Association of urinary levels of trace metals with type 2 diabetes and obesity in postmenopausal women in Korea: A community-based cohort study

Min Kyong Moon; Gowoon Lee; Sohyeon Choi; Inae Lee; Aram Lee; Min Joo Kim; Suhyun Park; Yoon Hee Cho; Young Joo Park; Sohee Oh; Jeongim Park; Nam H Cho; Kyungho Choi

doi:10.1016/j.ijheh.2024.114508

Association of urinary levels of trace metals with type 2 diabetes and obesity in postmenopausal women in Korea: A community-based cohort study

Int J Hyg Environ Health. 2024 Dec 19:264:114508. doi: 10.1016/j.ijheh.2024.114508. Online ahead of print.

Authors

Min Kyong Moon¹, Gowoon Lee², Sohyeon Choi³, Inae Lee⁴, Aram Lee³, Min Joo Kim⁵, Suhyun Park⁶, Yoon Hee Cho⁷, Young Joo Park⁸, Sohee Oh⁹, Jeongim Park³, Nam H Cho¹⁰, Kyungho Choi¹¹

Affiliations

¹ Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea; Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea.
² Graduate School of Public Health, Seoul National University, Seoul, South Korea; Department of Safety Engineering, Korean National University of Transportation, Chungju, South Korea.
³ Department of Environmental Health Sciences, Soonchunhyang University, Asan, South Korea.
⁴ Department of Public Health, Keimyung University, Daegu, South Korea.
⁵ Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
⁶ Graduate School of Public Health, Seoul National University, Seoul, South Korea.
⁷ Center for Environmental Health Sciences, Department of Biomedical and Pharmaceutical Sciences, University of Montana, Missoula, MT, USA.
⁸ Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea; Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea.
⁹ Medical Research Collaborating Center, Seoul National University Boramae Medical Center, Seoul, South Korea.
¹⁰ Department of Preventive Medicine, Ajou University School of Medicine, Suwon, South Korea. Electronic address: chnaha@ajou.ac.kr.
¹¹ Graduate School of Public Health, Seoul National University, Seoul, South Korea. Electronic address: kyungho@snu.ac.kr.

PMID: 39705866
DOI: 10.1016/j.ijheh.2024.114508

Abstract

Several toxic metals have been associated with metabolic diseases like obesity and diabetes mellitus (DM) in humans. However, knowledge regarding the influence of many trace elements, especially in combination with essential elements is limited. This study aims to address this research gap by investigating the associations of both non-essential and essential inorganic trace elements in urine with DM and obesity, employing a group of postmenopausal women (n = 851) from the Korean Genome and Epidemiology Study (KoGES) cohort. Urine samples were collected during 2017-2018, and were analyzed for 19 trace elements using inductively coupled plasma-mass spectrometry and an automatic mercury analyzer. Outcomes of interest were metabolic diseases (DM and obesity) and DM-related traits (insulin resistance and β-cell function). After adjustment of covariates, such as age, alcohol consumption, smoking status, educational level, and daily energy intake, urinary Zn, Ni, Tl, and U levels were associated with the prevalence of DM and homeostatic model assessment (HOMA) for insulin resistance (IR) in the postmenopausal women. In the whole mixture model, however, no significant association was observed for the prevalence of DM. Urinary levels of Zn were negatively associated with HOMA of β-cell function (HOMA-β), positively correlated with HbA1c levels, HOMA-IR, and prevalent DM. In addition, urinary Zn, Co, Tl, and Cs were positively associated with obesity (body mass index ≥25 kg/m²). The present observation shows that several individual elements and their mixtures may be associated with the prevalence of DM, IR, or obesity.

Keywords: Diabetes mellitus; Essential elements; Insulin resistance; Obesity; Toxic metals.