Relationships between growth indicators, liver and kidney function markers, and blood concentrations of essential and potentially toxic elements in environmentally exposed young children.

Environmental exposure to multiple metals and metalloids is widespread, leading to a global concern relating to the adverse health effects of mixed-metals exposure, especially in young children living around industrial areas. This study aimed to quantify the concentrations of essential and potentially toxic elements in blood and to examine the potential associations between multiple elements exposures, growth determinants, and liver and kidney function biomarkers in children living in several industrial areas in Dhaka, Bangladesh. The blood distribution of 20 trace elements As, Ag, Bi, Br, Cd, Co, Cr, Cu, I, Mn, Hg, Mo, Ni, Pb, Se, Sb, Tl, V, U, and Zn, growth determinants such as body mass index and body fats, blood pressure, liver and kidney injury biomarkers including serum alanine aminotransferase and alkaline phosphatase activities, serum calcium, and creatinine levels, blood urea nitrogen, and hemoglobin concentrations, and glomerular filtration rate were measured in 141 children, aged six to 16 years. Among these elements, blood concentrations of Ag, U, V, Cr, Cd, Sb, and Bi were measured below LOQs and excluded from subsequent statistical analysis. This comprehensive study revealed that blood concentrations of these elements in children, living in industrial areas, exceeded critical reference values to varying extents; elevated exposure to As, Pb, Br, Cu, and Se was found in children living in multiple industrial areas. A significant positive association between elevated blood Tl concentration and obesity (ß = 0.300, p = 0.007) and an inverse relationship between lower As concentration and underweight (ß = -0.351, p < 0.001) compared to healthy weight children indicate that chronic exposure to Tl and As may influence the metabolic burden and physical growth in children. Concentration-dependent positive associations were observed between the blood concentrations of Cu, Se, and Br and hepatic- and renal dysfunction biomarkers, an inverse association with blood Mo and I level, however, indicates an increased risk of Cu, Se, and Br-induced liver and kidney toxicity. Further in-depth studies are warranted to elucidate the underlying mechanisms of the observed associations. Regular biomonitoring of elemental exposures is also indispensable to regulate pollution in consideration of the long-term health effects of mixed-elements exposure in children.

The prevalence and factors associated with obesity and hypertension in university academic staff: a cross-sectional study in Bangladesh.

Obesity is a major risk factor for hypertension, type 2 diabetes and other morbidities. On the other hand, hypertension is a leading cause of cardiovascular disease. The presence of obesity in hypertensive persons increases cardiovascular risk and related mortality. Data on the prevalence of obesity and hypertension in academic staff in Bangladesh are scarce. This study aimed to determine the prevalence and factors associated with obesity and hypertension among university academic staff in Bangladesh. In total, 352 academic staff were enrolled in this study from two universities in Bangladesh. A pre-structured questionnaire was used to obtain data on anthropometric, demographic and lifestyle-related factors. Bivariate and multivariate logistic regression analyses were performed to assess the factors associated with obesity and hypertension. Overall, the prevalence of general and abdominal obesity and hypertension was 26.7%, 46.9% and 33.7%, respectively. Female staff had a significantly higher prevalence of both general and abdominal obesity (41% and 64.1%, respectively) than male staff (21.5% and 34.9%, respectively) (p < 0.001). In contrast, male staff had a higher prevalence of hypertension (36.9%) than female staff (25.6%)(p < 0.001). An increased prevalence of hypertension was found in the higher BMI and WC groups of the participants. The prevalence of general obesity, abdominal obesity and hypertension was higher in the 30-40 years, > 50 years and 41-50 years age groups, respectively. According to the regression analysis, female gender and inadequate physical activity were independently associated with general and abdominal obesity. On the other hand, increased age, BMI, WC, presence of diabetes and smoking showed a significant association with hypertension. In conclusion, the prevalence of obesity and hypertension was higher among university academic staff members in Bangladesh. Our findings suggest that comprehensive screening programs are needed to facilitate the diagnosis, control, and prevention of obesity and hypertension in high-risk population groups.

Association of microalbuminuria with metabolic syndrome: a cross-sectional study in Bangladesh.

BACKGROUND AND AIMS: The objectives of this study were to estimate the prevalence of microalbuminuria and examine the association of microalbuminuria with metabolic syndrome (MetS) and its component in a Bangladeshi adult cohort. METHODS: This cross-sectional study included 175 subjects (84 males and 91 females; aged 19-59 years), recruited from the outdoor Department of Medicine and Endocrinology of a medical college hospital in Dhaka, Bangladesh. Lipid profile and fasting blood glucose (FBG) were measured in serum and albumin and creatinine were determined in urine samples. Microalbuminuria was defined as the urinary albumin-to-creatinine ratio (ACR) of 30 to 300 mg/g. The MetS was defined according to the criteria of the National Cholesterol Education Program (NECP). The association of microalbuminuria with MetS and its components was evaluated by multivariate logistic regression analysis. RESULTS: Among the study subjects, 66.3% were hypertensive and 70.3% were diabetic individuals. Overall, the prevalence of microalbuminuria was 29.7% with 31% in males and 28.6% in females. Microalbuminuria was 2.6 fold higher in hypertensive and diabetic adults than in the non-hypertensive or non-diabetic adults. The prevalence of microalbuminuria was much more frequent in persons with the MetS (36.0%) than the persons without the MetS (5.4%). The levels of FBG, systolic blood pressure (SBP), diastolic blood pressure (DBP) and triglycerides were significantly higher (p < 0.01 for all cases) in subjects with microalbuminuria. In regression analysis, after adjusting for sex, age, and body mass index, microalbuminuria was strongly correlated with MetS followed by elevated BP and FBG (p < 0.01 for all cases). CONCLUSIONS: Microalbuminuria was strongly associated with MetS in Bangladeshi adults. Elevated BP and FBG were the most predominant components of MetS among the study subjects. Comprehensive management of MetS at its early stage can be effective to prevent and reduce the progression of kidney injury and cardiovascular complications.

Relationship between serum uric acid and hypertension: a cross-sectional study in Bangladeshi adults.

Experimental evidence suggests a causal role of serum uric acid (SUA) in hypertension development. Currently, there are few data available on the association between SUA and hypertension; data from Bangladeshi adults are not available yet. This study evaluated the association of SUA with hypertension among Bangladeshi adults. Blood samples were obtained from 140 males and 115 females and analyzed for SUA and lipid levels. Hypertension was defined as SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg. All participants were divided into four quartiles based on SUA concentrations. Association of SUA with hypertension was evaluated by logistic regression models. The prevalence of hypertension and prehypertension was significantly higher in male (15.4 and 47.6%, respectively) than in the female (5.6 and 33.4%, respectively) subjects (p < 0.01). Males had a higher mean level of SUA (310.7 ± 67.9 µmol/L) than in the females (255.3 ± 69.3 µmol/L) (p < 0.001). Hyperuricemia was prevalent 9.1% in males and 10.3% in females. An increasing trend for hypertension and prehypertension was found in both genders with increasing SUA levels in the quartiles (p < 0.01). SUA levels in the quartiles were positively correlated with blood pressure (p < 0.01). After adjusting for baseline covariates, SUA levels were significantly associated with hypertension (p < 0.01). Findings of this study indicate the significance of maintaining normal SUA level to prevent hypertension.

Prevalence of hyperuricemia and the relationship between serum uric acid and obesity: A study on Bangladeshi adults.

BACKGROUND AND OBJECTIVES: Recent studies have shown that hyperuricemia is commonly associated with dyslipidemia, cardiovascular diseases, hypertension and metabolic syndrome. Elevated serum uric acid has been demonstrated to be associated with obesity in the adult population in many countries; however, there is still a lack of evidence for the Bangladeshi population. The aims of this study were to evaluate the prevalence of hyperuricemia and determine the relationship between serum uric acid (SUA) and obesity among the Bangladeshi adults. METHODS: In this cross-sectional study, blood samples were collected from 260 adults (142 males and 118 females) and analyzed for SUA and lipid profile. All participants were categorized as underweight (n = 11), normal (n = 66), overweight (n = 120) and obese (n = 63) according to the body mass index (BMI) scale for the Asian population. Based on SUA concentration the participants were stratified into four quartiles (Q1: < 232 µmol/L, Q2: 232-291 µmol/L, Q3: 292-345 µmol/L and Q4: > 345 µmol/L). RESULTS: The mean age and BMI of the participants were 32.5 ± 13.3 years and 24.9 ± 3.8 kg/m2, respectively. The average level of SUA was 294 ± 90 µmol/L with a significant difference between males and females (p < 0.001). Overall, the estimated prevalence of hyperuricemia was 9.3% with 8.4% in male and 10.2% in female participants. There were significant increases in the prevalence of obesity (17.4%, 22.2%, 28.6% and 31.8%, respectively, p < 0.01 for trend) across the SUA quartiles. A multiple logistic regression analysis revealed that SUA quartiles were independently associated with the presence of obesity (p < 0.01). CONCLUSION: Present study indicates a significant positive relationship between SUA and obesity among the Bangladeshi adults. Therefore, routine measurement of SUA is recommended in obese individuals to prevent hyperuricemia and its related complications.

Hypertension prevalence and influence of basal metabolic rate on blood pressure among adult students in Bangladesh.

BACKGROUND: Hypertension is a global health issue and is currently increasing at rapid pace in South Asian countries including Bangladesh. Although, some studies on hypertension have been conducted in Bangladesh, there is a lack of scientific evidence in the adult student population that was missing from the previous and recent national cross-sectional studies. Moreover, the specific risk factors of hypertension in the Bangladeshi adults still need to be investigated. This study was conducted to estimate hypertension prevalence among adult students in Bangladesh and to test the hypothesis of Luke et al. (Hypertension 43:555-560, 2004) that basal metabolic rate (BMR) and blood pressure are positively associated independent of body size. METHOD: The data was collected on 184 adult university students (118 female and 66 male) in Dhaka, Bangladesh. Anthropometric, BMR details and an average of at least two blood pressure measurements were obtained. Hypertension was defined by a systolic blood pressure (SBP) ≥ 140 mmHg and/or, diastolic blood pressure (DBP) ≥ 90 mmHg. RESULTS: Overall, 6.5% of participants had hypertension with significantly (p < 0.001) higher prevalence in male (12.1%) than in the female (3.4%) students. Age and BMI showed positive and significant correlation with hypertension among the students. When adjusted for body mass index (BMI), as well as other potentially confounding variables such as age, sex, smoking status and degree of urbanization, BMR was positively correlated with SBP and DBP (p < 0.001). Thus, higher BMR is associated with SBP and DBP; this is opposite the well documented inverse relationship between physical activity and blood pressure. If the influence of BMR on blood pressure is confirmed, the systematically elevated BMR might be an important predictor that can explain relatively high blood pressure and hypertension in humans. CONCLUSION: This study reports the prevalence and associated risk factors of hypertension in the Bangladeshi adult students. The study also showed a positive association between BMR and blood pressure among the participants. A large scale longitudinal study across the country is needed to find out the underlying causes of hypertension in the Bangladeshi adults. In addition, comprehensive and integrated intervention programs focusing on modifiable risk factors are recommended to make awareness and prevent hypertension.

Vitamin D and Parathyroid Hormone Status in Female Garment Workers: A Case-Control Study in Bangladesh.

Despite the abundant sunlight, vitamin D deficiency is prevalent in South Asian countries including Bangladesh. Information on vitamin D level is insufficient in adults particularly in female garment workers in Bangladesh. This study was designed to evaluate the status of vitamin D, parathormone (PTH), calcium, and alkaline phosphatase (ALP) among the female garment workers in Bangladesh. Blood samples were collected from female garment workers (n = 40, case group) and general female workers (n = 40, control group) in Dhaka. Serum vitamin D, PTH, calcium, and ALP were measured by chemiluminescence microparticle immunoassay. The mean level of vitamin D was significantly (p < 0.001) lower in case (14.2 ± 2.6 ng/mL) than in the control (22.4 ± 2.4 ng/mL) group. No significant difference was found at mean of PTH and calcium between case (33.9 ± 17.2 pg/mL; 9.1 ± 0.6 mg/dL, resp.) and control (35.9 ± 16.3 pg/mL; 9.3 ± 0.6 mg/dL, resp.) group. The mean ALP in case (117.2 ± 14.4 U/L) group was significantly (p < 0.001) higher than the control group (80.5 ± 30.6 U/L). Overall, PTH level did not show significant correlation with vitamin D. However, calcium and ALP levels showed a significant positive (p < 0.05) and negative (p < 0.001) correlation with vitamin D, respectively. This study indicates a high prevalence of vitamin D deficiency in the female garment workers in Bangladesh.

Biomonitoring of ochratoxin A in blood plasma and exposure assessment of adult students in Bangladesh.

SCOPE: Ochratoxin A (OTA), a mycotoxin known for its nephrotoxic, immunotoxic, and carcinogenic effects in animals, deserves attention due to its widespread occurrence as food and feed contaminant. Studies in many countries report the presence of OTA in human blood plasma or serum at variable levels. However, no biomonitoring study has been carried out in so far, and also food analysis data are insufficient to assess OTA exposure. METHODS AND RESULTS: Therefore, 64 blood samples were collected from healthy university students (32 female, 32 male) in Bangladesh for biomarker analysis. OTA and its metabolite ochratoxin alpha were determined in the plasma samples by a validated method using HPLC-fluorescence analysis. After liquid-liquid extraction, OTA was detected in all plasma samples (100%) at a range of 0.20-6.63 ng/mL and ochratoxin alpha was detected in 95% of the samples at 0.10-0.79 ng/mL. The OTA mean level in plasma of males (0.92 ± 1.09 ng/mL) and females (0.78 ± 1.02) were not significantly different. Statistical analysis of food consumption data for the participants, provided in a food frequency questionnaire, did not reveal a significant association between OTA level in plasma and their intake of typical staple foods (rice, wheat, maize, and lentil). CONCLUSION: The dietary intake of OTA (mean 11.7, max 91.7 ng/kg b.w./wk) calculated on the basis of plasma concentration in Bangladeshi students was lower than the tolerable weekly OTA intake (120 ng/kg b.w./wk) set by EFSA. Nonetheless, further biomonitoring is recommended in cohorts from other parts of the country that may have higher mycotoxin exposure than the present group.