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.
Metal exposures have been inconsistently related to the risk of hyperuricemia, and limited research has investigated the interaction between obesity and metals in hyperuricemia. To explore their associations and interaction effects, 3300 participants were enrolled from 11 districts within 1 province in China, and the blood concentrations of 13 metals were measured to assess internal exposure. Multivariable logistic regression, restricted cubic spline (RCS), Bayesian kernel machine regression (BKMR), and interaction analysis were applied in the single- and multi-metal models. In single-metal models, five metals (V, Cr, Mn, Co, and Zn) were positively associated with hyperuricemia in males, but V was negatively associated with hyperuricemia in females. Following the multi-metal logistic regression, the multivariate-adjusted odds ratios (95% confidence intervals) of hyperuricemia were 1.7 (1.18, 2.45) for Cr and 1.76 (1.26, 2.46) for Co in males, and 0.68 (0.47, 0.99) for V in females. For V and Co, RCS models revealed wavy and inverted V-shaped negative associations with female hyperuricemia risk. The BKMR models showed a significant joint effect of multiple metals on hyperuricemia when the concentrations of five metals were at or above their 55th percentile compared to their median values, and V, Cr, Mn, and Co were major contributors to the combined effect. A potential interaction between Cr and obesity and Zn and obesity in increasing the risk of hyperuricemia was observed. Our results suggest that higher levels of Cr and Co may increase male hyperuricemia risk, while higher levels of V may decrease female hyperuricemia risk. Therefore, the management of metal exposure in the environment and diet should be improved to prevent hyperuricemia.
Background and purposeIn recent years, the incidence of obesity in people aged 60 and over has increased significantly, and abdominal obesity has been recognized as an independent risk factor for diabetes. Aging causes physiologic decline in multiple body systems, leading to changes in obesity indicators such as BMI. At present, the relationship between abdominal obesity markers and Diabetes mellitus (DM) in people aged 60 years and older remains unclear. Therefore, it is necessary to study the correlation between anthropometric indices and diabetes and explore potential predictors.MethodsThe basic demographic information of participants aged 60 and above in Zhongshan City in 2020 was collected. Physical parameters, blood glucose and other biochemical indices were measured comprehensively. Binary logistic regression analysis was used to explore the relationship between abdominal obesity indicators [Waist circumference, Neck Circumference, Waist-to-hip ratio, Chinese Visceral Obesity Index (CVAI), and visceral obesity index] and diabetes mellitus. ROC characteristic curve was used to analyze the predictive ability of abdominal obesity indicators to DM, and the non-restrictive cubic spline graph was used to visualize the screened obesity indicators and diabetes risk.ResultsAmong 9,519 participants, the prevalence of diabetes was 15.5%. Compared with low CVAI, High CVAI level was significantly associated with increased prevalence of DM in males and females (all p < 0.05), in males (OR, 2.226; 95%CI: 1.128–4.395), females (OR, 1.645; 95%CI: 1.013–2.669). After adjusting for potential confounding factors, there were gender differences between neck circumference and the prevalence of DM, and above-normal neck circumference in males was significantly associated with increased prevalence of DM (OR, 1.381; 95% CI: 1.091–1.747) (p < 0.05).ConclusionAmong these anthropometric indices, CVAI is consistent with the features of fat distribution in older individuals and shows superior discriminative power as a potential predictor of DM, compared to traditional anthropometric parameters.
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