Korean Journal of Clinical Laboratory Science (대한임상검사과학회지)

Korean Society for Clinical Laboratory Science (대한임상검사과학회)
권호 표지
DOI QR코드

DOI QR Code

The Association of Mercury and ALT with Obesity in Korean Adults: Using Data from the Korea National Health and Nutrition Examination Survey for 11 Years (KNHANES 2005, 2008~2017)

대한민국 성인에서 비만에 대한 수은과 ALT의 관련성 : 11년간의 국민건강영양조사 자료를 사용하여 (KNHANES 2005, 2008~2017)

  • Pyo, Sang Shin (Department of Biomedical Laboratory Science, Jungwon University)
  • Received : 2022.07.26
  • Accepted : 2022.08.17
  • Published : 2022.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

The association between heavy metals in the blood and obesity has been examined in many studies. However, inconsistencies have been observed in the results from these studies. The present study was conducted using data from 119,181 participants of the Korea National Health and Nutrition Examination Survey (KNHANES) for 11 years in 2005 and between 2008 and 2017. The subjects with missing heavy metal blood tests, health interview data, and health examination data were excluded from the study. The study population comprised 1,844 individuals (972 men, 872 women) who were eligible for inclusion. It was found that obesity and abdominal obesity were associated with an increase in both blood mercury (P<0.001) and alanine aminotransferase (ALT) (P<0.001). After adjusting the confounding factors, those with concurrent high levels of ALT and the highest tertile of mercury showed an increased risk of obesity (odds ratio 4.46, 95%, confidence interval 2.23~8.90, P<0.001) as well as abdominal obesity (odds ratio 5.36, 95%, confidence interval 2.57~11.17, P<0.001). The interrelationship of mercury and ALT with the parameters of body mass index (P for interaction=0.009) and waist circumference (P for interaction=0.012), respectively, have been observed to be significant, suggesting that the reciprocal relationship could contribute to obesity and abdominal obesity.

혈액 중금속과 비만 사이의 연관성은 많은 연구에서 조사되었다. 그러나 일관되지 않은 연구 결과가 여전히 존재한다. 이 연구는 2005년과 2008년부터 2017년까지 11년간 119,181명의 참가자를 대상으로 한 국민건강영양조사의 데이터를 사용하여 수행되었다. 혈액 중금속 검사, 건강면접 자료, 건강검진 자료가 누락된 피험자는 연구에서 제외하였다. 연구 모집단에 포함될 자격이 있는 1,844명(남성 972명, 여성 872명)으로 구성되었다. 비만과 복부 비만은 혈중 수은 증가(P<0.001) 및 알라닌 아미노전이효소(ALT) 증가(P<0.001) 모두와 관련이 있는 것으로 나타났다. 교란요인들을 보정한 결과, 높은 ALT 수치와 가장 높은 삼분위수의 수은 수치에 동시에 해당되는 사람은 비만(오즈비 4.46, 95%, 신뢰구간 2.23~8.90, P<0.001) 및 복부 비만(오즈비 5.36, 95%, 신뢰구간 2.57~11.17, P<0.001)의 위험이 증가되는 것으로 나타났다. 수은과 ALT의 상호 관계는 체질량지수(P for interaction=0.009)와 허리둘레(P for interaction=0.012)에 대해 각각 유의하게 관찰되었는데, 이는 이 상호 관계가 비만과 복부 비만에 기여할 수 있음을 암시한다.

Keywords

Acknowledgement

This work was supported by the Jungwon University Research Grant (2021-044).

References

  1. Rice KM, Walker EM, Wu M, Gillette C, Blough ER. Environmental mercury and its toxic effects. J Prev Med Public Health. 2014;47:74-83. https://doi.org/10.3961/jpmph.2014.47.2.74
  2. Ahmad S, Mahmood R. Mercury chloride toxicity in human erythrocytes: enhanced generation of ros and rns, hemoglobin oxidation, impaired antioxidant power, and inhibition of plasma membrane redox system. Environ Sci Pollut Res Int. 2019;26:5645-5657. https://doi.org/10.1007/s11356-018-04062-5
  3. Pamphlett R, Kum Jew S, Doble PA, Bishop DP. Elemental analysis of aging human pituitary glands implicates mercury as a contributor to the somatopause. Front Endocrinol. 2019;10:419. https://doi.org/10.3389/fendo.2019.00419
  4. Kern JK, Geier DA, Sykes LK, Haley BE, Geier MR. The relation-ship between mercury and autism: a comprehensive review and discussion. J Trace Elem Med Biol. 2016;37:8-24. https://doi.org/10.1016/j.jtemb.2016.06.002
  5. Wang G, Tang WY, Ji H, Wang X. Prenatal exposure to mercury and precocious puberty: a prospective birth cohort study. Hum Reprod. 2021;36:712-720. https://doi.org/10.1093/humrep/deaa315
  6. Zahir F, Rizwi SJ, Haq SK, Khan RH. Low dose mercury toxicity and human health. Environ Toxicol Pharmacol. 2005;20:351-360. https://doi.org/10.1016/j.etap.2005.03.007
  7. Lee S, Yoon JH, Won JU, Lee W, Lee JH, Seok H, et al. The association between blood mercury levels and risk for overweight in a general adult population: results from the korean national health and nutrition examination survey. Biol Trace Elem Res. 2016;171:251-261. https://doi.org/10.1007/s12011-015-0530-1
  8. Park JS, Ha KH, He K, Kim DJ. Association between blood mercury level and visceral adiposity in adults. Diabetes Metab J. 2017;41:113-120. https://doi.org/10.4093/dmj.2017.41.2.113
  9. Shin YY, Ryu IK, Park MJ, Kim SH. The association of total blood mercury levels and overweight among korean adolescents: analysis of the korean national health and nutrition examination survey (knhanes) 2010-2013. Korean J Pediatr. 2018;61:121-128. https://doi.org/10.3345/kjp.2018.61.4.121
  10. Nasab H, Rajabi S, Eghbalian M, Malakootian M, Hashemi M, Mahmoudi-Moghaddam H. Association of as, pb, cr, and zn urinary heavy metals levels with predictive indicators of cardiovascular disease and obesity in children and adolescents. Chemosphere. 2022;294:133664. https://doi.org/10.1016/j.chemosphere.2022.133664
  11. Tinkov AA, Filippini T, Ajsuvakova OP, Aaseth J, Gluhcheva YG, Ivanova JM, et al. The role of cadmium in obesity and diabetes. Sci Total Environ. 2017;601-602:741-755. https://doi.org/10.1016/j.scitotenv.2017.05.224
  12. Cave M, Appana S, Patel M, Falkner KC, McClain CJ, Brock G. Polychlorinated biphenyls, lead, and mercury are associated with liver disease in american adults: Nhanes 2003-2004. Environ Health Perspect. 2010;118:1735-1742. https://doi.org/10.1289/ehp.1002720
  13. Chang Y, Ryu S, Sung E, Jang Y. Higher concentrations of alanine aminotransferase within the reference interval predict nonalcoholic fatty liver disease. Clin Chem. 2007;53:686-692. https://doi.org/10.1373/clinchem.2006.081257
  14. Dai W, Ye L, Liu A, Wen SW, Deng J, Wu X, et al. Prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus: a meta-analysis. Medicine (Baltimore). 2017;96:e8179. https://doi.org/10.1097/md.0000000000008179
  15. Bekkelund SI, Jorde R. Alanine aminotransferase and body composition in obese men and women. Dis Markers. 2019;2019: 1695874. https://doi.org/10.1155/2019/1695874
  16. Kim J, Jo I. Relationship between body mass index and alanine aminotransferase concentration in non-diabetic korean adults. Eur J Clin Nutr. 2010;64:169-175. https://doi.org/10.1038/ejcn.2009.131
  17. Oh K, Kim Y, Kweon S, Kim S, Yun S, Park S, et al. Korea national health and nutrition examination survey, 20th anniversary: accomplishments and future directions. Epidemiol Health. 2021;43:e2021025. https://doi.org/10.4178/epih.e2021025
  18. Kim BY, Kang SM, Kang JH, Kang SY, Kim KK, Kim K-B, et al. 2020 Korean society for the study of obesity guidelines for the management of obesity in Korea. J Obes Metab Syndr. 2021; 30:81-92. https://doi.org/10.7570/jomes21022
  19. Zafari N, Churilov L, MacIsaac RJ, Torkamani N, Baxter H, Kiburg KV, et al. Diagnostic performance of the chronic kidney disease epidemiology collaboration (ckd-epi) equation at estimating glomerular filtration rate in adults with diabetes mellitus: a systematic review and meta-analysis protocol. BMJ Open. 2019;9:e031558. https://doi.org/10.1136/bmjopen-2019-031558
  20. Eom SY, Choi SH, Ahn SJ, Kim DK, Kim DW, Lim JA, et al. Reference levels of blood mercury and association with metabolic syndrome in korean adults. Int Arch Occup Environ Health. 2014;87:501-513. https://doi.org/10.1007/s00420-013-0891-8
  21. Kim NY, Ahn SJ, Ryu DY, Choi BS, Kim H, Yu IJ, et al. Effect of life-styles on the blood mercury level in korean adults. HumExp Toxicol. 2013;32:591-599. https://doi.org/10.1177/0960327112467041
  22. Kim YA, Kim YN, Cho KD, Kim MY, Kim EJ, Baek OH, et al. Blood heavy metal concentrations of korean adults by seafood consumption frequency: using the fourth korea national health and nutrition examination survey (knhanes iv), 2008. Korean J Nutr. 2011;44:518-526. https://doi.org/https://doi.org/10.4163/kjn.2011.44.6.518
  23. Kawakami T, Hanao N, Nishiyama K, Kadota Y, Inoue M, Sato M, et al. Differential effects of cobalt and mercury on lipid metabolism in the white adipose tissue of high-fat diet-induced obesity mice. Toxicol Appl Pharmacol. 2012;258:32-42. https://doi.org/10.1016/j.taap.2011.10.004
  24. Chang JW, Chen HL, Su HJ, Liao PC, Guo HR, Lee CC. Simultaneous exposure of non-diabetics to high levels of dioxins and mercury increases their risk of insulin resistance. J Hazard Mater. 2011;185:749-755. https://doi.org/10.1016/j.jhazmat.2010.09.084
  25. Houston MC. Role of mercury toxicity in hypertension, cardiovascular disease, and stroke. J Clin Hypertens (Greenwich). 2011;13:621-627. https://doi.org/10.1111/j.1751-7176.2011.00489.x
  26. Tinkov AA, Ajsuvakova OP, Skalnaya MG, Popova EV, Sinitskii AI, Nemereshina ON, et al. Mercury and metabolic syndrome: a review of experimental and clinical observations. Biometals. 2015;28:231-254. https://doi.org/10.1007/s10534-015-9823-2
  27. Salonen JT, Seppanen K, Lakka TA, Salonen R, Kaplan GA. Mercury accumulation and accelerated progression of carotid atherosclerosis: a population-based prospective 4-year follow-up study in men in eastern finland. Atherosclerosis. 2000;148:265-273. https://doi.org/10.1016/s0021-9150(99)00272-5
  28. Bautista LE, Stein JH, Morgan BJ, Stanton N, Young T, Nieto FJ. Association of blood and hair mercury with blood pressure and vascular reactivity. Wmj. 2009;108:250-252.
  29. Kobal AB, Horvat M, Prezelj M, Briski AS, Krsnik M, Dizdarevic T, et al. The impact of long-term past exposure to elemental mercury on antioxidative capacity and lipid peroxidation in mercury miners. J Trace Elem Med Biol. 2004;17:261-274. https://doi.org/https://doi.org/10.1016/S0946-672X(04)80028-2
  30. Roy C, Tremblay PY, Ayotte P. Is mercury exposure causing diabetes, metabolic syndrome and insulin resistance? A systematic review of the literature. Environ Res. 2017;156:747-760. https://doi.org/10.1016/j.envres.2017.04.038