The associations of non-essential metal mixture with fasting plasma glucose among Chinese older adults without diabetes

Jing-Yuan Lei; Pan-Pan Wang; Hong-Li Wang; Yuan Wang; Liang Sun; Bing Hu; Su-Fang Wang; Dong-Mei Zhang; Gui-Mei Chen; Chun-Mei Liang; Fang-Biao Tao; Lin-Sheng Yang; Qing-Si Wu

doi:10.1007/s11356-023-29503-8

The associations of non-essential metal mixture with fasting plasma glucose among Chinese older adults without diabetes

Environ Sci Pollut Res Int. 2023 Sep;30(45):100613-100625. doi: 10.1007/s11356-023-29503-8. Epub 2023 Aug 28.

Authors

Jing-Yuan Lei^#¹, Pan-Pan Wang^#¹, Hong-Li Wang^#², Yuan Wang², Liang Sun³, Bing Hu³, Su-Fang Wang⁴, Dong-Mei Zhang⁵, Gui-Mei Chen⁵, Chun-Mei Liang¹, Fang-Biao Tao⁶, Lin-Sheng Yang², Qing-Si Wu⁷

Affiliations

¹ School of Public Health, Department of Hygiene Inspection and Quarantine, Anhui Medical University, Hefei, 230032, Anhui, China.
² School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei, 230032, Anhui, China.
³ Fuyang Center for Diseases Prevention and Control, Fuyang, 236069, Anhui, China.
⁴ School of Public Health, Department of Nutrition and Food Hygiene, Anhui Medical University, Hefei, 230032, Anhui, China.
⁵ School of Health Services Management, Anhui Medical University, Hefei, 230032, Anhui, China.
⁶ MOE Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China.
⁷ Department of Blood Transfusion, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China. wuqingsi@ahmu.edu.cn.

^# Contributed equally.

PMID: 37639099
DOI: 10.1007/s11356-023-29503-8

Abstract

The evidence about the effect of non-essential metal mixture on fasting plasma glucose (FPG) levels among older adults without diabetes is limited. This study aims to estimate the individual and joint relationship between five non-essential metals and FPG levels in Chinese older adults without diabetes. This study included 2362 older adults without diabetes. Urinary concentrations of five non-essential metals, i.e., cesium (Cs), aluminum (Al), thallium (Tl), cadmium (Cd), and arsenic (As), were detected by inductively coupled plasma mass spectrometry (ICP-MS). The associations of single metals and the metal mixture with FPG levels were assessed using linear regression and Bayesian kernel machine regression (BKMR) models, respectively. Adjusted single-metal linear regression models showed positive associations of urinary Al (β = 0.016, 95%CI: 0.001-0.030) and Cs (β = 0.018, 95%CI: 0.006-0.031) with FPG levels. When comparing the 2th, 3th, and 4th quartiles of urine Cs to its 1th quartile, the significant associations between Cs and FPG levels were found and presented as an "inverted U" trend (β_{Q2 vs. Q1}: 0.034; β_{Q3 vs. Q1}:0.054; β_{Q4 vs. Q1}: 0.040; all P<0.05). BKMR analyses showed urinary level of Cs exhibited an "inverted U" shape association with FPG levels. Moreover, the FPG levels increased linearly with the raised levels of the non-essential metal mixture, and the posterior inclusion probability (PIP) of Cs was the highest (0.92). Potential positive interaction of As and Cs on FPG levels was found in BKMR model. Stratified analysis displayed significant interactions of hyperlipidemia and urine Cs or Tl on FPG levels. An inverse U-shaped association between Cs and FPG was found, individually and as mixture. The FPG levels increased with the raised levels of the non-essential metal mixture, and Cs was the most contributor to FPG levels. Further research is required to confirm the correlation between non-essential metals and FPG levels and to clarify the underlying mechanisms.

Keywords: Bayesian kernel machine regression; Diabetes mellitus; Fasting plasma glucose; Metals; Mixture; Older adults.