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Lin S, He J, Zhou Y, Bao Y, Feng X, Cheng H, Cai H, Hu S, Wang L, Zheng Y, Zhang M, Fan Q, Wen S, Lin Y, Liu C, Chen X, Wang F, Ge X, Yang X. Cross-sectional and Longitudinal Associations Between Metal Mixtures and Serum C3, C4: Result from the Manganese‑exposed Workers Healthy Cohort. Biol Trace Elem Res 2024:10.1007/s12011-024-04143-2. [PMID: 38492120 DOI: 10.1007/s12011-024-04143-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024]
Abstract
Exposure to metal mixtures compromises the immune system, with the complement system connecting innate and adaptive immunity. Herein, we sought to explore the relationships between blood cell metal mixtures and the third and fourth components of serum complement (C3, C4). A total of 538 participants were recruited in November 2017, and 289 participants were followed up in November 2021. We conducted a cross-sectional analysis at baseline and a longitudinal analysis over 4 years. Least Absolute Shrinkage and Selection Operator (LASSO) was employed to identify the primary metals related to serum C3, C4; generalized linear model (GLM) was further used to evaluate the cross-sectional associations of the selected metals and serum C3, C4. Furthermore, participants were categorized into three groups according to the percentage change in metal concentrations over 4 years. GLM was performed to assess the associations between changes in metal concentrations and changes in serum C3, C4 levels. At baseline, each 1-unit increase in log10-transformed in magnesium, manganese, copper, rubidium, and lead was significantly associated with a change in serum C3 of 0.226 (95% CI: 0.146, 0.307), 0.055 (95% CI: 0.022, 0.088), 0.113 (95% CI: 0.019, 0.206), - 0.173 (95% CI: - 0.262, - 0.083), and - 0.020 (95% CI: - 0.039, - 0.001), respectively. Longitudinally, decreased copper concentrations were negatively associated with an increment in serum C3 levels, while decreased lead concentrations were positively associated with an increment in serum C3 levels. However, no metal was found to be primarily associated with serum C4 in LASSO, so we did not further explore the relationship between them. Our research indicates that copper and lead may affect complement system homeostasis by influencing serum C3 levels. Further investigation is necessary to elucidate the underlying mechanisms.
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Affiliation(s)
- Sencai Lin
- School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Junxiu He
- School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Yinghua Zhou
- School of Medicine, Guangxi University of Science and Technology, Liuzhou, 545006, China
| | - Yu Bao
- School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Xiuming Feng
- School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Hong Cheng
- School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Haiqing Cai
- School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Sihan Hu
- School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Lin Wang
- School of Science, Guangxi University of Science and Technology, Liuzhou, 545006, Guangxi, China
| | - Yuan Zheng
- School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Mengdi Zhang
- School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Qinghua Fan
- School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Shifeng Wen
- School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Yuanxin Lin
- School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Chaoqun Liu
- School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Xing Chen
- School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Fei Wang
- School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Xiaoting Ge
- School of Medicine, Guangxi University of Science and Technology, Liuzhou, 545006, China.
| | - Xiaobo Yang
- School of Public Health, Guangxi Medical University, Nanning, 530021, China.
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Wei Y, Wang X, Sun Q, Shi W, Zhang W, Gao X, Li Y, Hao R, Dong X, Chen C, Cao K, Jiang W, Yang Z, Zhu Y, Lv Y, Xv D, Li J, Shi X. Associations of environmental cadmium exposure with kidney damage: Exploring mediating DNA methylation sites in Chinese adults. Environ Res 2024; 251:118667. [PMID: 38462081 DOI: 10.1016/j.envres.2024.118667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 03/12/2024]
Abstract
Environmental exposure is widely recognized as the primary sources of Cadmium (Cd) in the human body, and exposure to Cd is associated with kidney damage in adults. Nevertheless, the role of DNA methylation in Cd-induced kidney damage remains unclear. This study aimed to investigate the epigenome-wide association of environmental Cd-related DNA methylation changes with kidney damage. We included 300 non-smoking adults from the China in 2019. DNA methylation profiles were measured with Illumina Infinium MethylationEPIC BeadChip array. Linear mixed-effect model was employed to estimate the effects of urinary Cd with DNA methylation. Differentially methylated positions (DMPs) associated with urinary Cd were then tested for the association with kidney damage indicators. The mediation analysis was further applied to explore the potential DNA methylation based mediators. The prediction model was developed using a logistic regression model, and used 1000 bootstrap resampling for the internal validation. We identified 27 Cd-related DMPs mapped to 20 genes after the adjustment of false-discovery-rate for multiple testing among non-smoking adults. 17 DMPs were found to be associated with both urinary Cd and kidney damage, and 14 of these DMPs were newly identified within the Chinese. Mediation analysis revealed that DNA methylation of cg26907612 and cg16848624 mediated the Cd-related reduced kidney damage. In addition, ten variables were selected using the LASSO regression analysis and were utilized to develop the prediction model. It found that the nomogram model predicted the risk of kidney damage caused by environmental Cd with a corrected C-index of 0.779. Our findings revealed novel DMPs associated with both environmental Cd exposure and kidney damage among non-smoking adults, and developed an easy-to-use nomogram-illustrated model using these novel DMPs. These findings could provide a theoretical basis for formulating prevention and control strategies for kidney damage from the perspective of environmental pollution and epigenetic regulation.
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Affiliation(s)
- Yuan Wei
- Department of Hygienic Inspection, School of Public Health, Jilin University, Changchun, Jilin, 130021, China; China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Xiaochen Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Qi Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Wanying Shi
- Department of Epidemiology and Health Statistics, and Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Wenli Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Xu Gao
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100083, China
| | - Yawei Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Ruiting Hao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Xiaojie Dong
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Chen Chen
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Kangning Cao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Weilong Jiang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Zhengxiong Yang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Ying Zhu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Yuebin Lv
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Dongqun Xv
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Juan Li
- Department of Hygienic Inspection, School of Public Health, Jilin University, Changchun, Jilin, 130021, China.
| | - Xiaoming Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, China.
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Wu L, Zhang S, Zhang J, Xin Y, Niu P, Li J. Associations of heavy metal mixtures with blood pressure among U.S. adults in NHANES 2017-2018 by four statistical models. Chin Med J (Engl) 2024; 137:628-630. [PMID: 38282382 PMCID: PMC10932526 DOI: 10.1097/cm9.0000000000002956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Indexed: 01/30/2024] Open
Affiliation(s)
- Luli Wu
- Department of Occupational and Environmental Health, School of Public Health, Capital Medical University, Beijing 100069, China
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Shixuan Zhang
- Department of Nutrition, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Junrou Zhang
- Department of Occupational and Environmental Health, School of Public Health, Capital Medical University, Beijing 100069, China
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Ye Xin
- Department of Occupational and Environmental Health, School of Public Health, Capital Medical University, Beijing 100069, China
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Piye Niu
- Department of Occupational and Environmental Health, School of Public Health, Capital Medical University, Beijing 100069, China
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Jie Li
- Department of Occupational and Environmental Health, School of Public Health, Capital Medical University, Beijing 100069, China
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing 100069, China
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Shen T, Zhong L, Ji G, Chen B, Liao M, Li L, Huang H, Li J, Wei Y, Wu S, Chen Z, Ma W, Dong M, Wu B, Liu T, Chen Q. Associations between metal(loid) exposure with overweight and obesity and abdominal obesity in the general population: A cross-sectional study in China. Chemosphere 2024; 350:140963. [PMID: 38114022 DOI: 10.1016/j.chemosphere.2023.140963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/26/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023]
Abstract
Previous studies have revealed links between metal(loid)s and health problems; however, the link between metal(loid)s and obesity remains controversial. We evaluated the cross-sectional association between metal(loid) exposure in whole blood and obesity among the general population. Vanadium (V), chromium (Cr), manganese (Mn), cobalt (Co), nickel (Ni), copper (Cu), zinc (Zn), arsenic (As), selenium (Se), molybdenum (Mo), cadmium (Cd), antimony (Sb), thallium (T1), and lead (Pb) were measured in 3029 subjects in Guangdong Province (China) using ICP-MS. The prevalence of overweight and obesity (OWO) and abdominal obesity (AOB) was calculated according to body mass index (BMI) and waist circumference (WC), respectively. Multivariate analysis showed that elevated blood Cu, Cd, and Pb levels were inversely associated with the risk of OWO, and these associations were confirmed by a linear dose-response relationship. Elevated blood Co concentration was associated with a decreased risk of AOB. A quantile g-computation approach showed a significantly negative mixture-effect of 13 metal(loid)s on OWO (OR: 0.96; 95% CI: 0.92, 0.99). Two metals-Ni and Mo-were inversely associated with the risk of OWO but positively associated with AOB. We cross-grouped the two obesity measurement types and found that the extremes of metal content were present in people with AOB only. In conclusion, blood Cu, Mo, Ni, Cd, and Pb were inversely associated with the risk of OWO. The presence of blood Co may be protective, while Ni and Mo exposure might increase the risk of AOB. The association between metal(loid) exposure and obesity warrants further investigation in longitudinal cohort studies.
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Affiliation(s)
- Tianran Shen
- Guangdong Pharmaceutical University, Guangzhou, 510310, China; Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Liling Zhong
- Guangdong Pharmaceutical University, Guangzhou, 510310, China; Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Guiyuan Ji
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511530, China
| | - Baolan Chen
- Guangdong Pharmaceutical University, Guangzhou, 510310, China; Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Mengfan Liao
- Guangdong Pharmaceutical University, Guangzhou, 510310, China; Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Lvrong Li
- Guangdong Pharmaceutical University, Guangzhou, 510310, China; Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Huiming Huang
- Guangdong Pharmaceutical University, Guangzhou, 510310, China; Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Jiajie Li
- Guangdong Pharmaceutical University, Guangzhou, 510310, China; Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Yuan Wei
- Guangdong Pharmaceutical University, Guangzhou, 510310, China; Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Shan Wu
- Guangdong Pharmaceutical University, Guangzhou, 510310, China; Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Zihui Chen
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511530, China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, 510632, China
| | - Ming Dong
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, 510399, China
| | - Banghua Wu
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, 510399, China.
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, 510632, China.
| | - Qingsong Chen
- Guangdong Pharmaceutical University, Guangzhou, 510310, China; Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China; NMPA Key Laboratory for Technology Research and Evaluation of Pharmacovigilance, Guangdong Pharmaceutical University, Guangzhou, 511400, China.
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Sun Y, Mao Q, Zhou D, Tian J, Du H, Yu Q, Zhao J, Duan W, Liu C, Duan Y, Zhou J, Zhang T, Xia Z, Yin Y, Liu Y, Zhao X, Xu S. Association of multiple blood metals and systemic atherosclerosis: A cross-sectional study in the CAD population. Chemosphere 2024; 349:140991. [PMID: 38141683 DOI: 10.1016/j.chemosphere.2023.140991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 12/03/2023] [Accepted: 12/17/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND Coronary atherosclerotic disease (CAD) is often accompanied by peripheral atherosclerosis, resulting in a higher risk of ischemia and cardiovascular death. Exposure to metals is associated with atherosclerotic plaques at specific sites. However, less is known about the effects of mixed metals on systemic atherosclerotic burden in CAD patients. OBJECTIVES To investigate the association of metal mixtures with systemic atherosclerotic burden in a CAD population. METHODS A cross-sectional study including 1562 CAD patients from Southwest China was conducted. The levels of 10 blood metals were measured via inductively coupled plasma spectrometry. More than one vessel with a stenosis ≥50% vessel diameter was defined as CAD. Carotid and lower limb atherosclerosis was assessed by using ultrasound, and coronary atherosclerosis was quantified via arterial angiography. Systemic atherosclerosis was scored according to the presence or absence of lesions at the three sites and the total number of lesions. To investigate the combined impacts and interaction effects of metals, Bayesian kernel machine regression was used. Weighted quantile regression was used to identify the contributions of the metals. RESULTS Significant overall associations of mixed metals with systemic atherosclerotic burden were found. These positive overall associations were mainly driven by Cd, Cu and Pb in systemic atherosclerosis. The main contributing factors were As and Cu for coronary atherosclerosis as well as Cd, Cu and Pb for carotid and lower limb atherosclerosis. Cd and Pb or Cr can interact, and Pb interacts with age, sex and alcohol. CONCLUSIONS In CAD patients, exposure to combinations of metals was highly positively associated with systemic atherosclerotic burden. These significant trends were more pronounced in the peripheral arteries and carotid arteries. Controlling environmental metal exposure can contribute to reducing systemic atherosclerosis in CAD patients.
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Affiliation(s)
- Yapei Sun
- Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing 400060, China; Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing 400060, China; School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Qi Mao
- Department of Cardiology, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China
| | - Denglu Zhou
- Department of Cardiology, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China
| | - Jiacheng Tian
- Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing 400060, China; Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing 400060, China; School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Hang Du
- Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing 400060, China; Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing 400060, China
| | - Qin Yu
- Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing 400060, China; Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing 400060, China
| | - Jianhua Zhao
- Department of Cardiology, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China
| | - Weixia Duan
- Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing 400060, China; Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing 400060, China
| | - Cong Liu
- Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing 400060, China; Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing 400060, China
| | - Yu Duan
- Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing 400060, China; Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing 400060, China
| | - Jie Zhou
- Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing 400060, China; Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing 400060, China; School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Tian Zhang
- Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing 400060, China; Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing 400060, China
| | - Zhiqin Xia
- Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing 400060, China; Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing 400060, China; School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Yangguang Yin
- Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing 400060, China; Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing 400060, China
| | - Yongsheng Liu
- Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing 400060, China; Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing 400060, China
| | - Xiaohui Zhao
- Department of Cardiology, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China.
| | - Shangcheng Xu
- Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing 400060, China; Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing 400060, China; School of Public Health, Nanjing Medical University, Nanjing 211166, China.
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Hu WL, Xiao W, Shen WB, Wu YY, Li X, Zhong Q, Li GA, Lu HH, Liu JJ, Zhang ZH, Huang F. Effect of exposures to multiple metals on blood pressure and hypertension in the elderly: a community-based study. Biometals 2024; 37:211-222. [PMID: 37792258 DOI: 10.1007/s10534-023-00543-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/15/2023] [Indexed: 10/05/2023]
Abstract
A chronic disease, hypertension (HTN) is prevalent among the elderly. Exploring the factors that influence HTN and blood pressure (BP) changes is of great public health significance. However, mixed exposure to multiple serum metals has had less research on the effects on BP and HTN for the elderly. From April to August 2019, 2372 people participated in the community physical examination program for the elderly in Tongling City, Anhui Province. We measured BP and serum levels of 10 metals and collected basic demographic information. We analyzed the relationship between metal levels and changes in BP and HTN by the least absolute shrinkage and selection operator regression, Bayesian kernel machine regression model, and generalized linear model. In multiple models, lead (Pb) and cadmium (Cd) were still significantly associated with HTN occurrence after adjusting for potential confounders (Pb: ORquartile 4 VS quartile 1 = 1.20, 95% CI 1.01-1.43; Cd: ORquartile 4 VS quartile 1 = 1.37, 95% CI 1.16-1.62). In the male subgroup, results were similar to those of the general population. In the female group, Cd was positively correlated with HTN and systolic blood pressure, while Pb was not. According to this study, Pb and Cd were correlated with BP and HTN positively, and there was a certain joint effect. To some extent, our findings provide clues for the prevention of hypertension in the elderly.
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Affiliation(s)
- Wen-Lei Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Wei Xiao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Wen-Bin Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Yue-Yang Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Xue Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Qi Zhong
- Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Guo-Ao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Huan-Huan Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Jian-Jun Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Zhi-Hua Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China.
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Li YQ, Zhang ST, Ke NY, Fang YC, Hu WL, Li GA, Huang F, Zhou YF. The impact of multiple metals exposure on the risk of developing proliferative diabetic retinopathy in Anhui, China: a case-control study. Environ Sci Pollut Res Int 2023; 30:112132-112143. [PMID: 37831242 DOI: 10.1007/s11356-023-30294-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/02/2023] [Indexed: 10/14/2023]
Abstract
Through multiple different pathways, the environmental multiple metals make their ways to the human bodies, where they induce different levels of the oxidative stress response. This study further investigated the impact of multiple-metal exposure on the risk of developing proliferative diabetic retinopathy (PDR). We designed a case-control study with type 2 diabetic patients (T2D), in which the case group was the proliferative diabetic retinopathy group (PDR group), while the control group was the non-diabetic retinopathy group (NDR group). Graphite furnace atomic absorption spectrometry (GFAAS) and inductively coupled plasma optical emission spectrometry (ICP-OES) were used to detect the metal levels in our participants' urine samples. The least absolute shrinkage and selection operator (LASSO) regression approach was used to include these representative trace elements in a multiple exposure model. Following that, logistic regression models and Bayesian kernel machine regression (BKMR) models were used to describe the effect of different elements and also analyze their combined effect. In the single-element model, we discovered that lithium (Li), cadmium (Cd), and strontium (Sr) were all positively related to PDR. The multiple-exposure model revealed a positive relationship between Li and PDR risk, with a maximum quartile OR of 2.80 (95% CI: 1.10-7.16). The BKMR model also revealed that selenium (Se) might act as a protective agent, whereas magnesium (Mg), Li, and Cd may raise the risk of PDR. In conclusion, our study not only revealed an association between exposure to multiple metals and PDR risk but it also implied that urine samples might be a useful tool to assess PDR risk.
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Affiliation(s)
- Yan-Qing Li
- Department of Ophthalmology, First Affiliated Hospital of Anhui Medical University, No.218, Jixi Road, Shushan District, Hefei, Anhui, China
| | - Si-Tian Zhang
- Department of Ophthalmology, First Affiliated Hospital of Anhui Medical University, No.218, Jixi Road, Shushan District, Hefei, Anhui, China
| | - Nai-Yu Ke
- Department of First Clinical Medical College, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Yan-Cheng Fang
- Department of Ophthalmology, First Affiliated Hospital of Anhui Medical University, No.218, Jixi Road, Shushan District, Hefei, Anhui, China
| | - Wen-Lei Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Guo-Ao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Yan-Feng Zhou
- Department of Ophthalmology, First Affiliated Hospital of Anhui Medical University, No.218, Jixi Road, Shushan District, Hefei, Anhui, China.
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Yimthiang S, Pouyfung P, Khamphaya T, Vesey DA, Gobe GC, Satarug S. Evidence Linking Cadmium Exposure and β 2-Microglobulin to Increased Risk of Hypertension in Diabetes Type 2. Toxics 2023; 11:516. [PMID: 37368616 DOI: 10.3390/toxics11060516] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/31/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023]
Abstract
The most common causes of chronic kidney disease, diabetes, and hypertension are significant public health issues worldwide. Exposure to the heavy metal pollutant, cadmium (Cd), which is particularly damaging to the kidney, has been associated with both risk factors. Increased levels of urinary β2-microglobulin (β2M) have been used to signify Cd-induced kidney damage and circulating levels have been linked to blood pressure control. In this study we investigated the pressor effects of Cd and β2M in 88 diabetics and 88 non-diabetic controls, matched by age, gender and locality. The overall mean serum β2M was 5.98 mg/L, while mean blood Cd and Cd excretion normalized to creatinine clearance (Ccr) as ECd/Ccr were 0.59 µg/L and 0.0084 µg/L of filtrate (0.95 µg/g creatinine), respectively. The prevalence odds ratio for hypertension rose by 79% per every ten-fold increase in blood Cd concentration. In all subjects, systolic blood pressure (SBP) showed positive associations with age (β = 0.247), serum β2M (β = 0.230), and ECd/Ccr (β = 0.167). In subgroup analysis, SBP showed a strong positive association with ECd/Ccr (β = 0.303) only in the diabetic group. The covariate-adjusted mean SBP in the diabetics of the highest ECd/Ccr tertile was 13.8 mmHg higher, compared to the lowest tertile (p = 0.027). An increase in SBP associated with Cd exposure was insignificant in non-diabetics. Thus, for the first time, we have demonstrated an independent effect of Cd and β2M on blood pressure, thereby implicating both Cd exposure and β2M in the development of hypertension, especially in diabetics.
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Affiliation(s)
- Supabhorn Yimthiang
- Occupational Health and Safety, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Phisit Pouyfung
- Occupational Health and Safety, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Tanaporn Khamphaya
- Occupational Health and Safety, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - David A Vesey
- The Centre for Kidney Disease Research, Translational Research Institute, Brisbane 4102, Australia
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane 4102, Australia
| | - Glenda C Gobe
- The Centre for Kidney Disease Research, Translational Research Institute, Brisbane 4102, Australia
- School of Biomedical Sciences, The University of Queensland, Brisbane 4072, Australia
- NHMRC Centre of Research Excellence for CKD QLD, UQ Health Sciences, Royal Brisbane and Women's Hospital, Brisbane 4029, Australia
| | - Soisungwan Satarug
- The Centre for Kidney Disease Research, Translational Research Institute, Brisbane 4102, Australia
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9
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Zhang Z, Guo S, Hua L, Wang B, Chen Q, Liu L, Xiang L, Sun H, Zhao H. Urinary Levels of 14 Metal Elements in General Population: A Region-Based Exploratory Study in China. Toxics 2023; 11:488. [PMID: 37368588 DOI: 10.3390/toxics11060488] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023]
Abstract
Metal pollution may lead to a variety of diseases; for this reason, it has become a matter of public concern worldwide. However, it is necessary to use biomonitoring approaches to assess the risks posed to human health by metals. In this study, the concentrations of 14 metal elements in 181 urine samples obtained from the general population of Gansu Province, China, were analyzed using inductively coupled plasma mass spectrometry. Eleven out of fourteen target elements had detection frequencies above 85%, namely, Cr, Ni, As, Se, Cd, Al, Fe, Cu and Rb. The concentrations of most metal elements in the urine of our subjects corresponded to the medium levels of subjects in other regional studies. Gender exerted a significant influence (p < 0.05) on the concentrations of Tl, Rb and Zn. The concentrations of Ni, As, Pb, Sr, Tl, Zn, Cu and Se showed significant differences among different age groups and the age-related concentration trends varied among these elements. There were significant differences in the urine concentrations of Zn and Sr between those subjects in the group who were frequently exposed to soil (exposed soil > 20 min/day) and those in the group who were not, indicating that people in regular contact with soil may be more exposed to metals. This study provides useful information for evaluating the levels of metal exposure among general populations.
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Affiliation(s)
- Zining Zhang
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin 300350, China
| | - Sai Guo
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin 300350, China
| | - Liting Hua
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin 300350, China
| | - Beibei Wang
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Qiusheng Chen
- Institute of Agro-Product Safety and Nutrition, Tianjin Academy of Agricultural Sciences, Tianjin 300381, China
| | - Lu Liu
- Institute of Agro-Product Safety and Nutrition, Tianjin Academy of Agricultural Sciences, Tianjin 300381, China
| | - Li Xiang
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Hong Kong, China
| | - Hongwen Sun
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin 300350, China
| | - Hongzhi Zhao
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin 300350, China
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10
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Zhang J, Wang X, Ma Z, Dang Y, Yang Y, Cao S, Ouyang C, Shi X, Pan J, Hu X. Associations of urinary and blood cadmium concentrations with all-cause mortality in US adults with chronic kidney disease: a prospective cohort study. Environ Sci Pollut Res Int 2023; 30:61659-61671. [PMID: 36933131 DOI: 10.1007/s11356-023-26451-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/10/2023] [Indexed: 05/10/2023]
Abstract
Epidemiological evidence for the relationship between cadmium exposure and mortality in specific chronic kidney disease (CKD) populations remains scarce. We aimed to explore the relationships between cadmium concentrations in urine and blood and all-cause mortality among CKD patients in the USA. This cohort study was composed of 1825 CKD participants from the National Health and Nutrition Examination Survey (NHANES) (1999-2014) who were followed up to December 31, 2015. All-cause mortality was ascertained by matching the National Death Index (NDI) records. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality in relation to urinary and blood cadmium concentrations by Cox regression models. During an average follow-up period of 82 months, 576 CKD participants died. Compared with the lowest quartiles, HRs (95% CIs) for all-cause mortality associated with the fourth weighted quartiles of urinary and blood cadmium concentrations were 1.75 (1.28 to 2.39) and 1.59 (1.17 to 2.15), respectively. Furthermore, the HRs (95% CIs) for all-cause mortality per ln-transformed IQR increment in cadmium concentrations in urine (1.15 μg/g UCr) and blood (0.95 μg/L) were 1.40 (1.21 to 1.63) and 1.22 (1.07 to 1.40), respectively. Linear concentration-response relationships between urinary and blood cadmium concentrations and all-cause mortality were also found. Our findings suggested that increased cadmium concentrations in both urine and blood significantly contributed to enhanced mortality risk in CKD patients, thus highlighting that efforts to reduce cadmium exposure may reduce mortality risk in high-risk populations with CKD.
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Affiliation(s)
- Jia Zhang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Xiao Wang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Zhibin Ma
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Ying Dang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Yaya Yang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Shuting Cao
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Changping Ouyang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Xiaoru Shi
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Jinhua Pan
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Xiaobin Hu
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China.
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11
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Li A, Li Y, Mei Y, Zhao J, Zhou Q, Li K, Zhao M, Xu J, Ge X, Xu Q. Associations of metals and metals mixture with lipid profiles: A repeated-measures study of older adults in Beijing. Chemosphere 2023; 319:137833. [PMID: 36693480 DOI: 10.1016/j.chemosphere.2023.137833] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/25/2022] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Metals inevitably and easily enter into human bodies and can induce a series of pathophysiological changes, such as oxidative stress damage and lipid peroxidation, which then may further induce dyslipidemia. However, the effects of metals and metals mixture on the lipid profiles are still unclear, especially in older adults. A three-visits repeated measurement of 201 older adults in Beijing was conducted from November 2016 to January 2018. Linear Mixed Effects models and Bayesian kernel machine regression models were used to estimate associations of eight blood metals and metals mixture with lipid profiles, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), Castelli risk indexes I (CRI-1), Castelli risk indexes II (CRI-2), atherogenic coefficient (AC), and non-HDL cholesterol (NHC). Cesium (Cs) was positively associated with TG (βCs = 0.14; 95% CI: 0.02, 0.26) whereas copper (Cu) was inversely related to TG (βCu = -0.65; 95%CI: -1.14, -0.17) in adjusted models. Manganese (Mn) was mainly related to higher HDL-C (βMn = 0.14; 95% CI: 0.07, 0.21) whereas molybdenum showed opposite association. Metals mixture was marginally positive associated with HDL-C, among which Mn played a crucial role. Our findings suggest that the effects of single metal on lipid profiles may be counteracted in mixtures in the context of multiple metal exposures; however, future studies with large sample size are still needed to focus on the detrimental effects of single metals on lipid profiles as well as to identify key components.
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Affiliation(s)
- Ang Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Yanbing Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Yayuan Mei
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Jiaxin Zhao
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Quan Zhou
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Kai Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Meiduo Zhao
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Jing Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Xiaoyu Ge
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Qun Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China.
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12
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Wu S, Li L, Ji G, Xing X, Li J, Ma A, Wei Y, Zhao D, Huang H, Ma W, Wu B, Dong M, Liu T, Chen Q. Association of multi-metals with the risk of hypertension and the interaction with obesity: A cross-sectional study in China. Front Public Health 2023; 11:1090935. [PMID: 37006554 PMCID: PMC10063192 DOI: 10.3389/fpubh.2023.1090935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 02/27/2023] [Indexed: 03/18/2023] Open
Abstract
BackgroundEnvironmental exposure to multiple metals have been inconsistently associated with hypertension. Obesity is an important independent risk factor for hypertension, and few studies have assessed the interaction between obesity and metals in this context. We aimed to clarify their association and interaction.MethodsThis cross-sectional study included 3,063 adults from 11 districts or counties, Guangdong. We measured the whole blood levels of 13 metals and used multipollutant-based statistical methods to analyze the association of metals with hypertension. The interaction between metals and obesity on hypertension was assessed on additive and multiplicative scales.ResultsFour metals (manganese, arsenic, cadmium, and lead) were significantly associated with hypertension risk, five metals (manganese, zinc, arsenic, cadmium, and lead) were related to elevated SBP levels, five metals (manganese, zinc, selenium, cadmium, and lead) were associated with elevated DBP levels in single-metal model. Manganese remained significantly related to hypertension risk [odds ratio, 1.35 (1.02–1.78)] after adjusting for these four metals. Significant positive dose-response relationships between manganese, arsenic, cadmium, lead and hypertension risk were observed (P for overall < 0.001, P for non-linearity > 0.05). Compared with those in the lowest quartile, participants in the highest manganese quartile had a 2.83 mmHg (95% Cl: 0.71–4.96) (PFDR = 0.040) higher level of SBP. Individuals in the highest quartiles of zinc and lead had a 1.45 mmHg (0.10–2.81) (PFDR = 0.033) and 2.06 mmHg (0.59–3.53) (PFDR = 0.020) higher level of DBP, respectively. The negative interactions between cadmium, lead and obesity influences hypertension risk. BKMR analysis showed a significant joint effect of manganese, arsenic, cadmium and lead on hypertension when the concentrations of four metals were at or above their 55th percentile compared to their median values.ConclusionsThe combined effect of four metals (manganese, arsenic, cadmium and lead) were associated with the prevalence of hypertension. Potential interaction effects of cadmium, lead and obesity on hypertension risk may exist. Further cohort studies in larger population are needed to clarify these findings.
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Affiliation(s)
- Shan Wu
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Lvrong Li
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Guiyuan Ji
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Xiaohui Xing
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
- Innovation Team of Environmental Health Assessment and Public Health Strategy, Guangzhou, China
| | - Jiajie Li
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Anping Ma
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, China
| | - Yuan Wei
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Dongwei Zhao
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Huimin Huang
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- Disease Control and Prevention Institute of Jinan University, Jinan University, Guangzhou, China
| | - Banghua Wu
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, China
| | - Ming Dong
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, China
- Ming Dong
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- Disease Control and Prevention Institute of Jinan University, Jinan University, Guangzhou, China
- Tao Liu
| | - Qingsong Chen
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
- National Medical Products Administration (NMPA) Key Laboratory for Technology Research and Evaluation of Pharmacovigilance, Guangdong Pharmaceutical University, Guangzhou, China
- *Correspondence: Qingsong Chen
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13
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Mirończuk A, Kapica-topczewska K, Socha K, Soroczyńska J, Jamiołkowski J, Chorąży M, Czarnowska A, Mitrosz A, Kułakowska A, Kochanowicz J. Disturbed Ratios between Essential and Toxic Trace Elements as Potential Biomarkers of Acute Ischemic Stroke. Nutrients 2023; 15:1434. [PMID: 36986164 PMCID: PMC10058587 DOI: 10.3390/nu15061434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/09/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023] Open
Abstract
Background: Cadmium (Cd) and lead (Pb) are known to be two of the metal contaminants that pose the greatest potential threat to human health. The purpose of this research study was to compare the levels of toxic metals (Cd, Pb) in patients with acute ischemic stroke (AIS), with a control group in Podlaskie Voivodeship, Poland. The study also aimed to assess the correlations between toxic metals and clinical data in AIS patients, and to assess the potential effect of smoking. Materials and methods: The levels of mineral components in the collected blood samples were assessed by means of atomic absorption spectrometry (AAS). Results: The Cd blood concentration was significantly higher in AIS patients as compared to the control group. We found that the molar ratios of Cd/Zn and Cd/Pb were significantly higher (p < 0.001; p < 0.001, respectively), when the molar ratios of Se/Pb, Se/Cd, and Cu/Cd were significantly lower (p = 0.01; p < 0.001; p < 0.001, respectively), in AIS patients as compared to control subjects. However, there were no considerable fluctuations in relation to the blood Pb concentration or molar ratios of Zn/Pb and Cu/Pb between our AIS patients and the control group. We also found that patients with internal carotid artery (ICA) atherosclerosis, particularly those with 20–50% ICA stenosis, had higher concentrations of Cd and Cd/Zn, but lower Cu/Cd and Se/Cd molar ratios. In the course of our analysis, we observed that current smokers among AIS patients had significantly higher blood-Cd concentrations, Cd/Zn and Cd/Pb molar ratios, and hemoglobin levels, but significantly lower HDL-C concentrations, Se/Cd, and Cu/Cd molar ratios. Conclusions: Our research has shown that the disruption of the metal balance plays a crucial role in the pathogenesis of AIS. Furthermore, our results broaden those of previous studies on the exposure to Cd and Pb as risk factors for AIS. Further investigations are necessary to examine the probable mechanisms of Cd and Pb in the onset of ischemic stroke. The Cd/Zn molar ratio may be a useful biomarker of atherosclerosis in AIS patients. An accurate assessment of changes in the molar ratios of essential and toxic trace elements could serve as a valuable indicator of the nutritional status and levels of oxidative stress in AIS patients. It is critical to investigate the potential role of exposure to metal mixtures in AIS, due to its public health implications.
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14
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Li YQ, Wang Q, Liu R, Li GA, He JL, Huang F, Zhou YF. Associations of exposure to multiple metals with the risk of age-related cataract in Anhui, China: a case-control study. Environ Sci Pollut Res Int 2023; 30:4680-4693. [PMID: 35972654 DOI: 10.1007/s11356-022-22494-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
It's well-known that multiple metal elements can lead to the change of oxidative stress response levels in vivo. However, their relationship with age-related cataract (ARC) had not been well studied. We designed a case-control study including 210 individuals with ARC and 210 matched control group. The metal levels in their urine specimens were measured using graphite furnace atomic absorption spectrometry (GFAAS) and inductively coupled plasma optical emission spectrometry (ICP-OES). Least Absolute Shrinkage and Selection Operator (LASSO) regression was used to select representative metals into the multi-element model and reduce dimension. Multivariate logic analysis and Bayesian kernel machine regression (BKMR) were subsequently used to explore the association of ARC risk with multiple metal elements. We found that magnesium (Mg), chromium (Cr), arsenic (As), manganese (Mn), and selenium (Se) were positively associated with ARC in the single-element model. The multiple exposure model indicated a positive association between Mg and As, in which the OR in their highest quartile were 3.32 (95% CI: 1.24-8.89) and 7.09 (95% CI: 2.56-19.63). The BKMR model also showed the effect of As increased monotonically with its increasing concentration, and high levels of Mg and As had a significant positive effect on ARC risk. In conclusion, we found that exposure to multiple metals was associated with increased ARC risk. Further research is needed to verify these findings in the future.
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Affiliation(s)
- Yan-Qing Li
- Department of Ophthalmology, First Affiliated Hospital of Anhui Medical University, No.218, Jixi Road, Shushan District, Hefei, 230022, Anhui, China
| | - Qian Wang
- Department of Ophthalmology, First Affiliated Hospital of Anhui Medical University, No.218, Jixi Road, Shushan District, Hefei, 230022, Anhui, China
| | - Ran Liu
- Department of Ophthalmology, First Affiliated Hospital of Anhui Medical University, No.218, Jixi Road, Shushan District, Hefei, 230022, Anhui, China
| | - Guo-Ao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jia-Liu He
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Yan-Feng Zhou
- Department of Ophthalmology, First Affiliated Hospital of Anhui Medical University, No.218, Jixi Road, Shushan District, Hefei, 230022, Anhui, China.
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Chen H, Zou Y, Leng X, Huang F, Huang R, Wijayabahu A, Chen X, Xu Y. Associations of blood lead, cadmium, and mercury with resistant hypertension among adults in NHANES, 1999-2018. Environ Health Prev Med 2023; 28:66. [PMID: 37914348 PMCID: PMC10636284 DOI: 10.1265/ehpm.23-00151] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/30/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Resistant hypertension (RHTN), a clinically complex condition with profound health implications, necessitates considerable time and allocation of medical resources for effective management. Unraveling the environmental risk factors associated with RHTN may shed light on future interventional targets aimed at reducing its incidence. Exposure to heavy metal has been linked to an increased risk of hypertension, while the relationship with RHTN remains poorly understood. METHODS Using the 1999-2018 National Health and Nutrition Examination Survey (NHANES) data, we examined the association of blood lead (Pb), cadmium (Cd), and mercury (Hg) with RHTN using a multinomial logistic regression model. The combined effects of the metals and the contribution of each metal were assessed using a weighted quantile sum (WQS) analysis. RESULTS A total of 38281 participants were included in the analysis. Compared with no resistant hypertension (NRHTN), per 1 µg/dL increase in blood Pb concentration, the proportion of RHTN increased by 16% [adjusted odds ratio (aOR), 1.16; 95% confidence interval (CI) 1.01-1.32]. When analyzed by quartiles (Q), the aOR [95% CI] for Pd was 1.30[1.01,1.67] (Q4 vs. Q1); there was a significant dose-response relationship (p < 0.05). Likewise, as a continuous variable, each 1 µg/dL increase in blood Cd level was associated with a 13% increase in the proportion of RHTN (aOR: 1.13; 95%CI: [1.00,1.27]); when analyzed as quartile, aOR [95% CI] for Cd were 1.30[1.01,1.69] (Q3 vs. Q1), and 1.35[1.03,1.75] (Q4 vs. Q1); the dose-response relationship was significant (p < 0.05). WQS analysis showed a significant combined effects of Pb, Cd, and Hg on RHTN, with Pb as the highest weight (0.64), followed by Cd (0.25) and Hg (0.11). Stratified analysis indicated that the associations for the two heavy metals were significant for participants who were male, ≼ 60 years old, and with kidney dysfunction. CONCLUSION Findings of this study with national data provide new evidence regarding the role of environmental heavy metal exposure in RHTN. The prevention strategies aimed at reducing heavy metal exposure should particularly focus on Americans who are middle-aged, male, and afflicted with kidney dysfunction.
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Affiliation(s)
- Hao Chen
- Department of Occupational and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Yunfeng Zou
- Department of Occupational and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Xuebing Leng
- Department of Microbiology and Immunology, Miller School of Medicine, University of Miami, Miami, FL, US
| | - Feng Huang
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
- Guangxi Key Laboratory of Precision Medicine in Cardio-Cerebrovascular Diseases, Nanning, 530021, China
- Guangxi Clinical Research Center for Cardio-Cerebrovascular Diseases, Nanning, 530021, China
| | - Rongjie Huang
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
- Guangxi Key Laboratory of Precision Medicine in Cardio-Cerebrovascular Diseases, Nanning, 530021, China
- Guangxi Clinical Research Center for Cardio-Cerebrovascular Diseases, Nanning, 530021, China
| | - Akemi Wijayabahu
- Department of Epidemiology, University of Florida, Gainesville, Florida, USA
- Department of Environmental and Occupational Health, George Washington University, Washington, D.C., USA
| | - Xinguang Chen
- Global Health Institute, Xi’an Jiaotong University, Xi’an, 710020, China
| | - Yunan Xu
- Department of Medical Research, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
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Zheng S, Nie Z, Lv Z, Wang T, Wei W, Fang D, Zou X, Fu Y, Cao T, Liang Z, Lu Q, Huang H, Wen Y, Huang S. Associations between plasma metal mixture exposure and risk of hypertension: A cross-sectional study among adults in Shenzhen, China. Front Public Health 2022; 10:1039514. [PMID: 36582368 PMCID: PMC9794142 DOI: 10.3389/fpubh.2022.1039514] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
Background Metal exposure affects human health. Current studies mainly focus on the individual health effect of metal exposure on hypertension (HTN), and the results remain controversial. Moreover, the studies assessing overall effect of metal mixtures on hypertension risk are limited. Methods A cross-sectional study was conducted by recruiting 1,546 Chinese adults who attended routine medical check-ups at the Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen. The plasma levels of 13 metals were measured using inductively coupled plasma mass spectrometry. Multivariate logistic regression model, restricted cubic spline (RCS) model and the Bayesian Kernel Machine Regression (BKMR) model were applied to explore the single and combined effect of metals on the risk of HTN. Results A total of 642 (41.5%) participants were diagnosed with HTN. In the logistic regression model, the adjusted odds ratios (ORs) were 0.71 (0.52, 0.97) for cobalt, 1.40 (1.04, 1.89) for calcium, 0.66 (0.48, 0.90), and 0.60 (0.43, 0.83) for aluminum in the second and third quartile, respectively. The RCS analysis showed a V-shaped or an inverse V-shaped dose-response relationship between metals (aluminum or calcium, respectively) and the risk of HTN (P for non-linearity was 0.017 or 0.009, respectively). However, no combined effect was found between metal mixture and the risk of hypertension. Conclusions Plasma levels of cobalt, aluminum and calcium were found to be associated with the risk of HTN. Further studies are needed to confirm our findings and their potential mechanisms with prospective studies and experimental study designs.
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Affiliation(s)
- Sijia Zheng
- School of Public Health, Shanxi Medical University, Taiyuan, China,Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Zhiqiang Nie
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ziquan Lv
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Tian Wang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Weizhou Wei
- Shenzhen Yutian Community Health Service Centre, Shenzhen, China
| | - Daokui Fang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Xuan Zou
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yulin Fu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Tingting Cao
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Zhaoyi Liang
- School of Public Health, Shanxi Medical University, Taiyuan, China,Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Qi Lu
- School of Public Health, Shanxi Medical University, Taiyuan, China,Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Hui Huang
- Department of Cardiology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Ying Wen
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China,Ying Wen
| | - Suli Huang
- School of Public Health, Shanxi Medical University, Taiyuan, China,Shenzhen Center for Disease Control and Prevention, Shenzhen, China,*Correspondence: Suli Huang
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Gong R, Pu X, Cheng Z, Ding J, Chen Z, Wang Y. The association between serum cadmium and diabetes in the general population: A cross-sectional study from NHANES (1999-2020). Front Nutr 2022; 9:966500. [PMID: 36570173 PMCID: PMC9768494 DOI: 10.3389/fnut.2022.966500] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
Background Associations between serum cadmium and diabetes had been reported in previous studies, however there was still considerable controversy regarding associations. Studies in general population that investigated the effects of serum cadmium on diabetes were currently lacking. We designed this cross-sectional study among U.S. adults under high and low cadmium exposure to assess associations between serum cadmium and diabetes. Methods This cross-sectional study analyzed 52,593 adults who aged more than 20 years and participated in the National Health and Nutrition Examination Survey (NHANES), 1999-2020. The missing values and extreme values in the covariables were filled by multiple interpolation. Univariate logistics regression, multivariate logistics regression and smooth fitting curves were used to analyze the association between serum cadmium and diabetes. Simultaneously, sensitivity analysis was carried out by converting the serum cadmium from continuous variable to categorical variable. The stratification logistics regression model was used to analyze whether there were special groups in each subgroup to test the stability of the results. Results In this cross-sectional study, serum cadmium levels were negatively correlated with the occurrence of diabetes in the low serum cadmium exposure group (OR = 0.811, 95% CI 0.698, 0.943; P = 0.007). There was no association between serum cadmium level and the occurrence of diabetes in the high serum cadmium exposure group (OR = 1.01, 95% CI 0.982, 1.037; P = 0.511). These results were consistent across all the subgroups (P for interaction >0.05). Conclusion Serum cadmium was negatively associated diabetes among the representative samples of the whole population in the United States under the normal level of serum cadmium exposure. However, there was no association between serum cadmium level and the occurrence of diabetes in the high serum cadmium exposure group. This study promoted an update of new preventative strategy targeting environment for the prevention and control of diabetes in the future.
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Affiliation(s)
| | - Xiaolu Pu
- Qinghai University, Xining, Qinghai, China
| | - Zhenqian Cheng
- Department of Clinical Nutrition, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
| | - Jie Ding
- Department of Clinical Nutrition, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
| | - Zhenghao Chen
- University of Electronic Science and Technology of China, Chengdu, Sichuan, China,*Correspondence: Zhenghao Chen
| | - Yongjun Wang
- Department of Clinical Nutrition, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China,National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,Yongjun Wang
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18
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Li G, Su W, Zhong Q, Hu M, He J, Lu H, Hu W, Liu J, Li X, Hao J, Huang F. Individual PM 2.5 component exposure model, elevated blood pressure and hypertension in middle-aged and older adults: A nationwide cohort study from 125 cities in China. Environ Res 2022; 215:114360. [PMID: 36184965 DOI: 10.1016/j.envres.2022.114360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/07/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
Recently, elevated blood pressure (BP) and hypertension (HTN) have caused a huge burden of health loss. Previous studies used ambient air pollutants as a proxy for individual exposure, limiting the assessment of its multiple exposure to health effects. For the first time, this study constructed individual PM2.5 component (SO42-, NO3-, NH4+, OM, and BC) exposure model DAG (Directed Acyclic Graph), DAG-oriented generalized linear model and random forest model, and explored the effects of single and multiple exposures to PM2.5 components on BP at different stages by the generalized linear model (GLM) and Quantile g-Computation (QgC) model based on a large cohort study in China. We defined BP in four stages according to the 2017 ACC/AHA guidelines. After excluding the lack of key information, the cohort analyses ultimately included 9031 participants. Our results showed that the individual PM2.5 component exposure model had good efficacy. Single or multiple exposure to PM2.5 components had significant positive effects on normal BP to elevated BP and elevated BP to stage 1 HTN. In addition, males, the elderly and urban residents were more sensitive to PM2.5 components. This study provided implications for environmental exposure assessment and control of particulate pollution in the future.
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Affiliation(s)
- Guoao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Wanying Su
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Qi Zhong
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Mingjun Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jialiu He
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Huanhuan Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Wenlei Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jianjun Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Xue Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jiahu Hao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.
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Guo X, Li N, Wang H, Su W, Song Q, Liang Q, Liang M, Sun C, Li Y, Lowe S, Bentley R, Song EJ, Zhou Q, Ding X, Sun Y. Combined exposure to multiple metals on cardiovascular disease in NHANES under five statistical models. Environ Res 2022; 215:114435. [PMID: 36174761 DOI: 10.1016/j.envres.2022.114435] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 09/13/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND It is well-documented that heavy metals are associated with cardiovascular disease (CVD). However, there is few studies exploring effect of metal mixture on CVD. Therefore, the primary objective of present study was to investigate the joint effect of heavy metals on CVD and to identify the most influential metals in the mixture. METHODS Original data for study subjects were obtained from the National Health and Nutrition Examination Survey. In this study, adults with complete data on 12 kinds of urinary metals (antimony, arsenic, barium, cadmium, cobalt, cesium, molybdenum, mercury, lead, thallium, tungsten, and uranium), cardiovascular disease, and core covariates were enrolled. We applied five different statistical strategies to examine the CVD risk with metal exposure, including multivariate logistic regression, adaptive elastic net combined with Environmental Risk Score, Quantile g-computation, Weighted Quantile Sum regression, and Bayesian kernel machine regression. RESULTS Higher levels of cadmium, tungsten, cobalt, and antimony were significantly associated with Increased risk of CVD when covariates were adjusted for multivariate logistic regression. The results from multi-pollutant strategies all indicated that metal mixture was positively associated with the risk of CVD. Based on the results of multiple statistical strategies, it was determined that cadmium, tungsten, cobalt, and antimony exhibited the strongest positive correlations, whereas barium, lead, molybdenum, and thallium were most associated with negative correlations. CONCLUSION Overall, our study demonstrates that exposure to heavy metal mixture is linked to a higher risk of CVD. Meanwhile, this association may be driven primarily by cadmium, tungsten, cobalt, and antimony. Further prospective studies are warranted to validate or refute our primary findings as well as to identify other important heavy metals linked with CVD.
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Affiliation(s)
- Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, PR China
| | - Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, PR China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, PR China
| | - Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, PR China
| | - Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, PR China
| | - Qiwei Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, PR China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, PR China
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago, 2900 N. Lake Shore Drive, Chicago, IL, 60657, USA
| | - Yaru Li
- Internal Medicine, Swedish Hospital, 5140 N California Ave, Chicago, IL, 60625, USA
| | - Scott Lowe
- College of Osteopathic Medicine, Kansas City University, 1750 Independence Ave, Kansas City, MO, 64106, USA
| | - Rachel Bentley
- College of Osteopathic Medicine, Kansas City University, 1750 Independence Ave, Kansas City, MO, 64106, USA
| | - Evelyn J Song
- Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Qin Zhou
- Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, PR China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, PR China; Chaohu Hospital, Anhui Medical University, Hefei, 238006, Anhui, PR China.
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20
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Li Z, Fan Y, Tao C, Yan W, Huang Y, Qian H, Xu Q, Wan T, Chen Y, Qin Y, Lu C. Association between exposure to cadmium and risk of all-cause and cause-specific mortality in the general US adults: A prospective cohort study. Chemosphere 2022; 307:136060. [PMID: 35981619 DOI: 10.1016/j.chemosphere.2022.136060] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/15/2022] [Accepted: 08/09/2022] [Indexed: 05/25/2023]
Abstract
BACKGROUND Cadmium has been suggested to accumulate in the body over a lifetime, posing a great threat to human health. So far, few studies have studied the association between cadmium exposure and long-term health outcomes in adults. OBJECTIVES To investigate the risk of mortality with blood cadmium level in adults (participants of NHANES, 1999-2014). METHODS We evaluated the associations between cadmium and risk of mortality. Data on mortality and cadmium exposure were collected in NHANES database including 39,865 participants. Multivariate Cox regression models were established for calculating hazard ratios (HRs) and 95%CI between cadmium exposure and all-cause and specific-cause mortality outcomes. RESULTS Totally, 39,865 individuals with 19,260 males (48.3%) and 20,605 females (51.7%) were included in the study. During a total of 341,017 person-years of follow-up 5,094 deaths were documented, including 1,067 cardiovascular disease (CVD) and 890 cancers. Compared with the lowest quantile of cadmium exposure level group, the adjusted HRs in the highest quantile cadmium exposure level group were 1.73 (95%CI: 1.52-1.97) for all-cause mortality, 1.72 (95%CI: 1.28-2.30) for CVD mortality and 1.87 (95%CI: 1.49-2.36) for cancer mortality, respectively (P for trend: <0.001). Additionally, significant interactions with smoking status in the stratified analyses of all-cause mortality and cancer mortality, age in the stratified analyses of cancer mortality were found (P for interaction: 0.002, <0.001 and 0.012). CONCLUSIONS In this nationwide representative sample of the population, we found that higher blood cadmium concentration was associated with increased risks of all-cause and specific-cause mortality. These data further evidence the link between mortality and cadmium concentration. It is of great importance for both policy makers and the public to minimize cadmium exposure, and to reduce long-term adverse health effects.
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Affiliation(s)
- Zhi Li
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Yun Fan
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Department of Microbes and Infection, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Chengzhe Tao
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Wenkai Yan
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Yuna Huang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Hong Qian
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Qiaoqiao Xu
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Tingya Wan
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Yiyuan Chen
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Yufeng Qin
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Department of Microbes and Infection, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
| | - Chuncheng Lu
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
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Liu Y, Yu L, Zhu M, Lin W, Liu Y, Li M, Zhang Y, Ji H, Wang J. Associations of exposure to multiple metals with blood pressure and hypertension: A cross-sectional study in Chinese preschool children. Chemosphere 2022; 307:135985. [PMID: 35964715 DOI: 10.1016/j.chemosphere.2022.135985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 08/01/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
Exposure to metals might be a risk factor for hypertension, which contributes largely to the global burden of disease and mortality. However, relevant epidemiological studies of associations between metals exposure with hypertension among preschoolers are limited. This study aimed to explore the associations of urine metals with blood pressure and hypertension among Chinese preschoolers. A total of 1220 eligible participants who had urine metals measurement, blood pressure measurements, and relevant covariates were included in this cross-sectional study. Urine concentrations of metals were measured by inductively coupled plasma mass spectrometer. The single and multiple metals regression models were used to investigate the associations of urine metal with blood pressure and the risk of hypertension after adjusting for potential confounders. We observed urine concentrations of chromium, iron, and barium were negatively associated with levels of systolic blood pressure, diastolic blood pressure and the risk of hypertension in the single metal model (all P-FDR adjustment <0.05). Significant associations of urine chromium concentrations with systolic blood pressure, diastolic blood pressure and the risk of hypertension were found in the multi-metal model (β or OR (95% confidence interval) was -3.07 (-5.12, -1.02), -2.25 (-4.29, -0.22), and 0.51 (0.26, 0.97) for 3rd quartile, compared with 1st quartile, respectively). The same association was found for barium concentrations in the multi-metal model, while none of the associations among iron quartiles was significant. In addition, urine chromium, iron and barium may have joint effects on systolic blood pressure, diastolic blood pressure and hypertension. Children's age and body mass index could modify the associations of chromium, iron, and barium concentrations with blood pressure. Our findings suggested that exposure to chromium, iron, and barium was inversely associated with blood pressure and hypertension among preschool children. These findings need further validation in prospective studies.
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Affiliation(s)
- Yanli Liu
- Department of Preventive Medicine, School of Public Health and Management, Hubei University of Medicine, Shiyan, Hubei, China; Department of Endocrinology, Renmin Hospital, Hubei University of Medicine, Shiyan, 44200, China
| | - Lili Yu
- Dianjiang Traditional Chinese Medical Hospital, Chongqing, China; Center for Environment and Health in Water Source Area of South-to-North Water Diversion, Hubei University of Medicine, 30 Renmin South Road, Shiyan, 442000, Hubei, China
| | - Meiqin Zhu
- Center for Environment and Health in Water Source Area of South-to-North Water Diversion, Hubei University of Medicine, 30 Renmin South Road, Shiyan, 442000, Hubei, China
| | - Wei Lin
- Center for Environment and Health in Water Source Area of South-to-North Water Diversion, Hubei University of Medicine, 30 Renmin South Road, Shiyan, 442000, Hubei, China
| | - Yang Liu
- Center for Environment and Health in Water Source Area of South-to-North Water Diversion, Hubei University of Medicine, 30 Renmin South Road, Shiyan, 442000, Hubei, China
| | - Mingzhu Li
- Center for Environment and Health in Water Source Area of South-to-North Water Diversion, Hubei University of Medicine, 30 Renmin South Road, Shiyan, 442000, Hubei, China
| | - Yao Zhang
- Department of Preventive Medicine, School of Public Health and Management, Hubei University of Medicine, Shiyan, Hubei, China; Center for Environment and Health in Water Source Area of South-to-North Water Diversion, Hubei University of Medicine, 30 Renmin South Road, Shiyan, 442000, Hubei, China
| | - Hongxian Ji
- Department of Child Health, Shiyan Maternal and Child Health Hospital, Shiyan, 44200, China
| | - Jing Wang
- Department of Endocrinology, Renmin Hospital, Hubei University of Medicine, Shiyan, 44200, China; Center for Environment and Health in Water Source Area of South-to-North Water Diversion, Hubei University of Medicine, 30 Renmin South Road, Shiyan, 442000, Hubei, China.
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Zhong J, Liu L, Zhang L, Xu Z, Peng L, Zhao X, Yang Q, Yang T, Xu D, Hong F. Association of Urinary Zinc Concentrations with Dyslipidemia and Its Subtypes: Baseline Data from the Chinese Multi-Ethnic Cohort (CMEC) Study. Biol Trace Elem Res 2022:10.1007/s12011-022-03454-6. [PMID: 36284051 DOI: 10.1007/s12011-022-03454-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/17/2022] [Indexed: 11/02/2022]
Abstract
This study elucidates the association between urinary zinc concentration and the risk of developing dyslipidemia and its subtypes in China's ethnic minority residents. Based on the baseline survey data of the Chinese Multi-Ethnic Cohort (CMEC) study, 10,620 subjects were included in the study. Logistic regression analysis evaluated the relationship between urinary zinc concentration and dyslipidemia and its subtypes. After adjustment, compared with urinary zinc concentration quartile 1 (Q1), the odds ratios (ORs) and 95% confidence intervals (95% CIs) of dyslipidemia participants in the quartile 2 (Q2), quartile 3 (Q3), and quartile 4 (Q4) groups were 1.091 (0.963, 1.237), 1.151 (1.051, 1.304), and 1.393 (1.230, 1.579), respectively (P for trend < 0.001). While that of hypertriglyceridemia participants in the Q2, Q3, and Q4 groups were 1.130 (0.979, 1.306), 1.283 (1.113, 1.480), and 1.483 (1.287, 1.709), respectively (P for trend < 0.001). Lastly, the ORs and 95% CIs of hyperbetalipoproteinemia participants in the Q2, Q3, and Q4 groups were 1.166 (0.945, 1.439), 1.238 (1.007, 1.522), and 1.381 (1.126, 1.695), respectively (P for trend < 0.002). This study found that urinary zinc concentrations were not associated with hypercholesterolemia and hypoalphalipoproteinemia. The dose-response relationship was non-linear between urinary zinc concentration and dyslipidemia, hypertriglyceridemia and hyperbetalipoproteinemia (P for trend < 0.001). In the stratified analysis, urinary zinc levels were positively associated with the risk of dyslipidemia, hypertriglyceridemia, and hyperbetalipoproteinemia in male, ≥ 60 years old, Miao nationality, hypertension, diabetes, and BMI ≥ 24.0 kg/m2 subgroups. Our study provides some possible evidence that elevated urinary zinc concentrations are associated with an increased risk of dyslipidemia, hypertriglyceridemia, hyperbetalipoproteinemia.
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Affiliation(s)
- Jianqin Zhong
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Leilei Liu
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Linyuan Zhang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Zixuan Xu
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Lian Peng
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Xiaolan Zhao
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Qianyuan Yang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Tingting Yang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Degan Xu
- Guiyang Center for Disease Control and Prevention, Guiyang, 550003, China
| | - Feng Hong
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China.
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23
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Li G, Lu H, Hu W, Liu J, Hu M, He J, Huang F. Outdoor air pollution enhanced the association between indoor air pollution exposure and hypertension in rural areas of eastern China. Environ Sci Pollut Res Int 2022; 29:74909-74920. [PMID: 35641748 DOI: 10.1007/s11356-022-21127-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
Recently, the high prevalence of hypertension (HTN) has caused serious disease burden. Previous studies mostly focused on the separate association between outdoor or indoor air pollution and HTN, and did not explore their possible interaction with HTN. To explore this issue, this study investigated the relationship between indoor and outdoor air pollution and HTN and their possible interactions among adult residents in 14 rural areas in eastern China. The generalized linear model (GLM) and interplot model were used to evaluate the separate effects and potential interaction of outdoor or indoor air pollutants on HTN. In separate analyses, we found a significant positive association between outdoor and indoor air pollution and HTN, and a significant negative association between range hood use and HTN. In the interaction analysis, outdoor air pollution could significantly enhance the positive effects of indoor air pollution on HTN. In addition, PM2.5 and O3 could significantly reduce the protective effect of range hoods use on HTN. Finally, we found that females were more susceptible to both indoor and outdoor air pollution.
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Affiliation(s)
- Guoao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Huanhuan Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Wenlei Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jianjun Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Mingjun Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jialiu He
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.
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24
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Guo X, Su W, Li N, Song Q, Wang H, Liang Q, Li Y, Lowe S, Bentley R, Zhou Z, Song EJ, Cheng C, Zhou Q, Sun C. Association of urinary or blood heavy metals and mortality from all causes, cardiovascular disease, and cancer in the general population: a systematic review and meta-analysis of cohort studies. Environ Sci Pollut Res Int 2022; 29:67483-67503. [PMID: 35917074 DOI: 10.1007/s11356-022-22353-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
Amounting epidemiological evidence has shown detrimental effects of heavy metals on a wide range of diseases. However, the effect of heavy metal exposure on mortality in the general population remains unclear. The primary objective of this study was to clarify the associations between heavy metals and mortality from all causes, cardiovascular disease (CVD), and cancer based on prospective studies. We comprehensively searched Pubmed, Embase, and Web of Science electronic databases to identify studies published from their inception until 1 March 2022. Investigators identified inclusion criteria, extracted study characteristics, and assessed the methodological quality of included studies according to standardized guidelines. Meta-analysis was conducted if the effect estimates of the same outcome were reported in at least three studies. Finally, 42 original studies were identified. The results of meta-analysis showed that cadmium and lead exposure was significantly associated with mortality from all causes, CVD, and cancer in the general population. Moderate evidence suggested there was a link between arsenic exposure and mortality. The adverse effects of mercury and other heavy metals on mortality were inconclusive. Epidemiological evidence for the joint effect of heavy metal exposure on mortality was still indeterminate. In summary, our study provided compelling evidence that exposure to cadmium, lead, and arsenic were associated with mortality from all causes, CVD, and cancer, while the evidence on other heavy metals, for example mercury, was insignificant or indeterminate. Nevertheless, further prospective studies are warranted to explore the joint effects of multiple metal exposure on mortality.
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Affiliation(s)
- Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - Qiwei Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - Yaru Li
- Internal Medicine, Swedish Hospital, 5140 N California Ave, Chicago, IL, 60625, USA
- College of Osteopathic Medicine, Des Moines University, 3200 Grand Ave, Des Moines, IA, 50312, USA
| | - Scott Lowe
- College of Osteopathic Medicine, Kansas City University, 1750 Independence Ave, Kansas City, MO, 64106, USA
| | - Rachel Bentley
- College of Osteopathic Medicine, Kansas City University, 1750 Independence Ave, Kansas City, MO, 64106, USA
| | - Zhen Zhou
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, TAS, 7000, Australia
| | - Evelyn J Song
- Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Ce Cheng
- The University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, AZ, 85724, USA
- Banner-University Medical Center South, 2800 E Ajo Way, Tucson, AZ, 85713, USA
| | - Qin Zhou
- Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago, 2900 N. Lake Shore Drive, Chicago, IL, 60657, USA.
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25
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Urbano T, Filippini T, Wise LA, Lasagni D, De Luca T, Sucato S, Polledri E, Malavolti M, Rigon C, Santachiara A, Pertinhez TA, Baricchi R, Fustinoni S, Vinceti M. Associations of urinary and dietary cadmium with urinary 8-oxo-7,8-dihydro-2'-deoxyguanosine and blood biochemical parameters. Environ Res 2022; 210:112912. [PMID: 35150710 DOI: 10.1016/j.envres.2022.112912] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/04/2022] [Accepted: 02/05/2022] [Indexed: 06/14/2023]
Abstract
Cadmium is a heavy metal with established adverse effects on human health, namely on bone, liver and kidney function and the cardiovascular system. We assessed cadmium exposure and its correlation with biomarkers of toxicity. We recruited 137 non-smoking blood donors without a history of chronic disease or cancer who resided in the Northern Italy province of Reggio Emilia (mean age 47 years, range 30-60 years) in the 2017-2019 period. We used a semi-quantitative food frequency questionnaire to estimate dietary cadmium intake and urine samples to assess concentrations of urinary cadmium and 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG). Median urinary cadmium and 8-oxodG concentrations were 0.21 μg/L (interquartile range (IQR): 0.11-0.34 μg/L) and 3.21 μg/g creatinine (IQR: 2.21-4.80 μg/g creatinine), respectively, while median dietary cadmium intake was 6.16 μg/day (IQR: 5.22-7.93 μg/day). We used multivariable linear and spline regression models to estimate mean differences exposure concentrations. Dietary and urinary cadmium were positively correlated, and both were positively and linearly correlated with 8-oxodG. We found a positive association of urinary cadmium with blood alanine aminotransferase (ALT), total cholesterol, low-density lipoprotein (LDL)-cholesterol and thyroid-stimulating hormone (TSH) concentrations. We also observed a positive association with triglycerides, in both linear (beta regression coefficient = 77.03, 95% confidence interval 32.27-121.78) and non-linear spline regression analyses. Despite the positive correlation between dietary and urinary cadmium estimates, dietary cadmium intake showed inconsistent results with the study endpoints and generally weaker associations, suggesting a decreased capacity to reflect actual cadmium exposure. Overall, these findings suggest that even low levels of cadmium exposure may adversely alter hematological and biochemical variables and induce oxidative stress.
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Affiliation(s)
- Teresa Urbano
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Tommaso Filippini
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Daniela Lasagni
- Transfusion Medicine Unit, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Tiziana De Luca
- Transfusion Medicine Unit, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Sabrina Sucato
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Elisa Polledri
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Marcella Malavolti
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Chiara Rigon
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | | | | | - Roberto Baricchi
- Transfusion Medicine Unit, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Silvia Fustinoni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, Milan, Italy
| | - Marco Vinceti
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
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26
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Zhong Q, Wu HB, Lu HH, Pan HH, Cheng Y, Qin QR, Huang F. Interaction of biomass fuels use and metals exposure on hypertension: A prospective cohort study in rural areas along the Yangtze River, China. Ecotoxicol Environ Saf 2022; 239:113643. [PMID: 35588614 DOI: 10.1016/j.ecoenv.2022.113643] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 05/09/2022] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
Humans maybe simultaneously exposed to multiple-metals and indoor air pollution in daily life. However, limited prospective studies have assessed the interaction between multiple metals exposure and biomass fuels use on hypertension in China. The prospective cohort study in rural areas along the Yangtze River included 2625 adults in 2014-2015, and they were followed up till 2019. Among 1248 rural residents who were without hypertension at baseline, 377 hypertension events (30.21%) were observed after 4.5 years of average follow-up time. First-morning urine samples of residents were collected at baseline, the association between urinary metals level and hypertension were assessed using quantile g-computation. Additionally, we also examined the effect of biomass fuels use, fuels switching, and cookstove ventilation on the association of metals exposure with hypertension. Quantile g-computation analyses showed a positive joint effect of 17 metals on hypertension, with the odds ratio (OR) of 1.68 (95% CI: 0.89, 3.14) when increasing all seventeen metals by one quartile, and cadmium, lithium, copper contributed the largest positive weights. Biomass fuels use can interact with cadmium exposure on hypertension with OR for interaction of 1.28 (95%CI: 1.00, 1.73), and increase the association between copper, manganese and zinc exposure and systolic blood pressure, lithium exposure and diastolic blood pressure at the follow-up visit. Moreover, switching from biomass fuels to clean fuels during follow up, cookstove ventilation can alleviate the risk of higher blood pressure from metals exposure. In rural areas along the Yangtze River, China, biomass fuels use for cooking can interact with multiple-metals exposure on hypertension. Residents who switched from biomass fuels to clean fuels and who used ventilation had a lower risk of hypertension. Further cohort studies are needed to clarify the mechanism of combined effects of metals exposure and biomass fuels use on the human health.
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Affiliation(s)
- Qi Zhong
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Hua-Bing Wu
- The Second Hospital of Anhui Medical University, China
| | - Huan-Huan Lu
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Hai-Hong Pan
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Ying Cheng
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Qi-Rong Qin
- Maanshan Center for Disease Control and Provention, Maanshan, Anhui 243000, China
| | - Fen Huang
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.
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27
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Li G, Liu J, Lu H, Hu W, Hu M, He J, Yang W, Zhu Z, Zhu J, Zhang H, Zhao H, Huang F. Multiple environmental exposures and obesity in eastern China: An individual exposure evaluation model. Chemosphere 2022; 298:134316. [PMID: 35302002 DOI: 10.1016/j.chemosphere.2022.134316] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/09/2022] [Accepted: 03/12/2022] [Indexed: 06/14/2023]
Abstract
Obesity has caused a huge burden of disease. Few studies have explored individuals' environmental exposure level and the impact of multiple environmental exposures on obesity. The aim of this study was to explore individual air pollution exposure evaluation, and the association between and multiple environmental factors and obesity among adult residents in rural areas of China. In this study, 8400 residents of 14 districts and counties in eastern of China were selected by multistage stratified cluster sampling, and a total of 8377 residents were included in the final analysis. We adopted BMI (Body Mass Index) > 28 kg/m2 as the definition of obesity. First, an individual air pollution evaluation model was established based on the monitoring data of air pollution stations closest to residential address, different demographic characteristics of residents and daily living habits using generalized linear model and random forest model. Then, we used Bayesian Kernel Machine Regression (BKMR) and Quantile g-Computation (QgC) models to explore multiple environmental exposures on obesity. The results showed that six air pollutants were significantly positively associated with obesity, and green space had a significant protective effect on obesity. The BKMR model showed that the effects of different air pollutants on obesity were significantly enhanced by each other, while green space significantly reduced the positive effect of air pollution on obesity. The QgC model showed a significant positive association with obesity when all environmental factors were exposed as a whole, especially in males, higher household incomes and young people. It suggested that relevant authorities should improve regional air quality and green space to reduce the burden of disease caused by obesity.
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Affiliation(s)
- Guoao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jianjun Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Huanhuan Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Wenlei Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Mingjun Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jialiu He
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Wanjun Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Zhenyu Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jinliang Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Hanshuang Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Huanhuan Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.
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28
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Yang Q, Liu R, Gao Y, Kang H, Zhang Z, Han Z, Zhang Y, Li Y, Mu L, Lei L. Mediating effect of telomere length in a hypertension population exposed to cadmium: a case-control study. J Hum Hypertens 2022. [PMID: 35534619 DOI: 10.1038/s41371-022-00685-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 03/06/2022] [Accepted: 03/30/2022] [Indexed: 11/08/2022]
Abstract
Cadmium (Cd) is associated with telomere length and hypertension, respectively, but the mechanism behind its relationship is unclear. Our study aimed to clarify the role of telomere length in the relationship between Cd and hypertension. A 1:1 matched case-control study was conducted with 213 hypertensive patients and 213 normotensive controls in Taiyuan, Shanxi Province, China, from February and June 2016. General demographic characteristics information and lifestyle were collected using a structured questionnaire. Urine samples were collected to test urinary Cd (UCd) levels and corrected by urinary creatinine (UCr) levels. Peripheral leukocyte absolute telomere length (ATL) was measured using quantitative polymerase chain reaction. Logistic regression was used to screen the influencing factors of hypertension. A mediation effect analysis was used to explore the role of telomere length between Cd exposure and the risk of hypertension. We found that the hypertension group had a significantly higher UCd level compared to the control group (0.91 vs 0.80 μg/g Cr, P < 0.01), while ATL showed the opposite relationship (2.36 vs 2.65 kb, P < 0.01). The Regression analysis of hypertension identified these significant predictors: family history of hypertension (OR = 3.129, 95% confidence interval (95% CI): 1.767-5.540), Body mass index (BMI, OR = 1.088, 95% CI: 1.023-1.157), total cholesterol (TC, OR = 1.277, 95% CI: 1.024-1.592), UCd (OR = 2.092, 95% CI: 1.179-3.710), ATL (OR = 0.105, 95% CI: 0.025-0.453) and 8-hydroxy-2-deoxyguanosine (8-OHdG, OR = 7.864, 95% CI: 3.516-17.589). Mediating effect analysis revealed that ATL was a potential partial mediating factor between Cd and hypertension. Cd may induce hypertension by affecting telomere length, but this requires further exploration.
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29
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Shi P, Liu S, Xia X, Qian J, Jing H, Yuan J, Zhao H, Wang F, Wang Y, Wang X, Wang X, He M, Xi S. Identification of the hormetic dose-response and regulatory network of multiple metals co-exposure-related hypertension via integration of metallomics and adverse outcome pathways. Sci Total Environ 2022; 817:153039. [PMID: 35026265 DOI: 10.1016/j.scitotenv.2022.153039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/03/2022] [Accepted: 01/06/2022] [Indexed: 06/14/2023]
Abstract
Environmental stressors, including heavy metals, can be associated with hypertension development. However, little information regarding the dose-response relationship and toxicity mechanisms of metal mixtures with hypertension development is currently available. Therefore, we recruited 940 participants from six factories in northeastern China and measured the urinary concentrations of 19 metals. Then, we used Bayesian kernel machine regression (BKMR) to explore associations between metals co-exposure and hypertension. The BKMR model indicated a hermetic dose-response relationship between eight urinary metals (Co, Cr, Ni, Cd, As, Fe, Zn, and Pb) and hypertension risk. Moreover, heterogeneous and non-linear association patterns were detected across different metals/metalloids concentrations. Next, for the first time, we analyzed data of chemicals containing specific metal elements in the Comparative Toxicogenomics Database (CTD) from a disease perspective and provided insights from various biological levels to explain heavy metal co-exposure-related hypertension. On the molecular scale, 43 chemical components and 112 potential target genes were detected for metal exposure-related hypertension. Further, the network topology analysis indicated that target genes such as insulin (INS, degree = 78), albumin (ALB, degree = 74), renin (REN, degree = 71), interleukin-6 (IL6, degree = 70), endothelin 1 (EDN1, degree = 70), and endothelial nitric oxide synthase (NOS3, degree = 69) have a strong correlation with heavy metals co-exposure. Finally, we used integrative analyses in the adverse outcome pathway (AOP) wiki to analyze the co-exposure of heavy metals and hypertension and support an integrated metallomics approach. We selected the AOP 149 as the framework and found that the molecular initiating events (MIEs) of hypertension stems from the oxidation of AA residues on critical peptides of the NO pathway. The NOS3 was particularly promising since its subunit has three metal ion cross-linking domains with Zn2+, Fe2+, and Ga3+, which might serve as a binding site for heavy metal ions.
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Affiliation(s)
- Peng Shi
- Department of Environmental and Occupational Health, School of Public Health, China Medical University, Shenyang 110122, PR China
| | - Shengnan Liu
- Program of Environmental Toxicology, School of Public Health, China Medical University, Shenyang 110122, PR China
| | - Xinyu Xia
- Department of Environmental and Occupational Health, School of Public Health, China Medical University, Shenyang 110122, PR China
| | - Jili Qian
- Department of Health Statistics, School of Public Health, China Medical University, Shenyang 110122, PR China
| | - Hongmei Jing
- Department of Environmental and Occupational Health, School of Public Health, China Medical University, Shenyang 110122, PR China
| | - Jiamei Yuan
- Department of Environmental and Occupational Health, School of Public Health, China Medical University, Shenyang 110122, PR China
| | - Hanqing Zhao
- Department of Environmental and Occupational Health, School of Public Health, China Medical University, Shenyang 110122, PR China
| | - Fei Wang
- Department of Environmental and Occupational Health, School of Public Health, China Medical University, Shenyang 110122, PR China
| | - Yue Wang
- Department of Environmental and Occupational Health, School of Public Health, China Medical University, Shenyang 110122, PR China; Key Laboratory of Environmental Health Damage Research and Assessment, China Medical University, Shenyang 110122, PR China
| | - Xue Wang
- Department of Environmental and Occupational Health, School of Public Health, China Medical University, Shenyang 110122, PR China; Key Laboratory of Environmental Health Damage Research and Assessment, China Medical University, Shenyang 110122, PR China
| | - Xuan Wang
- Department of Environmental and Occupational Health, School of Public Health, China Medical University, Shenyang 110122, PR China; Central Hospital, Shenyang Medical College, Shenyang 110122, PR China
| | - Miao He
- Department of Environmental and Occupational Health, School of Public Health, China Medical University, Shenyang 110122, PR China; Key Laboratory of Environmental Health Damage Research and Assessment, China Medical University, Shenyang 110122, PR China
| | - Shuhua Xi
- Department of Environmental and Occupational Health, School of Public Health, China Medical University, Shenyang 110122, PR China.
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Lu Y, Zhang Y, Guan Q, Xu L, Zhao S, Duan J, Wang Y, Xia Y, Xu Q. Exposure to multiple trace elements and miscarriage during early pregnancy: A mixtures approach. Environ Int 2022; 162:107161. [PMID: 35219936 DOI: 10.1016/j.envint.2022.107161] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/19/2022] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Exposure to some conventional trace elements has been found to be associated with miscarriage; however, evidence for combined exposure is inconclusive. Therefore, it is important to explore the joint associations between toxic and essential trace elements and miscarriage. METHODS This cross-sectional study measured a wide range of element levels in the whole blood of pregnant women by using inductively coupled plasma mass spectrometry. The associations between individual elements and miscarriage were appraised using logistic regression model. Multi-exposure models, including Bayesian kernel machine regression (BKMR) and weighted quantile sum regression (WQS), were used to explore the mixed exposure to elements. Furthermore, grouped weighted quantile sum (GWQS) considered multiple elements with different magnitudes and directions of associations. RESULTS In logistic regression, the odds ratios (ORs) with a 95% confidence interval (CI) in the highest quartiles were 5.45 (2.00, 15.91) for barium, 0.28 (0.09, 0.76) for copper, and 0.32 (0.12, 0.83) for rubidium. These exposure-outcome associations were confirmed and supplemented by BKMR, which indicated a positive association for barium and negative associations for copper and rubidium. In WQS, a positive association was found between mixed elements and miscarriage (OR: 1.71; 95% CI: 1.07, 2.78), in which barium (75.7%) was the highest weighted element. The results of GWQS showed that the toxic trace element group dominated by barium was significantly associated with increased ORs (OR: 2.71; 95% CI: 1.74, 4.38). Additionally, a negative association was observed between the essential trace element group and miscarriage (OR: 0.32; 95% CI: 0.18, 0.54), with rubidium contributing the most to the result. CONCLUSIONS As a toxic trace element, barium was positively associated with miscarriage both by individual and multiple evaluations, while essential trace elements, particularly rubidium and copper, exhibited negative associations. Our findings provide significant evidence for exploring the effects of trace elements on miscarriage.
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Affiliation(s)
- Yingying Lu
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Yuqing Zhang
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Quanquan Guan
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Lu Xu
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Shuangshuang Zhao
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Jiawei Duan
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yan Wang
- Department of Prenatal Diagnosis, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Yankai Xia
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China.
| | - Qing Xu
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China; State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China.
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Li G, Zhu Z, Hu M, He J, Yang W, Zhu J, Zhao H, Zhang H, Huang F. Effects of carbon dioxide and green space on sleep quality of the elderly in rural areas of Anhui Province, China. Environ Sci Pollut Res Int 2022; 29:21107-21118. [PMID: 34750758 DOI: 10.1007/s11356-021-17296-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
Sleep quality leads to many healthy problems, which has caused global concern. Most studies have focused on the sleep quality in some large cities, ignoring the elderly in rural areas who may have more serious sleep problems. Therefore, this study aimed to understand the sleep status of the elderly in rural areas of Anhui Province and the influence of environmental factors on it. The data of carbon dioxide (CO2) concentrations for this study were obtained from the Dalhousie University atmospheric composition analysis group. The data of normalized differential vegetation index (NDVI) in 2014 was produced and processed by remote sensing inversion on the basis of medium resolution satellite images. The 2686 individuals were selected from rural areas of Anhui Province by multi-stage stratified cluster sampling. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The independent, interactive, and mediating effects of CO2 and green space on sleep quality were evaluated by generalized linear model, interaction model, and mediating effect model, respectively. In this study, we found that the prevalence of sleep disturbance in the elderly was 58.40%. In the univariate model, we found that the risk of sleep disturbance increased by 1.6% for each 1 μg/m3 increase in concentrations of CO2, while decreased by 1.5% for every 0.1 increase in NDVI. In the interaction model, the negative correlation between green space and sleep quality decreased with concentrations of CO2 increased. In addition, green space was a mediating factor between CO2 and sleep quality in the mediating effect model.
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Affiliation(s)
- Guoao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Zhenyu Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Mingjun Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Jialiu He
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Wanjun Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Jinliang Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Huanhuan Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Hanshuang Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China.
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Yim G, Wang Y, Howe CG, Romano ME. Exposure to Metal Mixtures in Association with Cardiovascular Risk Factors and Outcomes: A Scoping Review. Toxics 2022; 10:toxics10030116. [PMID: 35324741 PMCID: PMC8955637 DOI: 10.3390/toxics10030116] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/24/2022] [Accepted: 02/26/2022] [Indexed: 12/18/2022]
Abstract
Since the National Institute of Environmental Health Sciences (NIEHS) declared conducting combined exposure research as a priority area, literature on chemical mixtures has grown dramatically. However, a systematic evaluation of the current literature investigating the impacts of metal mixtures on cardiovascular disease (CVD) risk factors and outcomes has thus far not been performed. This scoping review aims to summarize published epidemiology literature on the cardiotoxicity of exposure to multiple metals. We performed systematic searches of MEDLINE (PubMed), Scopus, and Web of Science to identify peer-reviewed studies employing statistical mixture analysis methods to evaluate the impact of metal mixtures on CVD risk factors and outcomes among nonoccupationally exposed populations. The search was limited to papers published on or after 1998, when the first dedicated funding for mixtures research was granted by NIEHS, through 1 October 2021. Twenty-nine original research studies were identified for review. A notable increase in relevant mixtures publications was observed starting in 2019. The majority of eligible studies were conducted in the United States (n = 10) and China (n = 9). Sample sizes ranged from 127 to 10,818. Many of the included studies were cross-sectional in design. Four primary focus areas included: (i) blood pressure and/or diagnosis of hypertension (n = 15), (ii) risk of preeclampsia (n = 3), (iii) dyslipidemia and/or serum lipid markers (n = 5), and (iv) CVD outcomes, including stroke incidence or coronary heart disease (n = 8). The most frequently investigated metals included cadmium, lead, arsenic, and cobalt, which were typically measured in blood (n = 15). The most commonly utilized multipollutant analysis approaches were Bayesian kernel machine regression (BKMR), weighted quantile sum regression (WQSR), and principal component analysis (PCA). To our knowledge, this is the first scoping review to assess exposure to metal mixtures in relation to CVD risk factors and outcomes. Recommendations for future studies evaluating the associations of exposure to metal mixtures with risk of CVDs and related risk factors include extending environmental mixtures epidemiologic studies to populations with wider metals exposure ranges, including other CVD risk factors or outcomes outside hypertension or dyslipidemia, using repeated measurement of metals to detect windows of susceptibility, and further examining the impacts of potential effect modifiers and confounding factors, such as fish and seafood intake.
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Yang J, Lo K, Yang A. Trends in Urinary and Blood Cadmium Levels in U.S. Adults with or without Comorbidities, 1999-2018. Nutrients 2022; 14:nu14040802. [PMID: 35215454 PMCID: PMC8880632 DOI: 10.3390/nu14040802] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 12/10/2022] Open
Abstract
Although cadmium (Cd) exposure has been declining in the United States (U.S.) over the years, the level of exposure for people with pre-existing comorbidities is unclear. This study characterized the trends of blood Cd levels (bCd) (n = 44,498) and urinary Cd levels (uCd) (n = 15,107) by pre-existing comorbidities among adults participating in the U.S. National Health and Nutrition Examination Survey. We calculated age- and sex-standardized annual geometric mean (GM) levels, and used aJoinpoint regression model to examine the trends over time. The GM levels of bCd declined from 1999–2000 to 2017–2018 survey cycles (from 0.49 to 0.33 μg/L), while women and current smokers had higher levels. Participants with comorbidities had higher bCd and declined over time: cardiovascular disease (CVD) (0.50 to 0.42 μg/L), hypertension (0.49 to 0.35 μg/L), chronic kidney disease (CKD) (0.54 to 0.37 μg), and cancer (0.57 to 0.38 μg) versus those without these comorbidities. We observed the similar pattern of changes for uCd and participants with CVD, CKD, and cancer had higher levels. To conclude, the trend in urinary and blood Cd levels in U.S adults decreased in the past 20 years, and the levels varied by sex, smoking status, and comorbidities.
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Affiliation(s)
- Jingli Yang
- College of Earth and Environmental Sciences, Lanzhou University, Lanzhou 730000, China;
| | - Kenneth Lo
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong SAR, China
- Correspondence: (K.L.); (A.Y.)
| | - Aimin Yang
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
- Correspondence: (K.L.); (A.Y.)
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Mo X, Cai J, Lin Y, Liu Q, Xu M, Zhang J, Liu S, Wei C, Wei Y, Huang S, Mai T, Tan D, Lu H, Luo T, Gou R, Zhang Z, Qin J. Correlation between urinary contents of some metals and fasting plasma glucose levels: A cross-sectional study in China. Ecotoxicol Environ Saf 2021; 228:112976. [PMID: 34781133 DOI: 10.1016/j.ecoenv.2021.112976] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/02/2021] [Accepted: 11/05/2021] [Indexed: 06/13/2023]
Abstract
Many metals are involved in the pathogenesis of diabetes, but most of existing studies focused on single metals. The study of mixtures represents real-life exposure scenarios and deserves attention. This study aimed to explore the potential relationship of urinary copper (Cu), zinc (Zn), arsenic (As), selenium (Se), and strontium (Sr) contents with fasting plasma glucose (FPG) levels in 2766 participants. The levels of metals in urine were determined by inductively coupled plasma-mass spectrometry. We used linear regression models and the Bayesian kernel machine regression (BKMR) to evaluate the association between metals and FPG levels. In the multiple metals linear regression, Zn (β = 0.434), Se (β = 0.172), and Sr (β = -0.143) showed significant association with FPG levels (all P < 0.05). The BKMR model analysis showed that the results of single metal association were consistent with the multiple metals linear regression. The mixture of five metals had a positive over-all effect on FPG levels, and Zn (PIP = 1.000) contributed the most to the FPG levels. Cu and As were negatively correlated with FPG levels in women. The potential interaction effect between Cu and Sr was observed in participants aged ≥ 60 years old (Pinteraction = 0.035). In summary, our results suggested that multiple metals in urine are associated with FPG levels. Further studies are needed to confirm these findings and clarify the underlying mechanisms.
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Affiliation(s)
- Xiaoting Mo
- Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Jiansheng Cai
- Guangxi Key Laboratory of Tumor Immunology and Microenvironmental Regulation, Guilin Medical University, Guilin 541004, Guangxi, China
| | - Yinxia Lin
- Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Qiumei Liu
- Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Min Xu
- Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Junling Zhang
- Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Shuzhen Liu
- Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Chunmei Wei
- Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Yanfei Wei
- Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Shenxiang Huang
- Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Tingyu Mai
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin 541004, Guangxi, China
| | - Dechan Tan
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin 541004, Guangxi, China
| | - Huaxiang Lu
- Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Tingyu Luo
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin 541004, Guangxi, China
| | - Ruoyu Gou
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin 541004, Guangxi, China
| | - Zhiyong Zhang
- Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China; Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin 541004, Guangxi, China.
| | - Jian Qin
- Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China.
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