Relationship between Selected Serum Metallic Elements and Obesity in Children and Adolescent in the U.S.

Abstract

The prevalence of obesity has increased at an alarming rate worldwide. Metallic elements are involved in the pathogenesis of obesity and related diseases. To date, whether environmental exposure to metallic elements has effects on obesity in children and adolescents is still unclear. The aim of the current study was to investigate the association of blood metallic elements with obesity in U.S. children and adolescents. This cross-sectional study was performed with 5404 children and adolescents (6–19 years, 2745 males and 2659 females) who participated in the US National Health and Nutrition Examination Survey 2011–2014. Blood lead, mercury, selenium, manganese, copper, and zinc, as well as biochemical parameters including triglyceride (TG), cholesterol, low-density lipoprotein (LDL), and homeostasis model assessment of insulin resistance (HOMA-IR) were assessed for all subjects. Multivariate logistic regression and linear regression were applied to assess associations of metallic elements and overweight, obesity status, and serum metabolites as distinct outcomes adjusted for age, gender, ethnicity, and the poverty income ratio. When stratified by age and sex, significant associations were found between the highest quartile of copper concentrations in blood with obesity status (OR = 9.27, 95% CI: 5.43, 15.82, pfor trend < 0.001) and cholesterol (OR = 3.08, 95% CI: 1.43, 6.63, pfor trend < 0.001). The highest concentrations of manganese in the blood was associated with obesity in those aged 6–19 years (OR = 2.29, 95% CI: 1.74, 3.02, pfor trend < 0.001). Moreover, blood mercury and selenium showed positive relationships with cholesterol. Further, a negative association existed between blood zinc and obesity. The National Health and Nutrition Examination Survey data provide epidemiological evidence that blood metallic elements are positively associated with obesity in children and adolescents. However, the underlying mechanisms still need further exploration.

Association between Serum Copper and Serum Lipids in Adults

“…Fan et al [17] used data from the NHANES, conducted in 2011-2014, and researched the relationship between serum copper and serum lipids in children and adolescent. Fan's study found that there was a positive association between serum copper and TC level, but no statistically significant association between serum copper and LDL cholesterol and TG [17]. Another US study conducted by Neggers et al [22] reported no association between serum copper and lipid profile levels.…”

“…Previous experimental studies in animals [13][14][15] consistently found that severe copper deficiency could raise serum cholesterol, whereas, results of studies on the effect of serum copper on lipid metabolism in human subjects were inconsistent. Most studies suggested that serum copper level was positively associated with TC [16][17][18], LDL cholesterol [16,19], or TG [16,20,21]. However, some studies found no evidence of associations between serum copper and TC [20], TG [17,18,22], LDL cholesterol [17,23], and HDL cholesterol [16,21,22].…”

“…Most studies suggested that serum copper level was positively associated with TC [16][17][18], LDL cholesterol [16,19], or TG [16,20,21]. However, some studies found no evidence of associations between serum copper and TC [20], TG [17,18,22], LDL cholesterol [17,23], and HDL cholesterol [16,21,22]. In addition, other studies found that serum copper was inversely related to TC [23] and HDL cholesterol [23][24][25].…”

Associação das concentrações séricas de zinco com hipercolesterolemia e resistência à insulina em crianças brasileiras

“…A associação positiva entre a hipercolesterolemia e as concentrações séricas e plasmáticas de zinco foi também observada por Fan et al 29 e Garcia et al 13 em crianças e adolescentes obesos nos Estados Unidos e escolares no México, respectivamente. Evidências sugerem que a concentração de zinco pode atuar de forma indireta no aumento de colesterol sérico total com a zinco-α-2 glicoproteína (ZAG), uma proteína que induz a mobilização de lipídios no tecido adiposo, com aumento das concentrações séricas de triacilgliceróis e colesterol 30 .…”

“…Pesquisas também realizadas com crianças pré-púberes obesas iranianas 31 demonstraram uma redução do colesterol sérico de forma significante naquelas que foram suplementadas com zinco. A associação entre a hipercolesterolemia e o zinco sérico pode ser diferente em populações obesas com baixa expressão da ZAG ou com alterações em outros parâmetros bioquímicos, como altas concentrações de leptina e baixas de adiponectina 29 . Mais estudos são necessários para comprovar a causalidade entre essas relações.…”