Multiple metals exposure, elevated blood glucose and dysglycemia among Chinese occupational workers.
Exposure to metals may adversely affect cardiometabolic health. The aim of this study is to directly evaluate the roles of multiple metals exposure in glucose homeostasis, the dysfunction of which has been linked to diabetes and cardiovascular diseases (CVDs).



We performed a cross-sectional analysis of baseline data from 464 metal-exposed workers who participated in a large prospective occupational study in China (Jinchang Cohort). The logistic regression model was used to evaluate the association between urinary metal levels and high fasting plasma glucose (high-FPG) (≥ 75th percentile) and dysglycemia.



Increasing levels of urinary nickel were prospectively associated with high-FPG: multivariable odds ratios (ORs) were 1.00 for the 1st quartile (lowest), 1.20 (95% confidence interval [CI]: 0.60-2.43) for the 2nd quartile, 1.64 (0.78-3.49) for the 3rd quartile and 3.17 (1.38-7.30) for the 4th quartile (highest) (P-trend=0.004). The positive associations were also observed between urinary zinc and high-FPG (4th vs. 1st quartile=2.71, 95%CI: 1.26-5.84, P-trend=0.01). Inverse associations between urinary cobalt and risk of high-FPG and dysglycemia were observed (P-trend <0.05). For dysglycemia, the positive trends of increasing levels of urinary nickel and zinc still remained, although urinary nickel was no longer statistically significant. A significant association between urinary arsenic and dysglycemia was also found. However, no associations were observed between urinary copper, cadmium, and risk of high-FPG or dysglycemia.



Multiple urinary metals, particularly arsenic, nickel, zinc, and cobalt, were associated with elevated blood glucose among Chinese occupational workers, supporting the notion that metal exposure plays a critical role in the development of diabetes.
Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China; Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA.
Aimin
A
Yang
Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA; Department of Medicine (Endocrinology), Rhode Island Hospital and the Alpert Medical School, Brown University, Providence, RI. USA.
Simin
S
Liu
Center of Medical Laboratory, Lanzhou University, Lanzhou, Gansu, China.
Ning
N
Cheng
Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang, Gansu, China.
Hongquan
H
Pu
Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China.
Min
M
Dai
Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang, Gansu, China.
Jiao
J
Ding
Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
Juansheng
J
Li
Center of Medical Laboratory, Lanzhou University, Lanzhou, Gansu, China.
Haiyan
H
Li
Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
Xiaobin
X
Hu
Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
Xiaowei
X
Ren
Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China.
Jie
J
He
Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA. Electronic address: tongzhang_zheng@brown.edu.
Tongzhang
T
Zheng
Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China. Electronic address: baiyana@lzu.edu.cn.
Yana
Y
Bai
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology; D005260:Female; D044882:Glucose Metabolism Disorders / Q000453:epidemiology* / Q000652:urine; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology* / Q000652:urine; D008297:Male; D008670:Metals / Q000032:analysis / Q000652:urine*; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis* / Q000706:statistics & numerical data; D012307:Risk Factors; D014937:Work / Q000706:statistics & numerical data
D001786:Blood Glucose; D008670:Metals
Diabetes; Dysglycemia; Glucose; Metal; Occupation