Heavy metals and metalloids exposure and liver function in Chinese adults - A nationally representative cross-sectional study.

BACKGROUND: In China, the effects of heavy metals and metalloids (HMMs) on liver health are not consistently documented, despite their prevalent environmental presence. OBJECTIVE: Our research assessed the association between HMMs and liver function biomarkers in a comprehensive sample of Chinese adults. METHODS: We analyzed data from 9445 participants in the China National Human Biomonitoring survey. Blood and urine were evaluated for HMM concentrations, and liver health was gauged using serum albumin (ALB), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) metrics. Various statistical methods were employed to understand the relationship between 11 HMMs and liver function, adjusting for multiple factors. We also explored interactions with alcohol intake, gender, and age. RESULTS: Among HMMs, selenium in blood [weighted geometric mean (GM) = 95.56 µg/L] and molybdenum in urine (GM = 46.44 µg/L) showed the highest concentrations, while lead in blood (GM = 21.92 µg/L) and arsenic in urine (GM = 19.80 µg/L) had the highest levels among risk HMMs. Manganese and thallium consistently indicated potential risk factor to liver in both sample types, while selenium displayed potential liver protection. Blood HMM mixtures were negatively associated with ALB (ß = -0.614, 95% CI: -0.809, -0.418) and positively with AST (ß = 0.701, 95% CI: 0.290, 1.111). No significant associations were found in urine HMM mixtures. Manganese, tin, nickel, and selenium were notable in blood mixture associations, with selenium and cobalt being significant in urine. The relationship of certain HMMs varied based on alcohol consumption. CONCLUSION: This research highlights the complex relationship between HMM exposure and liver health in Chinese adults, particularly emphasizing metals like manganese, thallium, and selenium. The results suggest a need for public health attention to low dose HMM exposure and underscore the potential benefits of selenium for liver health. Further studies are essential to establish causality.

Vitamin B12 is associated negatively with anemia in older Chinese adults with a low dietary diversity level: evidence from the Healthy Ageing and Biomarkers Cohort Study (HABCS).

OBJECTIVE: The associations between plasma vitamin B12 level and anemia under different dietary patterns in elderly Chinese people are poorly understood. We aimed to examine the associations between plasma vitamin B12 levels and anemia under different dietary patterns in adults aged 65 years and older in nine longevity areas in China. METHODS: A total of 2405 older adults completed a food frequency questionnaire at the same time as a face-to-face interview. The dietary diversity score (DDS) was assessed based on the food frequency questionnaire, with the low DDS group referring to participants with a DDS score ≤ 4 points. Vitamin B12 levels were divided into two groups of high (>295 pg/mL) and low (≤ 295 pg/mL) with the median used as the cut-off point. Sub-analyses were also performed on older adults divided into tertiles of vitamin B12 levels: low (< 277 pg/mL), medium (277-375 pg/mL) and high (> 375 pg/mL) to study the association of these levels with anemia. RESULTS: Six hundred ninety-five (28.89%) of these people were diagnosed with anemia and had a mean age of 89.3 years. Higher vitamin B12 levels were associated with a decreased risk of anemia (multi-adjusted OR, 0.59, [95% CI, 0.45 ~ 0.77] P < 0.001) in older adults with a low DDS, whereas no significant association between vitamin B12 levels and anemia was found in older adults with a high DDS in a full-model after adjustment for various confounding factors (multi-adjusted OR, 0.88, [95% CI, 0.65 ~ 1.19], P = 0.41). CONCLUSION: The relationship between vitamin B12 levels and the prevalence of anemia was significant only when the level of dietary diversity in the older adults was relatively low. The dietary structure of the population should be taken into consideration in combination in order to effectively improve anemia status by supplementing vitamin B12.

The Relationship Between Physical Activity and All-Cause Mortality Among Older Adults - China, 1998-2018.

What is already known about this topic?: Previous research indicates that non-occupational physical activity can reduce mortality risk. Nevertheless, the relationship between occupational physical activity and health improvements has not been consistently established. What is added by this report?: The study found that regular exercise and leisure activities reduced the risk of all-cause mortality. However, the combination of exercise and leisure activities demonstrated more substantial benefits. Additionally, no meaningful association was identified between physical work and mortality risk within the older population. What are the implications for public health practice?: It may be beneficial to encourage older adults to engage in regular exercise and to partake actively in leisure activities. Combining these two elements might yield greater benefits than regular exercise alone.

Associations Between Specific Diets, Dietary Diversity, and Cognitive Frailty in Older Adults - China, 2002-2018.

What is already known about this topic?: The relationship between specific dietary patterns and dietary diversity with cognitive frailty continues to be a subject of ambiguity. What is added by this report?: This research revealed that regular consumption of fruit, meat, bean products, garlic, and tea was connected to a decreased risk of cognitive frailty. Compared to participants with dietary diversity score (DDS) ≤6 points, those with DDS of 9-10, 11-12, and ≥12 had a lower risk of cognitive frailty. What are the implications for public health practice?: The results of the study corroborate the relationship between the augmented consumption frequency of meat, fruit, bean products, garlic, and tea, in conjunction with an elevated DDS, and an increased risk of developing cognitive frailty.

Population Attributable Fractions for Modifiable Factors of Longevity and Healthy Longevity Among the Late-Elderly Aged 75 Years or Older - China, 1998-2018.

What is already known about this topic?: Limited evidence on healthy longevity was provided in the world, and no studies investigated the fractions of healthy longevity attributed to modifiable factors. What is added by this report?: Incidences of longevity and healthy longevity in China are provided. It reveals that the total weighted population attributable fractions for lifestyles and all modifiable factors were 32.8% and 83.7% for longevity, respectively, and 30.4% and 73.4% for healthy longevity, respectively. What are the implications for public health practice?: China has a high potential for longevity and healthy longevity. Strategies may be targeted at education and residence in early life as well as healthy lifestyles, disease prevention, and functional optimization in late life.

Association of low cadmium and mercury exposure with chronic kidney disease among Chinese adults aged ≥80 years: A cross-sectional study.

BACKGROUND: The heavy metals cadmium (Cd) and mercury (Hg) are known to be widespread environmental contaminants and high occupational exposure adversely affects the risk of chronic kidney disease (CKD). However, evidence from epidemiological studies linking low Cd and Hg exposure (or non-industrial) to the risk of progression to CKD are conflicting. This study aimed to explore the association of low Cd and Hg exposure with the risk of CKD in Chinese adults aged ≥80 years. METHODS: The participants were recruited for the Healthy Aging and Biomarkers Cohort Study in 2017, an ongoing perspective survey conducted in longevity areas in China initially involving 3016 older adults. We used logistic regression models to estimate odds ratios (ORs) with 95% confidence intervals of CKD setting Cd and Hg as categorical variables. Logistic regression with restricted cubic spline was used to characterize a dose-response relationships between Cd or Hg concentrations and the risk of CKD in the study population. RESULTS: The ORs for the risk of CKD comparing the fourth to the first quartile of blood Cd, blood Hg, urine Cd, and urine Hg were 1.77, 1.57, 2.03, and 1.50, respectively. Restricted cubic spline models showed that blood Cd and urine Hg were significantly linearly correlated with the risk of CKD, while blood Hg and urine Cd were non-linearly correlated with the risk of CKD with a steeper slope at concentrations <2.30 µg/L and 3.30 µg/g creatinine. CONCLUSIONS: Our findings suggest that even low Cd and Hg exposure (or non-industrial) were associated with increased risk of CKD in Chinese oldest old, although we did not find a significant multiplicative and additive interaction between Cd and Hg levels in relation to the risk of CKD.

Declines in Blood Lead Levels Among General Population - China, 2000-2018.

What is already known about this topic?: Environmental and occupational lead exposure has generally declined in the past two decades. However, there is no large-scale monitoring of blood lead levels (BLLs) in the Chinese general population. What is added by this report?: This nationally representative study showed declines of BLLs in all ages of participants; for children aged 3-5 years, down from 78.1 µg/L to 16.9 µg/L, corresponding to 78.4% decrease in the past two decades (2000-2018). What are the implications for public health practice?: Recommendations for elevated BLLs on screening children at high risk now need to be revisited and updated from 100 µg/L to 50 µg/L in guidelines to conform with the substantial declines in China.

[Association between anemia and 3-year all-cause mortality among oldest old people in longevity areas in China].

OBJECTIVE: To explore the association between anemia and 3-year all-cause mortality among the oldest old people in longevity areas in China. METHODS: In August 2012, questionnaire survey, health examination and blood test were conducted among 929 old people aged ≥ 80 years in 7 longevity areas in China, who were included in Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2009. Cox regression model was used to evaluate the association between anemia or different hemoglobin levels and mortality. RESULTS: Among the 929 subjects, the prevalence of anemia was 49.6%, the main form of anemia was normocytic anemia. During the three year follow-up period, a total of 447 subjects died, the overall mortality was 49.8% (56.0% in subjects with anemia and 43.3% in subjects without anemia). Compared with the subjects without anemia, the mortality risk increased by 25% in the subjects with anemia after adjusting confounding factors (HR = 1.25, 95% CI: 1.03-1.52). Macrocytic anemia, simplex microcytic anemia and microcytic hypochromic anemia were all associated with the increased mortality in the oldest old people. Compared with the subjects with low hemoglobin concentration, the subjects with high hemoglobin concentration had a lower mortality risk, and the association was more obvious in women. CONCLUSION: Anemia and low hemoglobin concentration were associated with higher mortality risk in the oldest old people in China, indicating the importance of anemia prevention and treatment among this population.

[Direct economic burden of cerebrovascular disease, during 1993-2008 in China].

OBJECTIVE: To evaluate the status and trend of direct economic burden on cerebrovascular disease, from 1993 to 2008 in China. METHODS: Using two-step model to calculate the economic cost with related trend of cerebrovascular disease within the population among the over 30-year-olds, from 1993 to 2008. Data was gathered from the National Health Service Surveys Analysis Reports of 1993, 1998, 2003 and 2008, that including both direct outpatient and inpatient cost. RESULTS: There appeared a significant increase on the burden of cerebrovascular diseases in the period of 15 years, with direct economic cost increasing from 8.473 billion to 103.125 billion RMB. In fact, the actual increase was 5.3 times, without the influence of the price. The average annual growth rate was 13.1%, exceeding the rate of total expenditure on health and GDP during the same time span. In addition, the growth rate in 2003-2008 was the fastest, which appeared to be 19.8%. CONCLUSION: Burden that caused by cerebrovascular disease on individuals and the whole society was heavy which warrented further theoratical and practical studies on it.