title: Association of blood manganese level with diabetes and renal dysfunction: a cross-sectional study of the Korean general population.
abstract: BACKGROUND
  The purpose of this study was to evaluate the association between blood manganese levels and the prevalence of chronic diseases in the Korean population.
  
  
  METHODS
  This was a cross-sectional study based on the Korean National Health and Nutrition Examination Survey (KNAHNES). The study included 3996 participants 20 years of age or older whose blood manganese levels had been measured. The participants were also evaluated for the presence of five chronic diseases: diabetes, renal dysfunction, hypertension, ischemic heart disease, and stroke.
  
  
  RESULTS
  Blood manganese levels were significantly lower in the diabetes group compared with the non-diabetes group (1.26 ± 0.02 vs. 1.35 ± 0.01 μg/dL; p = 0.001) and the renal dysfunction group compared with those with normal renal function (1.28 ± 0.03 vs. 1.35 ± 0.01 μg/dL; p = 0.04). There was no significant association between blood manganese levels and the presence of ischemic heart disease or stroke. A multivariate logistic regression analysis adjusted for age, sex, and body mass index was performed; the odds ratio was 0.652 (95% CI: 0.46-0.92) for diabetes and 0.589 (95% CI: 0.39-0.88) for renal dysfunction when comparing the higher quartiles (Q2-4) with the lowest quartile (Q1) of blood manganese level. The prevalence of diabetes was 7.6% in Q1 and 5.3% in Q2-4 (p = 0.02). Similarly, the prevalence of renal dysfunction was 6.8% in Q1, compared with 4.6% in Q2-4 (p = 0.02).
  
  
  CONCLUSIONS
  The prevalence of diabetes and renal dysfunction increased in participants with low blood manganese levels, suggesting that blood manganese may play a role in glucose homeostasis and renal function.
authors.forename: Eun Sil
authors.initials: ES
authors.lastname: Koh
authors.forename: Sung Jun
authors.initials: SJ
authors.lastname: Kim
authors.forename: Hye Eun
authors.initials: HE
authors.lastname: Yoon
authors.forename: Jong Hee
authors.initials: JH
authors.lastname: Chung
authors.forename: Sungjin
authors.initials: S
authors.lastname: Chung
authors.forename: Cheol Whee
authors.initials: CW
authors.lastname: Park
authors.forename: Yoon Sik
authors.initials: YS
authors.lastname: Chang
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seoul 137-701, Republic of Korea. imkidney@catholic.ac.kr.
authors.forename: Seok Joon
authors.initials: SJ
authors.lastname: Shin