The Associations between Blood and Urinary Concentrations of Metal Metabolites, Obesity, Hypertension, Type 2 Diabetes, and Dyslipidemia among US Adults: NHANES 1999–2016

Abstract

Background. Heavy metals are well known to be associated with cancer outcomes, but its association with obesity and cardiometabolic risk outcomes requires further study. Methods. Adult data from the National Health and Examination Survey (NHANES Continuous 1999–2016, n = 12,636 to 32,012) with data for blood or urinary metals concentrations and body mass index were used. The study aim was twofold: (1) to determine the association between heavy metals and obesity and (2) to examine the influence of heavy metals on the relationship between obesity and hypertension, type 2 diabetes, and dyslipidemia. Logistic regression was used to examine the main effects and interaction effects of metals and obesity for the odds of prevalent hypertension, type 2 diabetes, and dyslipidemia. Models were adjusted for age, gender, ethnicity, smoking status, physical active status, and poverty-income ratio, with additional adjustment for creatinine in models with the urinary measures of heavy metals. High-low concentration categories were defined by grouping metal quintiles with the most similar associations with obesity. Results. Blood lead had a negative linear association with obesity (odds ratio (OR) = 0.42, 95% confidence interval (CI) = 0.37–0.47). In those with obesity, high blood lead was associated with lower risk of prevalent dyslipidemia, while no association was found in those without obesity. The study observed a curvilinear relationship between urinary antimony and obesity with the moderate group having the highest odds of obesity (OR = 1.36, 1.16–1.59). However, the relationship between urinary antimony and prevalent hypertension and dyslipidemia risk was linear, positive, and independent of obesity. While not associated with prevalent obesity risk, high urinary uranium was associated with 30% ( P = 0.01 ) higher odds for prevalent type 2 diabetes. Conclusions. The impact of environmental factors on obesity and health may be complex, and this study reinforces the heterogeneous relationship between various metals, obesity, and obesity-related metabolic diseases even at levels observed in the general population.

Associations of exposure to multiple metals with blood pressure and hypertension: A cross-sectional study in Chinese preschool children

“…Previous literature in drinking water suggested high-Ba communities had lower cardiovascular disease and total mortality [43,44], which was similar to our results. Additionally, this study showed a signi cant interaction effect on blood pressure between urine Ba and overweight and obesity among children, which was consistent with Swayze et al study [45]. The study included 12256 participants from the continuous National Health and Nutrition Examination Survey 1999-2016 and suggested a greater effect of barium on hypertension in those with obesity.…”

Exploring the association between circulating trace elements, metabolic risk factors, and the adherence to a Mediterranean diet among children and adolescents with obesity

“…In line with previous studies describing the involvement of trace elements and heavy metals in the development of dyslipidemia factors, we found a negative correlation between various blood cholesterol fractions (e.g., TC, LDL-C) and plasmatic minerals (e.g., iron, cobalt, chromium, arsenic, lead). This could be attributed to the essential roles that trace elements seem to play in ameliorating atherogenic dyslipidemia through a myriad of mechanisms (e.g., lipid β-oxidation, expression of peroxisome proliferator-activated receptors), and particularly by interfering with cholesterol metabolism (37)(38)(39). Surprisingly, a positive association was found between plasma TG, iron, zinc, and lead, which could be due to their dietary co-occurrence (e.g., animalbased products).…”

Association of multi-metals with the risk of hypertension and the interaction with obesity: A cross-sectional study in China

“…Significantly negative interaction between blood Pb and BMI (only that of obesity but not overweight) was found. Conversely, Swayze et al ( 54 ) found an interaction between high Pb levels and non-obese subjects (BMI < 30 kg/m 2 ). This may be due to inconsistent results due to different definitions of obesity.…”