Researcher University of North Carolina Greensboro Ithaca, New York, United States
Disclosure(s):
Doreen Larvie, PhD: No relevant financial relationship(s) with ineligible companies to disclose.
Objectives: Metabolic dysfunction is characterized by obesity, insulin resistance, glucose perturbations and dyslipidemia. Trace elements such as cadmium, lead, arsenic, manganese, and selenium function as part of proteins and enzymes involved in immune regulation and have been implicated as risk factors in metabolic syndrome. However, evidence on the combined role of trace elements on metabolic derangements requires further study in large scale epidemiological data. The aim of the present analysis is to evaluate the association between metabolic health indicators and trace metal concentrations among participants (≥18 years) in the National Health and Nutrition Examination Survey (NHANES) 2017-2020.
Methods: Outcomes were insulin, low density lipoprotein, total cholesterol, and fasting plasma glucose concentrations. Exposures were blood concentrations of selenium, cadmium, lead, manganese, urine arsenic, and serum creatinine. Confounders were evaluated in crude and adjusted models based on 10% change in the effect estimate and biological plausibility. Interaction terms were used to investigate the impact of effect modifiers. Laboratory sample analysis in NHANES includes fasting plasma glucose (hexokinase method), and serum total cholesterol (enzymatic method). Linear regression analysis adjusted for the complex survey design was used to investigate the association between trace element concentrations and metabolic outcomes among adults (≥18 years).
Results: Among participants (≥18 years; 1,300), median total cholesterol, insulin and fasting blood glucose were, median (IQR): 183 (158-211) mg/dL, 9.4 (6.0-15.6) µU/mL, and 102 (95-111) mg/dL, respectively. Total cholesterol was positively associated with lead [β(95% CI): 5.2 (1.3, 9.1), p=0.014] and selenium [β(95% CI): 0.1 (0.01, 0.2), p=0.021]; low-density lipoprotein cholesterol was positively associated with lead [β(95% CI): 4.4 (0.2, 8.6), p=0.042]; insulin concentration was positively associated with blood manganese [β(95% CI): 0.9 (0.03, 1.8), p=0.044]; and fasting plasma glucose was inversely associated with blood lead [β(95% CI): -2.5 (-4.4, -0.5), p=0.018] concentrations.
Conclusions: Findings suggest that trace metals may alter the regulation of glucose, insulin, and lipid profile, demonstrating a role in the development of metabolic health outcomes.
