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      The association of total blood mercury levels and overweight among Korean adolescents: analysis of the Korean National Health and Nutrition Examination Survey (KNHANES) 2010–2013

      research-article
      , MD, , MD, , MD, PhD, , MD, PhD
      Korean Journal of Pediatrics
      The Korean Pediatric Society
      Adolescent, Blood, Mercury, Obesity, Overweight

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          Abstract

          Purpose

          Obesity has been associated with higher total blood mercury levels, based on animal studies; however, studies that focus on children and adolescents are lacking. We aimed to assess the association between total blood mercury levels and the incidence of overweight and abdominal obesity in Korean adolescents.

          Methods

          The study population comprised 1,567 adolescents (793 boys and 774 girls; aged 10–19 years), who participated in the Korea National Health and Nutrition Examination Survey 2010–2013. We analyzed total blood mercury levels according to obesity status in all participants.

          Results

          The geometric mean of total blood mercury levels was 1.93 µg/L. Participants with overweight (2.20 µg/L) and obesity (2.17 µg/L) had higher levels than those with normal weight (1.86 µg/L, P<0.0001). The prevalence of overweight significantly increased with elevation of the total blood mercury quartile in both sexes. Increased incidence of abdominal obesity corresponding to increased total blood mercury level was observed in boys. After adjusting for covariates, those in the highest total blood mercury quartile were found to be at higher risk of overweight/obesity than those in the lowest quartile in both sexes (odds ratio [95% confidence interval]: boys, 3.27 [1.66–6.41]; girls, 1.90 [1.03–3.49]). The association between total blood mercury quartile and abdominal obesity was significant after controlling for covariates in boys (2.35 [1.05–5.24]).

          Conclusion

          Our results suggest an association between total blood mercury levels and overweight in Korean adolescents.

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          Most cited references23

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          The endocrine effects of mercury in humans and wildlife.

          Mercury (Hg) is well studied and research continues as our knowledge of its health risks increases. One expanding area of research not well emphasized to date is the endocrine effects of Hg. This review summarizes the existing literature on the effects of Hg on the endocrine system and identifies gaps in the knowledge. It focuses on the thyroid, adrenal, and reproductive systems, including the accumulation of Hg in the endocrine system, sex differences that are manifested with Hg exposure, reproductive effects in male and female animals including humans, and Hg effects on the thyroid and adrenal systems. We concluded that there are five main endocrine-related mechanisms of Hg across these systems: (a) accumulation in the endocrine system; (b) specific cytotoxicity in endocrine tissues; (c) changes in hormone concentrations; (d) interactions with sex hormones; and (e) up-regulation or down-regulation of enzymes within the steroidogenesis pathway. Recommendations for key areas of research to better understand how the endocrine effects of Hg affect human and wildlife health were developed, and include increasing the amount of basic biological information available about Hg and wildlife species, exploring the role of Hg in the presence of other stressors and chemicals, understanding sublethal and indirect effects of Hg on adverse outcomes, developing better methods to extrapolate effects across species, and understanding the effects of Hg on multiple organ systems following exposure of an animal. Greater inclusion of endocrine endpoints in epidemiological and field studies on humans and wildlife will also advance the research in this area.
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            Waist-to-height ratio as a screening tool for obesity and cardiometabolic risk

            Eun Yoo (2016)
            The waist-to-height ratio (WHtR), calculated by dividing the waist circumference (WC) by height, has recently gained attention as an anthropometric index for central adiposity. It is an easy-to-use and less age-dependent index to identify individuals with increased cardiometabolic risk. A WHtR cutoff of 0.5 can be used in different sex and ethnic groups and is generally accepted as a universal cutoff for central obesity in children (aged ≥6 years) and adults. However, the WHtR has not been validated in preschool children, and the routine use of WHtR in children under age 6 is not recommended. Prospective studies and meta-analysis in adults revealed that the WHtR is equivalent to or slightly better than WC and superior to body mass index (BMI) in predicting higher cardiometabolic risk. In children and adolescents, studies have shown that the WHtR is similar to both BMI and WC in identifying those at an increased cardiometabolic risk. Additional use of WHtR with BMI or WC may be helpful because WHtR considers both height and central obesity. WHtR may be preferred because of its simplicity and because it does not require sex- and age-dependent cutoffs; additionally, the simple message 'keep your WC to less than half your height' may be particularly useful. This review article summarizes recent publications on the usefulness of using WHtR especially when compared to BMI and WC as a screening tool for obesity and related cardiometabolic risks, and recommends the use of WHtR in clinical practice for obesity screening in children and adolescents.
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              Additive effect of heavy metals on metabolic syndrome in the Korean population: the Korea National Health and Nutrition Examination Survey (KNHANES) 2009-2010.

              There have been increasing concerns regarding health problems due to endocrine disrupting chemicals (EDCs). We investigated association of heavy metals, including lead, mercury, and cadmium, with metabolic syndrome (MS) and its individual components in the Korean population. Participants included 1,961 males and 1,989 females 20 years of age or older from the fourth and fifth Korea National Health and Nutritional Examination Surveys of the Korean population (2009 and 2010). We examined the relationship of blood lead, mercury, and cadmium levels with MS and the additive effect of three heavy metals on MS after adjustment for age, sex, body mass index (BMI), region, smoking, alcohol consumption, and regular exercise. Blood concentration of lead showed a significant but modest association with prevalence of MS (P = 0.04). Other heavy metals did not show such a relationship with MS. When the participants were classified according to the sum of category numbers of the three heavy metals, adjusted odds ratios were 1.0, 1.355, 1.638, and 1.556 (P < 0.01). Among components of MS, significant relationship of the sum of heavy metals with hypertension and elevated triglyceride was demonstrated. Blood concentration of lead was positively associated with the prevalence of MS. Of particular interest, cumulative effect of a mixture of lead, mercury, and cadmium on prevalence of MS was stronger than the sum of effect of each heavy metal. Accumulative effect of exposure to heavy metals could be more additive or synergistic than individual exposure in the general population.
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                Author and article information

                Journal
                Korean J Pediatr
                Korean J Pediatr
                KJP
                Korean Journal of Pediatrics
                The Korean Pediatric Society
                1738-1061
                2092-7258
                April 2018
                23 April 2018
                : 61
                : 4
                : 121-128
                Affiliations
                Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea.
                Author notes
                Corresponding author: Shin-Hye Kim, MD. Department of Pediatrics, Inje University Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul 01757, Korea. Tel: +82-2-950-4812, Fax: +82-2-950-1246, S2635@ 123456paik.ac.kr
                Author information
                https://orcid.org/0000-0003-0413-122X
                Article
                10.3345/kjp.2018.61.4.121
                5924843
                29713358
                38b11c6d-c9b5-4a34-a008-ad1c067a63b2
                Copyright © 2018 by The Korean Pediatric Society

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 11 September 2017
                : 22 October 2017
                : 25 October 2017
                Categories
                Original Article

                Pediatrics
                adolescent,blood,mercury,obesity,overweight
                Pediatrics
                adolescent, blood, mercury, obesity, overweight

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