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Associations between metabolic syndrome and four heavy metals: A systematic review and meta-analysis
Journal article   Peer reviewed

Associations between metabolic syndrome and four heavy metals: A systematic review and meta-analysis

Ping Xu, Aiping Liu, Fengna Li, Alexey A. Tinkov, Longjian Liu and Ji-Chang Zhou
Environmental pollution (1987), v 273, 116480
15 Mar 2021
DOI: https://doi.org/10.1016/j.envpol.2021.116480
PMID: 33486246
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Arsenic Cadmium Lead Mercury Metabolic syndrome
Four most concerned heavy metal pollutants, arsenic, cadmium, lead, and mercury may share common mechanisms to induce metabolic syndrome (MetS). However, recent studies exploring the relationships between MetS and metal exposure presented inconsistent findings. We aimed to clarify the relationship between heavy metal exposure biomarkers and MetS using a meta-analysis and systematic review approach. Literature search was conducted in international and the Chinese national databases up to June 2020. Of selected studies, we extracted the relevant data and evaluated the quality of each study’s methodology. We then calculated the pooled effect sizes (ESs), standardized mean differences (SMDs), and their 95% confidence intervals (CIs) using a random-effect meta-analysis approach followed by stratification analyses for control of potential confounders. Involving 55,536 participants, the included 22 articles covered 52 observational studies reporting ESs and/or metal concentrations on specific metal and gender. Our results show that participants with MetS had significantly higher levels of heavy metal exposure [pooled ES = 1.16, 95% CI: 1.09, 1.23; n = 42, heterogeneity I2 = 75.6%; and SMD = 0.22, 95% CI: 0.15, 0.29; n = 32, I2 = 94.2%] than those without MetS. Pooled ESs in the subgroups stratified by arsenic, cadmium, lead, and mercury were 1.04 (95% CI: 0.97, 1.10; n = 8, I2 = 61.0%), 1.10 (0.95, 1.27; 11, 45.0%), 1.21 (1.00, 1.48; 12, 82.9%), and 1.26 (1.06, 1.48; 11, 67.7%), respectively. Pooled ESs in the subgroups stratified by blood, urine, and the other specimen were 1.22 (95% CI: 1.08, 1.38; n = 26, I2 = 75.8%), 1.06 (1.00, 1.13; 14, 58.1%), and 2.41 (1.30, 4.43; 2, 0.0%), respectively. In conclusion, heavy metal exposure was positively associated with MetS. Further studies are warranted to examine the effects of individual metals and their interaction on the relationship between MetS and heavy metals. [Display omitted] •Metabolic syndrome (MetS) is threatening human health globally at a high prevalence.•Heavy metals (arsenic, cadmium, lead, and mercury) share mechanisms inducing MetS.•Heavy metal exposure to MetS risk was meta-analyzed by including 55,536 subjects.•Studies meeting the inclusion criteria for meta-analysis were of observational design.•Lead and mercury but not arsenic and cadmium were prominently correlated with MetS. The exposure to heavy metals was positively associated with the prevalence of metabolic syndrome. Exposures to lead and mercury had a stronger association with the risk of metabolic syndrome.

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61 citations in Web of Science
62 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Web of Science research areas
Environmental Sciences
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