentration of Cr from 0.6 to 2.6 µg/L. The difference in the concentration of Co and Cr in serum is strictly related to the implant configuration, with the coupling CoCr-CoCr showing the highest and CoCr-Polyethylene showing the lowest concentration. Patient characteristics, BMI, sex, side and the time elapsed from the index surgery to the last follow-up did not exert a significant influence on the concentration of Co and Cr in serum in patients who have undergone total hip arthroplasty (THA).
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany.
- Department of Orthopaedic and Trauma Surgery, Eifelklinik St.Brigida, 52152, Simmerath, Germany.
| | - Marco Pilone
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081, Baronissi, SA, Italy
- Residency Program in Orthopedics and Traumatology, University of Milan, Milan, Italy
| | - Andreas Bell
- Department of Orthopaedic and Trauma Surgery, Eifelklinik St.Brigida, 52152, Simmerath, Germany
| | - Ricarda Merfort
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Riccardo Giorgino
- Residency Program in Orthopedics and Traumatology, University of Milan, Milan, Italy
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081, Baronissi, SA, Italy
- School of Pharmacy and Bioengineering, Faculty of Medicine, Keele University, ST4 7QB, Stoke On Trent, England
- Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Queen Mary University of London, Mile End Hospital, E1 4DG, London, England
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Yang A, Liu S, Cheng N, Pu H, Dai M, Ding J, Li J, Li H, Hu X, Ren X, He J, Zheng T, Bai Y. Multiple metals exposure, elevated blood glucose and dysglycemia among Chinese occupational workers. J Diabetes Complications 2017; 31:101-107. [PMID: 27623387 DOI: 10.1016/j.jdiacomp.2016.07.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 07/17/2016] [Accepted: 07/21/2016] [Indexed: 01/01/2023]
Abstract
AIMS Exposure to metals may adversely affect cardiometabolic health. The aim of this study is to directly evaluate the roles of multiple metals exposure in glucose homeostasis, the dysfunction of which has been linked to diabetes and cardiovascular diseases (CVDs). METHODS We performed a cross-sectional analysis of baseline data from 464 metal-exposed workers who participated in a large prospective occupational study in China (Jinchang Cohort). The logistic regression model was used to evaluate the association between urinary metal levels and high fasting plasma glucose (high-FPG) (≥ 75th percentile) and dysglycemia. RESULTS Increasing levels of urinary nickel were prospectively associated with high-FPG: multivariable odds ratios (ORs) were 1.00 for the 1st quartile (lowest), 1.20 (95% confidence interval [CI]: 0.60-2.43) for the 2nd quartile, 1.64 (0.78-3.49) for the 3rd quartile and 3.17 (1.38-7.30) for the 4th quartile (highest) (P-trend=0.004). The positive associations were also observed between urinary zinc and high-FPG (4th vs. 1st quartile=2.71, 95%CI: 1.26-5.84, P-trend=0.01). Inverse associations between urinary cobalt and risk of high-FPG and dysglycemia were observed (P-trend <0.05). For dysglycemia, the positive trends of increasing levels of urinary nickel and zinc still remained, although urinary nickel was no longer statistically significant. A significant association between urinary arsenic and dysglycemia was also found. However, no associations were observed between urinary copper, cadmium, and risk of high-FPG or dysglycemia. CONCLUSION Multiple urinary metals, particularly arsenic, nickel, zinc, and cobalt, were associated with elevated blood glucose among Chinese occupational workers, supporting the notion that metal exposure plays a critical role in the development of diabetes.
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Affiliation(s)
- Aimin Yang
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China; Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Simin Liu
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA; Department of Medicine (Endocrinology), Rhode Island Hospital and the Alpert Medical School, Brown University, Providence, RI. USA
| | - Ning Cheng
- Center of Medical Laboratory, Lanzhou University, Lanzhou, Gansu, China
| | - Hongquan Pu
- Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang, Gansu, China
| | - Min Dai
- Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - Jiao Ding
- Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang, Gansu, China
| | - Juansheng Li
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Haiyan Li
- Center of Medical Laboratory, Lanzhou University, Lanzhou, Gansu, China
| | - Xiaobin Hu
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xiaowei Ren
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Jie He
- Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - Tongzhang Zheng
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA.
| | - Yana Bai
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
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Kulanthaivel S, Roy B, Agarwal T, Giri S, Pramanik K, Pal K, Ray SS, Maiti TK, Banerjee I. Cobalt doped proangiogenic hydroxyapatite for bone tissue engineering application. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 58:648-58. [DOI: 10.1016/j.msec.2015.08.052] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Revised: 08/05/2015] [Accepted: 08/25/2015] [Indexed: 01/14/2023]
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Broding HC, Michalke B, Göen T, Drexler H. Comparison between exhaled breath condensate analysis as a marker for cobalt and tungsten exposure and biomonitoring in workers of a hard metal alloy processing plant. Int Arch Occup Environ Health 2008; 82:565-73. [PMID: 19034487 DOI: 10.1007/s00420-008-0390-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2007] [Accepted: 11/05/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Cobalt (Co), Tungsten (W) and Tungsten Carbides (WC) are major constituents of hard metal alloys. Whereas little is known about potential health hazards due to tungsten carbide exposure, occupational exposure to cobalt has been shown to induce a variety of respiratory diseases. Since the concentration of a potentially hazardous substance in the target organ is the most meaningful risk indicator in occupational medicine, the detection of hard metals in exhaled breath condensate (EBC) has been proposed to be a valuable instrument. The present study examines the correlation of Co and W concentrations in EBC and urine with one another and various spirometrical and clinical parameters to scrutinize this potential. METHODS A total of 62 subjects (90.3% males, age 40.6 +/- 9.2 years) were recruited from a hard metal processing plant in Germany. Examinations included the airborne workplace exposure, a complete spirometry, measurements of Co and W concentrations in EBC and urine with high resolution inductive coupled plasma mass spectrometry (HR ICP-MS) and graphite furnace atomic absorption spectrometry (GFAAS). RESULTS Air concentrations ranged between 0.0019 mg/m(3) and 0.074 mg/m(3) for Co and 0.012 mg/m(3) and 0.021 mg/m(3) for W. Median urine concentrations and interquartile ranges of the exposed subjects ranged from 0.81 (0.0-1.46) microg/l for Co and 30.5 (14.5-57.7) microg/l for W. Median breath condensate metal concentrations and interquartile ranges ranged from 8.4 (5.0-13.9) microg/l for Co and 8.8 (4.4-18.5) microg/l for W. Urine concentrations of Co and W were closely related to the airborne workplace exposure that had been assessed by air monitoring. EBC concentrations of Co and W showed no correlations to urinary W and Co concentrations and the ambient monitoring results of the individual workplace, respectively. Cobalt EBC concentration was elevated in subjects who reported to have suffered from respiratory disease; both Co and W concentrations in EBC, however, decreased with increasing spirometrical signs of obstruction. CONCLUSION According to our study, urinary concentrations of Co and W seem to be more reliable indicators of current workplace exposure than EBC concentrations. As far as new methods and exposure matrices for valid concentration measurements in respiratory organs and possible hazardous effects--especially of cobalt--in the lung are concerned, the present results are less clear-cut, and further research is required.
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Affiliation(s)
- Horst Christoph Broding
- Institute and Outpatient Clinic for Occupational-, Social- and Environmental Medicine, Friedrich-Alexander-University Erlangen-Nuremberg, 91054 Erlangen, Germany.
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Llobet JM, Domingo JL, Corbella J. Comparison of the effectiveness of several chelators after single administration on the toxicity, excretion and distribution of cobalt. Arch Toxicol 1986; 58:278-81. [PMID: 3087329 DOI: 10.1007/bf00297121] [Citation(s) in RCA: 35] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The effects of the chelating agents Na2Ca-ethylendiaminetetraacetate (EDTA), Na3Ca-diethylentriaminepentaacetate (DTPA), L-cysteine, 2,3-dimercaptosuccinic acid (DMSA), N-acetyl-L-cysteine (NAC), glutathione, D,L-penicillamine (D,L-PEN) and 2,3-dimercaptopropanol (BAL) on the toxicity, distribution and excretion of intraperitoneally injected cobalt were studied in male Swiss mice. To determine the effect of the various chelators on the toxicity of cobalt, various doses of CoCl2 (0.60-1.80 mmol/kg) were given, followed immediately by the IP administration of the chelator (at a dose equal to one-fourth of their respective LD50). EDTA and DTPA were the most effective. EDTA, DTPA and L-cysteine, NAC and glutathione were also the most effective in increasing the urinary excretion of cobalt and reducing the concentration of the metal in various tissues. EDTA appears to be the most effective agent of those tested in the prevention of acute cobalt intoxication.
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