Association Between Urinary Rare Earth Element Levels and Metabolic Syndrome: A Cross-sectional Study in the Minority Population of Guangxi in China.

This study aimed to investigate the association between rare earth elements (REEs) and metabolic syndrome (MetS). We used a cross-sectional design based on the baseline data of the Prospective Cohort Study of Chronic Diseases in Ethnic Minority Natural Population in Guangxi in China. Logistic regression and BKMR models were employed to evaluate the association between REEs and risk of MetS. Although REEs were not significantly associated with MetS, certain elements such as La, Pr, and Nd were negatively associated with abdominal obesity, whereas Ce, Pr, Nd, and Dy were positively associated with hypertension. BKMR models suggested a U-shaped relationship between mixed REEs and MetS, with varying effects on abdominal obesity and high blood pressure. This study suggests that exposure to REEs may be associated with a reduced risk of abdominal obesity and an increased risk of high blood pressure.

Xu X ，Lu P ，Luo X ，Wei G ，Huang X ，Lv F ，Mo C ，Lei L ，Huang D ，Su L ，Zeng X ，Qiu X ，Liu S ... -  《-》

Urine is better for rare earth elements bimonitoring in long-term exposed population: An exposure-response relationship study.

With the soaring use of rare earth elements (REEs) worldwidely in high-technology and clean energy industries, there were growing concerns for adverse health effect from the REEs exposure. However, there is a lack of biomonitoring research concerning both urine and blood in population with definite exposure. We performed a biomonitoring study that involved 103 REEs exposed males and 110 males as non-REEs exposed controls. We measured the levels of REEs in environment and urine and blood samples from participants, and explored the exposure-response relationship between REEs in environment and body fluids. The effects of exposure duration and smoking status on the internal exposure level of REEs were also investigated. The results showed environmental REEs level of exposure group was significantly higher than that of control group (range of geometric mean of exposure vs. control: 1.08-4.07 × 104 ng/m3 vs. <LOD-2.16 × 102 ng/m3). Six elements with detection rates higher than 60% in blood or urine samples were lanthanum (La), cerium (Ce), praseodymium (Pr), neodymium (Nd), samarium (Sm), gadolinium (Gd). We found the REEs concentrations both in urine and blood of exposure population were significantly higher than controls, median range of the above 6 elements of urine and blood was 0.02-1.06 μmol/mol vs. <LOD-0.01 μmol/mol creatinine and 0.01-0.79 μg/L vs. <LOD-0.38 μg/L. The correlations between both blood and urine level of REEs and environment level showed significant. The correlation coefficients with urine levels are higher than with blood. Biomonitoring results showed good exposure-response relationship in urine REEs, while no positive response in blood samples. Smoking status, drinking status and years of exposure showed little effect on the level of REEs. Our results suggested that both blood and urine can be used to monitor REEs exposure, while urinary REEs is promising for risk assessment in population.

He Z ，Liu L ，Wang T ，Zhou C ，Zhang X ，Wu N ，Xu M ，Gao J ，Li B ，Wang Y ，Zhi Q ，Zhang C ，Fan Y ，Dai J ，Gao S ，Duan H ... -  《-》

Association of "a body shape index" with the risk of developing colorectal cancer in U.S. patients with metabolic syndrome: evidence from the NHANES 1999-2018.

Colorectal cancer (CRC) is the third most common cancer worldwide and presents a significant challenge to public health. Metabolic syndrome (MetS) is a condition that is predominantly characterized by abdominal obesity and metabolic abnormalities such as hypertension, hyperglycemia, and hyperlipidemia, and it is one of the critical risk factors for CRC. Traditional anthropometric measures have limitations in accurately assessing the risk associated with abdominal obesity. This study aimed to investigate the association between "A Body Shape Index" (ABSI) and the risk of developing CRC among individuals with MetS utilizing data from the National Health and Nutrition Examination Survey (NHANES). This cross-sectional study conducted a statistical analysis of all adult participants who met the diagnostic criteria for MetS in the NHANES data from 1999 to 2018. The ABSI was calculated to quantify abdominal obesity. ABSI is derived from a formula that incorporates waist circumference (WC), body mass index (BMI), and height, and is calculated as ABSI = WC / (BMI^(2/3) × Height^(1/2)). Multivariate logistic regression modeling was used to examine the independent association between ABSI and CRC incidence. Receiver Operating Characteristic (ROC) curves were employed to analyze the ability of ABSI compared to traditional metrics in identifying CRC risk. This study involved 16,018 MetS patients with a mean age of 51.8 years, of whom 50.3% were male and 49.7% were female. Logistic regression adjusted for confounders revealed a significant association between an elevated ABSI and an increased risk of developing CRC (odds ratio (OR): 1.433, 95% confidence interval (CI): 1.116 to 1.841; P = 0.005). ROC analyses confirmed that the predictive accuracy of the ABSI for the risk of developing CRC area under the curve (AUC): (0.668, 95% CI: 0.624 to 0.713) surpassed that of traditional measurement methods. Among individuals with MetS, the ABSI is linked to an elevated risk of developing CRC. Compared with traditional anthropometric indices, the ABSI is a superior predictive marker for the risk of developing CRC.

Kurexi A ，Peng J ，Yao J ，Wang L ，Wang Q ... -  《BMC GASTROENTEROLOGY》

Utility of Anthropometric Indexes for Detecting Metabolic Syndrome in Resource-Limited Regions of Northwestern China: Cross-Sectional Study.

Anthropometric indexes offer a practical approach to identifying metabolic syndrome (MetS) and its components. However, there is a scarcity of research on anthropometric indexes tailored to predict MetS in populations from resource-limited regions. This study aimed to examine the association between 8 easy-to-collect anthropometric indexes and MetS, and determine the most appropriate indexes to identify the presence of MetS for adults in resource-limited areas. A total of 10,520 participants aged 18-85 years from Ningxia Hui Autonomous Region, China, were included in this cross-sectional study. Participants were recruited through a stratified sampling approach from January 1, 2020, to December 31, 2021. MetS was defined using the International Diabetes Federation (IDF) criteria. Eight anthropometric indexes were examined, including BMI, waist-to-height ratio (WHtR), weight-adjusted waist index (WWI), conicity index, a body shape index (ABSI), lipid accumulation products (LAP), visceral obesity index (VAI), and the triglyceride-glucose (TyG) index. Logistic regression analysis and restricted cubic splines (RCSs) were applied to identify the association between the anthropometric indexes. The receiver operating characteristic curve and the area under the curve (AUC) were analyzed to identify and compare the discriminative power of anthropometric indexes in identifying MetS. The Youden index was used to determine a range of optimal diagnostic thresholds. Logistic regression analysis was applied to identify the association between the anthropometric indexes. A total of 3324 (31.60%) participants were diagnosed with MetS. After adjusting for age, ethnicity, current residence, education level, habitual alcohol consumption, and tobacco use, all the 8 indexes were positively correlated with the risks of MetS (P<.05). LAP presented the highest adjusted odds ratios (adjOR 35.69, 95% CI 34.59-36.80), followed by WHtR (adjOR 29.27, 95% CI 28.00-30.55), conicity index (adjOR 11.58, 95% CI 10.95-12.22), TyG index (adjOR 5.53, 95% CI 5.07-6.04), BMI (adjOR 3.88, 95% CI 3.71-4.05), WWI (adjOR 3.23, 95% CI 3.02-3.46), VAI (adjOR 2.11, 95% CI 2.02-2.20), and ABSI (adjOR 1.71, 95% CI 1.62-1.80). Significantly nonlinear associations between the 8 indexes and the risk of MetS (all Pnonlinear<.001) were observed in the RCSs. WHtR was the strongest predictor of MetS for males (AUC 0.91, 95% CI 0.90-0.92; optimal cutoff 0.53). LAP were the strongest predictor of MetS for females (AUC 0.89, 95% CI 0.89-0.90; optimal cutoff 28.67). Statistical differences were present between WHtR and all other 7 anthropometric indexes among males and overall (all P<.05). In females, the AUC values between LAP and BMI, WWI, ABSI, conicity index, VAI, and TyG index were significantly different (P<.001). No statistical difference was observed between LAP and WHtR among females. According to 8 anthropometric and lipid-related indices, it is suggested that WHtR and LAP are the most appropriate indexes for identifying the presence of MetS in resource-limited areas.

Yang D ，Ma L ，Cheng Y ，Shi H ，Liu Y ，Shi C ... -  《JMIR Public Health and Surveillance》

Nonlinear correlation between serum vitamin D levels and the incidence of endometrial polyps in infertile women.

Are serum vitamin D levels associated with the incidence of endometrial polyps (EPs) in infertile patients? Serum 25(OH)D levels were nonlinearly correlated with the incidence of EPs in infertile women. EPs are a common condition that may affect the receptivity of the endometrium in women of reproductive age. Vitamin D regulates cell proliferation and differentiation, apoptosis, angiogenesis, anti-inflammation, and immunomodulation, in addition to its well-known functions in balancing calcium and phosphorus. Previous studies have shown that vitamin D concentrations are associated with reproductive outcomes, and that low vitamin D levels are associated with the incidence of colorectal polyps and nasal polyps. There is little evidence regarding the relationship between EPs and serum vitamin D levels. We conducted a cross-sectional study using data from Guangdong Women and Children Hospital from January 2019 to October 2023, enrolling 3107 patients. A total of 3107 infertile patients who underwent hysteroscopy were included in this study; 642 patients had endometrial polyps and 2465 had a normal uterine cavity. Hysteroscopy findings included risk of EPs, polyp size, percentage of multiple polyps, and incidence of chronic endometritis (CE). Serum vitamin D were assessed by measuring total 25(OH)D using chemiluminescence. According to international guideline recommendations for vitamin D deficiency, patients were divided into two groups: the <50 nmol/l group and the ≥50 nmol/l group. Univariable and multivariable logistic regression models, stratified analyses, and smooth curve fitting were used to examine the relationship between serum 25(OH)D levels and risk of EPs. Of all patients, 23.8% (740/3107) were vitamin D deficient (<50 nmol/l). The incidence of EPs was significantly higher in the 25(OH)D < 50 nmol/l group than in the ≥50 nmol/l group (24.9% vs 19.3%; P = 0.001). However, there were no differences in polyp size, proportion of multiple polyps, and presence of CE between the two groups. After controlling for confounders, 25(OH)D ≥ 50 nmol/l (compared with <50 nmol/l) was negatively associated with risk of EPs (adjusted OR, 0.733; 95% CI, 0.598-0.898). Other variables that had an impact on polyp incidence included BMI, type of infertility, CA125, and CD138-positive plasma cells. In addition, a linear regression model between age and serum 25(OH)D levels showed a positive linear association. Subgroup analyses were performed for different age groups, and the risk of EPs was significantly higher in the 25(OH)D < 50 nmol/l group than in the ≥50 nmol/l group, both in the younger subgroup (23.8% vs 19.1%) and in the older subgroup (28.0% vs 19.9%). The smooth curve fitting model showed a nonlinear correlation between 25(OH)D levels and risk of EPs (nonlinear P-value = 0.020), with an optimal threshold of 51.8 nmol/l for 25(OH)D levels. Moreover, subgroup smooth curve fitting models showed a nonlinear correlation between 25(OH)D levels and polyp risk in patients aged <35 years (nonlinear P-value = 0.010), whereas a linear correlation between 25(OH)D levels and polyp risk was found in patients aged ≥35 years (nonlinear P-value = 0.682). Caution should be exercised in interpreting our findings as this is a correlational study and causality cannot be inferred from our results. In addition, because of strict inclusion and exclusion criteria, our results may not be generalizable to unselected populations, including premenopausal women or women of other races. This study demonstrated for the first time that vitamin D deficiency is an independent risk factor for the incidence of EPs in infertile patients. Identifying modifiable risk factors (e.g. vitamin D deficiency) can help in the development of new strategies for treating polyps or to protect against polyp development. Further clinical intervention trials and laboratory studies are needed to evaluate the effect of vitamin D on the development of EPs and to elucidate the mechanisms. The study was funded by the National Natural Science Foundation of China (82101718) and Natural Science Foundation of Guangdong Province, China (2022A1515010776). No competing interest was involved in this study. N/A.

Zhou R ，Zhu Z ，Dong M ，Wang Z ，Huang L ，Wang S ，Zhang X ，Liu F ... -  《-》