Lead exposure and impaired glucose homeostasis in Chinese adults: A repeated measures study with 5 years of follow-up

Bin Wang; Wen Zhang; Chi Chen; Yi Chen; Fangzhen Xia; Ningjian Wang; Yingli Lu

doi:10.1016/j.ecoenv.2022.113953

Lead exposure and impaired glucose homeostasis in Chinese adults: A repeated measures study with 5 years of follow-up

Ecotoxicol Environ Saf. 2022 Sep 15:243:113953. doi: 10.1016/j.ecoenv.2022.113953. Epub 2022 Aug 9.

Authors

Bin Wang¹, Wen Zhang¹, Chi Chen¹, Yi Chen¹, Fangzhen Xia¹, Ningjian Wang², Yingli Lu³

Affiliations

¹ Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Department of Endocrinology and Metabolism, Huangpu Branch, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: wnj486@126.com.
³ Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Endocrinology and Metabolism, Huangpu Branch, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: luyingli2008@126.com.

PMID: 35961200
DOI: 10.1016/j.ecoenv.2022.113953

Abstract

Experimental studies suggest the diabetogenic effects of lead, but relevant data in humans are limited and have been primarily based on cross-sectional study design. We aimed to prospectively examine the association between lead exposure and glucose homeostasis in general population using repeated measurements. This cohort study included 5505 Chinese adults free of glucose-lowering medication use at baseline in 2014 and followed up 5 years later. Blood lead and glucose metabolic traits including fasting plasma glucose (FPG), fasting serum insulin, the homeostasis model assessment of insulin resistance (HOMA-IR), and HOMA of beta-cell function (HOMA-B) were measured at baseline and follow-up. Linear mixed models and linear regression models were performed to evaluate the associations between blood lead and markers of glucose homeostasis. After full adjustment for confounders including BMI, an interquartile range (IQR) increase in blood lead levels was associated with a 2.26 % increase in FPG (95 % CI: 0.16 %, 4.39 %) and an 11.3 % decrease in HOMA-B (95 % CI: - 19.1 %, - 2.71 %) in women. The odds ratios of hyperglycemia and beta-cell dysfunction corresponding to an IQR increase in blood lead levels were 1.39 (95 % CI: 0.99, 1.95) and 1.74 (95 % CI: 1.00, 3.03), respectively. Similar results were found for 5-year changes of glucose metabolic markers. Compared with the first quartile of baseline lead levels, the highest lead quartile was associated with an additional 3.03 % increase in FPG (95 % CI: 0.84 %, 5.26 %) and an additional 13.3 % decrease in HOMA-B (95 % CI: - 20.4 %, - 5.53 %) in women during follow-up. We observed no overall associations between blood lead levels and glucose metabolic markers in men. Our findings provide suggestive evidence that environmental exposure to lead might contribute to sex-dependent disruption of glucose homeostasis in general adult population.

Keywords: Glucose homeostasis; HOMA-B; Lead; Repeated measures; Type 2 diabetes.

MeSH terms

Adult
Blood Glucose / metabolism
China
Cohort Studies
Cross-Sectional Studies
Diabetes Mellitus, Type 2* / epidemiology
Female
Follow-Up Studies
Glucose
Homeostasis
Humans
Insulin / metabolism
Insulin Resistance* / physiology
Lead
Male

Substances

Blood Glucose
Insulin
Lead
Glucose