Relationship of individual and mixed urinary metals exposure with liver function in the China National Human Biomonitoring (CNHBM) of Zhejiang Province

Ping Cheng; Yi Tao; Jinfeng Hu; Hongxin Wang; Ruifang Zhao; Shenghua Mei; Yin Yang; Fugen Ye; Zhijian Chen; Hao Ding; Mingluan Xing; Peiwei Xu; Lizhi Wu; Xueqing Li; Xuwenqi Zhang; Zhengquan Ji; Jie Xiang; Dandan Xu; Yuan Chen; Xiaofeng Wang; Xiaoming Lou

doi:10.1016/j.chemosphere.2023.140050

Relationship of individual and mixed urinary metals exposure with liver function in the China National Human Biomonitoring (CNHBM) of Zhejiang Province

Chemosphere. 2023 Nov:342:140050. doi: 10.1016/j.chemosphere.2023.140050. Epub 2023 Sep 1.

Authors

Ping Cheng¹, Yi Tao², Jinfeng Hu³, Hongxin Wang⁴, Ruifang Zhao⁵, Shenghua Mei⁶, Yin Yang⁷, Fugen Ye⁸, Zhijian Chen⁹, Hao Ding¹⁰, Mingluan Xing⁹, Peiwei Xu⁹, Lizhi Wu⁹, Xueqing Li⁹, Xuwenqi Zhang¹⁰, Zhengquan Ji¹⁰, Jie Xiang⁹, Dandan Xu⁹, Yuan Chen⁹, Xiaofeng Wang¹¹, Xiaoming Lou¹²

Affiliations

¹ Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China. Electronic address: pchen@cdc.zj.cn.
² Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China.
³ Shangcheng District Center for Disease Control and Prevention, Hangzhou, 310009, China.
⁴ Wucheng District Center for Disease Control and Prevention, Jinhua, 321025, China.
⁵ Qujiang District Center for Disease Control and Prevention, Quzhou, 324022, China.
⁶ Longquan County Center for Disease Control and Prevention, Lishui, 323799, China.
⁷ Jinyun County Center for Disease Control and Prevention, Lishui, 321499, China.
⁸ Songyang County Center for Disease Control and Prevention, Lishui, 323499, China.
⁹ Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China.
¹⁰ Environmental Science Research & Design Institute of Zhejiang Province, Key Laboratory of Environmental Pollution Control Technology of Zhejiang Province, Hangzhou, 310007, China.
¹¹ Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China. Electronic address: xfwang@cdc.zj.cn.
¹² Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China. Electronic address: xmlou@cdc.zj.cn.

PMID: 37660798
DOI: 10.1016/j.chemosphere.2023.140050

Abstract

Background: Heavy metals have been reported to affect liver function. However, there is currently little and inconsistent knowledge about the effects of combined and individual urinary metals on specific parameters of liver function in the general population. Therefore, this study aimed to investigate their associations.

Methods: This study involved 807 general population from the China National Human Biomonitoring of Zhejiang Province 2017-2018. Concentrations of urinary metals, including Chromium (Cr), Cobalt (Co), Nickle (Ni), Arsenic (As), Selenium (Se), Molybdenum (Mo), Cadmium (Cd), Thallium (Tl) and Lead (Pb) were measured. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), total protein (TP), albumin (ALB), direct bilirubin (DBIL), total bilirubin (TBIL) as liver function biomarkers. Multivariable linear regression and weighted quantile sum (WQS) regression were employed to explore the associations of urinary metals with liver function biomarkers. Subgroup analysis stratified by gender and age, excluding smokers and drinkers for sensitivity analysis.

Results: Both statistical models indicated that urinary metals were positively associated with ALT and AST, while negatively with TP, ALB, DBIL and TBIL. In the WQS analysis, each quartile increase in the ln-transformed levels of metal mixtures was associated with 4.11 IU/L (95% CI: 1.07, 7.15) higher ALT and 3.00 IU/L (95% CI: 1.75, 4.25) higher AST, as well as, with 0.67 g/L (95% CI: 1.24, -0.11) lower TP, 0.74 g/L (95% CI: 1.09, -0.39) lower ALB, 0.38 μmol/L (95% CI: 0.67, -0.09) lower DBIL, and 1.56 μmol/L (95% CI: 2.22, -0.90) lower TBIL. The association between urinary metals and ALT was primarily driven by Cd (55.8%), Cr contributed the most to the association with AST (20.2%) and TBIL (45.2%), while the association with TP was primarily driven by Ni (38.2%), the association with ALB was primarily driven by As (32.8%), and the association with DBIL was primarily driven by Pb (30.9%). The associations between urinary metals and liver function might differ by sex and age.

Conclusion: Urinary metals were significantly associated with liver function parameters. Further studies are required to clarify the relationship between heavy metals and liver function.

Keywords: General population; Liver function; Metals; WQS.