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Circulation. Cardiovascular Quality and... Apr 2023Behavioral weight management programs (BWMPs) enhance weight loss in the short term, but longer term cardiometabolic effects are uncertain as weight is commonly... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Behavioral weight management programs (BWMPs) enhance weight loss in the short term, but longer term cardiometabolic effects are uncertain as weight is commonly regained. We assessed the impact of weight regain after BWMPs on cardiovascular risk factors, diabetes, and cardiovascular disease.
METHODS
Trial registries, 11 databases, and forward-citation searching (latest search, December 19) were used to identify articles published in English, from any geographical region. Randomized trials of BWMPs in adults with overweight/obesity reporting cardiometabolic outcomes at ≥12 months at and after program end were included. Differences between more intensive interventions and comparator groups were synthesized using mixed-effects, meta-regression, and time-to-event models to assess the impact of weight regain on cardiovascular disease incidence and risk.
RESULTS
One hundred twenty-four trials reporting on ≥1 cardiometabolic outcomes with a median follow-up of 28 (range, 11-360) months after program end were included. Median baseline participant body mass index was 33 kg/m; median age was 51 years. Eight and 15 study arms (7889 and 4202 participants, respectively) examined the incidence of cardiovascular disease and type 2 diabetes, respectively, with imprecise evidence of a lower incidence for at least 5 years. Weight regain in BWMPs relative to comparators reduced these differences. One and 5 years after program end, total cholesterol/HDL (high-density lipoprotein) ratio was 1.5 points lower at both times (82 studies; 19 003 participants), systolic blood pressure was 1.5 mm mercury and 0.4 mm lower (84 studies; 30 836 participants), and HbA1c (%) 0.38 lower at both times (94 studies; 28 083 participants). Of the included studies, 22% were judged at high risk of bias; removing these did not meaningfully change results.
CONCLUSIONS
Despite weight regain, BWMPs reduce cardiometabolic risk factors with effects lasting at least 5 years after program end and dwindling with weight regain. Evidence that they reduce the incidence of cardiovascular disease or diabetes is less certain. Few studies followed participants for ≥5 years.
REGISTRATION
URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD42018105744.
Topics: Adult; Humans; Middle Aged; Diabetes Mellitus, Type 2; Cardiovascular Diseases; Incidence; Weight Reduction Programs; Weight Gain
PubMed: 36974678
DOI: 10.1161/CIRCOUTCOMES.122.009348 -
Journal of Environmental Health Science... Jun 2020Exposure to mercury is one of the major global health concerns due to its stability, bioaccumulation and high toxicity. Therefore, the present study was conducted to... (Review)
Review
Exposure to mercury is one of the major global health concerns due to its stability, bioaccumulation and high toxicity. Therefore, the present study was conducted to assess the mean mercury level in hair and breast milk (BM) of Iranian lactating mothers (ILMs) through meta-analysis technique. We conducted a systematic literature search in online electronic databases included main domestic databases (SID, Magiran, Iran medex, Medlib and ISC) and international databases (Embase, Scopus and PubMed) for studies published between 2000 up 2018. Each process of research and evaluation of articles based on inclusion and exclusion criteria is done by two researchers, individually. From10 studies entered to meta-analysis process including 556 ILM, the mean hair mercury level (HML) and mean milk mercury level (MML) was estimated to be 0.15 μg/g (95 CI: 0.11-0.19, I2: 47.6%, P: 0.028) and 0.51 μg/l (95 CI: 0.28-0.74, I2: 1.9%, P: 0.421), respectively. In this meta-analysis, the mean HML and mean MML were estimated to be lower than the standard of World Health Organization (WHO). Although the mean mercury level in hair and BM of ILMs was lower than the WHO standard, but due to toxicity and serious concern of health, management and Periodic monitor are recommended in different cities of the country for evaluate the mercury levels in hair and BM of ILMs and to estimate the infant's exposure.
PubMed: 32399246
DOI: 10.1007/s40201-020-00460-5 -
Toxicology and Applied Pharmacology Feb 2014Reports from human case studies indicate a half-life for inorganic mercury in the brain in the order of years-contradicting older radioisotope studies that estimated... (Review)
Review
Reports from human case studies indicate a half-life for inorganic mercury in the brain in the order of years-contradicting older radioisotope studies that estimated half-lives in the order of weeks to months in duration. This study systematically reviews available evidence on the retention time of inorganic mercury in humans and primates to better understand this conflicting evidence. A broad search strategy was used to capture 16,539 abstracts on the Pubmed database. Abstracts were screened to include only study types containing relevant information. 131 studies of interest were identified. Only 1 primate study made a numeric estimate for the half-life of inorganic mercury (227-540 days). Eighteen human mercury poisoning cases were followed up long term including autopsy. Brain inorganic mercury concentrations at death were consistent with a half-life of several years or longer. 5 radionucleotide studies were found, one of which estimated head half-life (21 days). This estimate has sometimes been misinterpreted to be equivalent to brain half-life-which ignores several confounding factors including limited radioactive half-life and radioactive decay from surrounding tissues including circulating blood. No autopsy cohort study estimated a half-life for inorganic mercury, although some noted bioaccumulation of brain mercury with age. Modelling studies provided some extreme estimates (69 days vs 22 years). Estimates from modelling studies appear sensitive to model assumptions, however predications based on a long half-life (27.4 years) are consistent with autopsy findings. In summary, shorter estimates of half-life are not supported by evidence from animal studies, human case studies, or modelling studies based on appropriate assumptions. Evidence from such studies point to a half-life of inorganic mercury in human brains of several years to several decades. This finding carries important implications for pharmcokinetic modelling of mercury and potentially for the regulatory toxicology of mercury.
Topics: Animals; Brain; Half-Life; Humans; Mercury; Mercury Poisoning; Models, Animal
PubMed: 24368178
DOI: 10.1016/j.taap.2013.12.011 -
Biological Trace Element Research Feb 2022Metals, many of which are potentially toxic, are present in the aquatic environment originated from both natural and anthropogenic sources. In these ecosystems, these... (Review)
Review
Metals, many of which are potentially toxic, are present in the aquatic environment originated from both natural and anthropogenic sources. In these ecosystems, these elements are mostly deposited in the sediment, followed by water dissolution, potentially contaminating resident biota. Among several aquatic animals, crustaceans are considered excellent bioindicators, as they live in close contact with contaminated sediment. The accumulation of metal, whether they are classified as essential, when in excessive quantities or nonessential, not only cause damage to the health of these animals, but also to the man who consumes seafood. Among the main toxic elements to animal and human health are aluminum, arsenic, cadmium, chromium, copper, lead, mercury, nickel and silver. In this context, this systematic review aimed to investigate the dynamics of these metals in water, the main bioaccumulative tissues in crustaceans, the effects of these contaminants on animal and human health, and the regulatory limits for these metals worldwide. A total of 91 articles were selected for this review, and an additional 68 articles not found in the three assessed databases were considered essential and included, totaling 159 articles published between 2010 and 2020. Our results indicate that both chemical speciation and abiotic factors such as pH, oxygen and salinity in aquatic environments affect element bioavailability, dynamics, and toxicity. Among crustaceans, crabs are considered the main bioindicator biological system, with the hepatopancreas appearing as the main bioaccumulator organ. Studies indicate that exposure to these elements may result in nervous, respiratory, and reproductive system effects in both animals and humans. Finally, many studies indicate that the concentrations of these elements in crustaceans intended for human consumption exceed limits established by international organizations, both with regard to seafood metal contents and well as daily, weekly, or monthly intake limits set for humans, indicating consumer health risks.
Topics: Animals; Ecosystem; Environmental Biomarkers; Environmental Monitoring; Humans; Metals; Risk Assessment; Seafood; Water Pollutants, Chemical
PubMed: 33788164
DOI: 10.1007/s12011-021-02685-3 -
American Journal of Kidney Diseases :... Jul 2013Kidney injury from mercury is known to cause dose-related tubular dysfunction and idiosyncratic nephrotic syndrome according to various case reports. Motivated by a... (Review)
Review
Kidney injury from mercury is known to cause dose-related tubular dysfunction and idiosyncratic nephrotic syndrome according to various case reports. Motivated by a patient with subacute-onset nephrotic syndrome, histologic features of secondary focal segmental glomerulosclerosis, and concurrent mercury toxicity, we conducted a systematic review to explore renal histologic changes in patients with toxic mercury exposures and nephrotic syndrome. Data were extracted from a patient's clinical record. MEDLINE/Ovid was searched from 1950 to November 2010 using a prespecified search strategy. Two nephrology textbooks and the UpToDate online database also were searched. Inclusion criteria were studies of humans with nephrotic syndrome, nephrotic-range proteinuria, or kidney biopsy results reported. There were no exclusion criteria. We identified 27 other reports of 42 patients with nephrotic syndrome or nephrotic-range proteinuria. Of the 26 individuals, including our patient, who underwent kidney biopsy, histology showed glomerular disease in 21. Of these 20 biopsies, 4 showed minimal change disease and 15 showed membranous glomerulonephritis. Mercury exposure can lead to various glomerular lesions; we emphasize the importance of a careful occupational and dietary history in elucidating a cause for the undetermined nephrotic syndrome.
Topics: Animals; Environmental Exposure; Fishes; Fresh Water; Humans; Male; Mercury; Middle Aged; Nephrotic Syndrome
PubMed: 23602193
DOI: 10.1053/j.ajkd.2013.02.372 -
Chemosphere Feb 2023The various ingredients and impurities that can be detected within tattoo inks have been associated with a myriad of dermatologic complications. Legislation regarding... (Meta-Analysis)
Meta-Analysis Review
The various ingredients and impurities that can be detected within tattoo inks have been associated with a myriad of dermatologic complications. Legislation regarding these antigenic substances varies widely around the world, with Europe serving as both the research and regulatory center on these intradermal formulations. Although industry is said to be moving away from metallic and metalloid pigments in exchange for organic or organometallic dyes, surveys of commercially available inks continue to detect these elements at concentrations considered unsafe for application into the dermis. In order to better assess the formulation and safety of tattoo ink, we present a systematic review and meta-analysis of studies quantifying restricted metals and metalloids in commercially available tattoo ink products. Among the papers selected, inconsistencies were noted in the degree of specificity by which ink products were identified and the elements sampled for. In addition, the analytical targets' valency and/or solubility were not always considered in accordance with regulation criteria. Of note, chromium, by total content and that of its regulated +6 valency, exceeded its maximum allowed concentration in nearly every sample tested. Total copper content exceeded the limit for soluble copper in half of inks sampled. In descending order, concentrations of cadmium, barium, mercury, soluble copper, arsenic, zinc, antimony, and lead violated regulations in one-sixth or fewer of samples tested. Cobalt and tin levels never violated regulation. Overall, our findings indicate that unsafe levels of restricted elements continue to be detected across studies, warranting further investigation under a regulatory lens.
Topics: Tattooing; Ink; Copper; Metalloids; Metals; Coloring Agents
PubMed: 36436582
DOI: 10.1016/j.chemosphere.2022.137291 -
Food and Chemical Toxicology : An... Aug 2018Human consumption of fish protein, including canned tuna fish, is increasing steadily worldwide. However, there are some concerns about the potential exposure to... (Meta-Analysis)
Meta-Analysis Review
Human consumption of fish protein, including canned tuna fish, is increasing steadily worldwide. However, there are some concerns about the potential exposure to elevated concentrations of metals in canned tuna fish. Several studies have been conducted in Iran regarding the concentration of metals in seafood, including copper (Cu), selenium (Se), iron (Fe), zinc (Zn), mercury (Hg), lead (Pb), chromium (Cr), arsenic (As), nickel (Ni), tin (Sn), and cadmium (Cd) in canned tuna fish. The main aim of this study was to gather data from existing papers and to perform a meta-analysis of the pooled concentrations of metals to evaluate their non-carcinogenic and carcinogenic risks in children and adults consumers. Search was conducted retrieving data from the international biomedical databases with highly public access and consultation, e.g., Web of Science, PubMed, Science Direct, and Scopus, and national database (SID and Irandoc) between 1983 and November of 2017. Data from 23 articles and 1295 samples were assessed and extracted. The ranking order of metals based on mean concentrations (μg/g wet weight) were Fe (13.17) > Zn (9.31) > Se (2.23) > Al (1.8) > Cr (1.63) > Cu (1.52) > As (0.38) > Ni (0.33) > Pb (0.24) > Cd (0.14) > Hg (0.11) > Sn (0.1). Except for Cd and Se, concentrations of other metals in the canned tuna fish were lower than the limits recommended by the United States Environmental Protection Agency (USEPA), World Health Organization (WHO), Food and Agriculture Organization (FAO) and Iran National Standards Organization (INSO). The minimum and maximum target hazard quotient (THQ) for adults were 5.55E-5 for Al and 2.23E-08 for Cr. For children, they were 7.23E-05 for Al and 2.91E-08 for Cr. THQ, and total target hazard quotient (TTHQ) were ≤1.0 for adult and children consumers. The Incremental Lifetime Cancer Risk (ILCR) of As was 3.21E-5 in adults and 4.18E-5 in children. Adults and children that consume canned tuna fish in Iran are not at non-carcinogenic risk but have a carcinogenic risk due to As.
Topics: Animals; Carcinogens; Dietary Exposure; Food Handling; Humans; Iran; Metals; Risk Assessment; Seafood; Tuna
PubMed: 29913231
DOI: 10.1016/j.fct.2018.06.023 -
Ecotoxicology and Environmental Safety Jan 2023Risk assessment of heavy metals is critical in controlling and preventing risks of foodborne diseases. Fish can be used as bioindicators for exposure to potential toxic... (Review)
Review
Risk assessment of heavy metals is critical in controlling and preventing risks of foodborne diseases. Fish can be used as bioindicators for exposure to potential toxic elements (PTEs), which can represent potential risks for humans. The long Iranian coastline and three major fishery regions in the country, including the northern (Caspian Sea) and southern (Persian Gulf and Gulf of Oman) seas as well as inland waters and aquacultures (rivers, dams, wetlands and fish farms) have made Iran a large producer of fish. In the first step of the present study, data collection and report of PTEs in fish from the three fishery regions (2010-2022) were carried out. In the second step, health risks were assessed using Monte Carlo simulation in child and adult consumers. The average concentrations of Cd, Hg and Pb for the northern sea, southern sea, and inland waters and aquacultures were 0.273, 0.249, 1.077; 0.430, 0.423, 1.182; and 1.387, 0.232, 1.703 μg/g per dry weight, respectively. Based on the target hazard quotient results, Hg intake of Iranian children from all the three fishery regions was more than 1, which was alarming. In the adult age group, southern sea fish consumers were at risk of Hg adverse health effects. Moreover, Cd included the highest carcinogenic risk of toxic elements in fish from the three fishery regions of Iran. Estimation of THQ, HI, ILCR and EDI revealed that consumption of fish might induce health complexities for the consumers in Iran. Moreover, Iranians from northern and southern regions of the country consumed further seafood due to the availability of high seafood sources in these regions. Hence, various indices must be used for the risk assessment of general human health. Due to the high risks of carcinogenicity/non-carcinogenicity estimated in the risk assessment, consumption of fish by infants and pregnant women must critically be assessed.
Topics: Adult; Animals; Child; Female; Humans; Infant; Pregnancy; Cadmium; Environmental Monitoring; Fishes; Food Contamination; Indian Ocean; Iran; Mercury; Metals, Heavy; Risk Assessment
PubMed: 36508819
DOI: 10.1016/j.ecoenv.2022.114349 -
PloS One 2022The presence of harmful environmental exposures, which disproportionately affects low-and-middle income countries (LMICs), contributes to >25% of deaths and diseases...
BACKGROUND
The presence of harmful environmental exposures, which disproportionately affects low-and-middle income countries (LMICs), contributes to >25% of deaths and diseases worldwide and detrimentally affects child neurodevelopment. Few resources succinctly summarize the existing literature on this topic. Our objective is to systematically review and characterize the evidence regarding the relationship between heavy metals and neurodevelopment of children in LMICs.
METHODS
We conducted a medical librarian-curated search on multiple online databases to identify articles that included individuals <18 years living in a LMIC, quantitatively measured exposure to a heavy metal (either prenatal or postnatal), and used a standardized measurement of neurodevelopment (i.e. cognitive, language, motor, and behavior). Reviews, editorials, or case studies were excluded. Results were analyzed qualitatively, and quality was assessed.
RESULTS
Of the 18,043 screened articles, 298 full-text articles were reviewed, and 100 articles met inclusion criteria. The included studies represented data from 19 LMICs, only one of which was classified as a low-income country. Ninety-four percent of postnatal lead and all postnatal manganese studies showed a negative association with metal exposure and neurodevelopment, which were the strongest relationships among the metals studied. Postnatal exposure of mercury was associated with poor neurodevelopment in only half of studies. Limited data on postnatal arsenic and cadmium suggests an association with worse neurodevelopment. Findings were mixed for prenatal arsenic and lead, although some evidence supports that the neurotoxicity of lead was amplified in the presence of manganese.
CONCLUSIONS AND POTENTIAL IMPACT
We found that lead and manganese appear to consistently have a detrimental effect on the neurodevelopment of children, and more evidence is needed for mercury, arsenic, and cadmium. Better characterization of these effects can motivate and inform prioritization of much needed international policies and programs to reduce heavy metal exposures for young children within LMICs.
Topics: Arsenic; Cadmium; Child; Child, Preschool; Developing Countries; Female; Humans; Manganese; Mercury; Metals, Heavy; Pregnancy; Vitamins
PubMed: 35358213
DOI: 10.1371/journal.pone.0265536 -
Current Environmental Health Reports Sep 2019Urinary biomonitoring is widely used to assess environmental chemical exposure; however, a critical gap exists in whether and how to correct for the physiological...
BACKGROUND
Urinary biomonitoring is widely used to assess environmental chemical exposure; however, a critical gap exists in whether and how to correct for the physiological variation in water content of spot urine samples.
OBJECTIVE
The aim of this systematic review is to summarize the available evidence comparing the performance of urinary concentration correction methods used to determine urinary levels of arsenic, cadmium, and mercury.
METHODS
We searched PubMed/MEDLINE, Embase, LILIAC, Web of Science, and TOXNET up to Sept. 5, 2017 for articles evaluating urinary concentration correction methods (e.g., urine creatinine [U-Cre], specific gravity [U-SG], osmolality [U-Osm]) compared to 24-h or timed urine specimens for levels of arsenic, cadmium, and mercury. Data on study design, methods of urine collection, and the performance of selected correction methods were extracted.
RESULTS
A total of 10 papers met the inclusion criteria. Two papers evaluated the performance of urinary concentration correction methods for arsenic, four for cadmium, three for mercury, and one for multiple metals. The median sample size for arsenic was 105, for cadmium 107, and for mercury 35. The studies were highly heterogeneous in population selection, urine collection, urine quality control, statistical comparison among selected correction methods, and presentation of the results. The median (range) of correlation coefficients comparing each corrected values with corresponding levels of timed urine specimens are 0.74 (0.17-0.92) for un-correction (n = 13), 0.82 (0.52-0.98) for U-Cre (n = 13), and 0.75 (0.28-0.98) (n = 12) for U-SG.
CONCLUSION
Findings from limited evidence support that urine creatinine and urine-specific gravity corrections remain practical approaches to correct metal concentrations for urine dilution as compared to 24-h or 12-h urine samples. Further studies with larger sample sizes are needed to clarify this fundamental issue of environmental biomonitoring using spot urine samples in both general and priority populations.
Topics: Arsenic; Biomarkers; Cadmium; Environmental Exposure; Environmental Pollutants; Female; Humans; Mercury; Specific Gravity; Urinalysis
PubMed: 31372861
DOI: 10.1007/s40572-019-00242-8