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Relationship between heavy metal exposure and type 2 diabetes: a large-scale retrospective cohort study using occupational health examinations

OBJECTIVES: To investigate the associations between heavy metal exposure and serum ferritin levels, physical measurements and type 2 diabetes mellitus (DM). DESIGN: A retrospective cohort study. SETTING: Changwon, the location of this study, is a Korean representative industrial city. Data were obta...

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Autores principales: Ji, Jun Ho, Jin, Mi Hyeon, Kang, Jung-Hun, Lee, Soon Il, Lee, Suee, Kim, Sung-Hyun, Oh, Sung Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7934714/
https://www.ncbi.nlm.nih.gov/pubmed/33664065
http://dx.doi.org/10.1136/bmjopen-2020-039541
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author Ji, Jun Ho
Jin, Mi Hyeon
Kang, Jung-Hun
Lee, Soon Il
Lee, Suee
Kim, Sung-Hyun
Oh, Sung Yong
author_facet Ji, Jun Ho
Jin, Mi Hyeon
Kang, Jung-Hun
Lee, Soon Il
Lee, Suee
Kim, Sung-Hyun
Oh, Sung Yong
author_sort Ji, Jun Ho
collection PubMed
description OBJECTIVES: To investigate the associations between heavy metal exposure and serum ferritin levels, physical measurements and type 2 diabetes mellitus (DM). DESIGN: A retrospective cohort study. SETTING: Changwon, the location of this study, is a Korean representative industrial city. Data were obtained from medical check-ups between 2002 and 2018. PARTICIPANTS: A total of 34 814 male subjects were included. Of them, 1035 subjects with lead exposure, 200 subjects with cadmium exposure and the 33 579 remaining were assigned to cohort A, cohort B and the control cohort, respectively. Data including personal history of alcohol and smoking, age, height, weight, the follow-up duration, haemoglobin A1c (HbA1c), fasting blood sugar (FBS), ferritin levels, and lead and cadmium levels within 1 year after exposure were collected. PRIMARY OUTCOME MEASURE: In subjects without diabetes, changes in FBS and HbA1c were analysed through repeated tests at intervals of 1 year or longer after the occupational exposure to heavy metals. RESULTS: In Cohort A, DM was diagnosed in 33 subjects. There was a significant difference in lead concentrations between the subjects diagnosed with DM and those without DM during the follow-up period (3.94±2.92 mg/dL vs 2.81±2.03 mg/dL, p=0.002). Simple exposure to heavy metals (lead and cadmium) was not associated with DM in Cox regression models (lead exposure (HR) 1.01, 95% CI: 0.58 to 1.77, p 0.971; cadmium exposure HR 1.48, 95% CI: 0.61 to 3.55, p=0.385). Annual changes in FBS according to lead concentration at the beginning of exposure showed a positive correlation (r=0.072, p=0.032). CONCLUSION: Our findings demonstrated that simple occupational exposure to heavy metals lead and cadmium was not associated with the incidence of DM. However, lead concentrations at the beginning of the exposure might be an indicator of DM and glucose elevations.
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spelling pubmed-79347142021-03-19 Relationship between heavy metal exposure and type 2 diabetes: a large-scale retrospective cohort study using occupational health examinations Ji, Jun Ho Jin, Mi Hyeon Kang, Jung-Hun Lee, Soon Il Lee, Suee Kim, Sung-Hyun Oh, Sung Yong BMJ Open Occupational and Environmental Medicine OBJECTIVES: To investigate the associations between heavy metal exposure and serum ferritin levels, physical measurements and type 2 diabetes mellitus (DM). DESIGN: A retrospective cohort study. SETTING: Changwon, the location of this study, is a Korean representative industrial city. Data were obtained from medical check-ups between 2002 and 2018. PARTICIPANTS: A total of 34 814 male subjects were included. Of them, 1035 subjects with lead exposure, 200 subjects with cadmium exposure and the 33 579 remaining were assigned to cohort A, cohort B and the control cohort, respectively. Data including personal history of alcohol and smoking, age, height, weight, the follow-up duration, haemoglobin A1c (HbA1c), fasting blood sugar (FBS), ferritin levels, and lead and cadmium levels within 1 year after exposure were collected. PRIMARY OUTCOME MEASURE: In subjects without diabetes, changes in FBS and HbA1c were analysed through repeated tests at intervals of 1 year or longer after the occupational exposure to heavy metals. RESULTS: In Cohort A, DM was diagnosed in 33 subjects. There was a significant difference in lead concentrations between the subjects diagnosed with DM and those without DM during the follow-up period (3.94±2.92 mg/dL vs 2.81±2.03 mg/dL, p=0.002). Simple exposure to heavy metals (lead and cadmium) was not associated with DM in Cox regression models (lead exposure (HR) 1.01, 95% CI: 0.58 to 1.77, p 0.971; cadmium exposure HR 1.48, 95% CI: 0.61 to 3.55, p=0.385). Annual changes in FBS according to lead concentration at the beginning of exposure showed a positive correlation (r=0.072, p=0.032). CONCLUSION: Our findings demonstrated that simple occupational exposure to heavy metals lead and cadmium was not associated with the incidence of DM. However, lead concentrations at the beginning of the exposure might be an indicator of DM and glucose elevations. BMJ Publishing Group 2021-03-04 /pmc/articles/PMC7934714/ /pubmed/33664065 http://dx.doi.org/10.1136/bmjopen-2020-039541 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Occupational and Environmental Medicine
Ji, Jun Ho
Jin, Mi Hyeon
Kang, Jung-Hun
Lee, Soon Il
Lee, Suee
Kim, Sung-Hyun
Oh, Sung Yong
Relationship between heavy metal exposure and type 2 diabetes: a large-scale retrospective cohort study using occupational health examinations
title Relationship between heavy metal exposure and type 2 diabetes: a large-scale retrospective cohort study using occupational health examinations
title_full Relationship between heavy metal exposure and type 2 diabetes: a large-scale retrospective cohort study using occupational health examinations
title_fullStr Relationship between heavy metal exposure and type 2 diabetes: a large-scale retrospective cohort study using occupational health examinations
title_full_unstemmed Relationship between heavy metal exposure and type 2 diabetes: a large-scale retrospective cohort study using occupational health examinations
title_short Relationship between heavy metal exposure and type 2 diabetes: a large-scale retrospective cohort study using occupational health examinations
title_sort relationship between heavy metal exposure and type 2 diabetes: a large-scale retrospective cohort study using occupational health examinations
topic Occupational and Environmental Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7934714/
https://www.ncbi.nlm.nih.gov/pubmed/33664065
http://dx.doi.org/10.1136/bmjopen-2020-039541
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