The results of previous studies on the association between blood mercury (Hg) and bone mineral density (BMD) are inconsistent. We therefore used a large-scale nationwide representative sample of Korean men to investigate the relationship between these two parameters.
A nationwide cross-sectional study was conducted using data from the 2008 to 2010 Korean National Health and Nutrition Examination Survey to evaluate the relationship between blood Hg and BMD and the prevalence of osteopenia or osteoporosis in 1,190 men over 50 years of age. BMD was measured by dual-energy X-ray absorptiometry. Osteopenia and osteoporosis were diagnosed for each body site according to World Health Organization T-score criteria.
After adjusting for age, body mass index, caloric energy and calcium intake, vitamin D levels, fish consumption, alcohol consumption, smoking, and exercise, quartiles of blood Hg were positively associated with femur neck T-scores in multiple linear regression analysis (β=0.06, P-value=0.03). Compared with the lowest blood Hg quartile, the odds ratios and 95% confidence intervals for diagnosis of osteopenia or osteoporosis in the second and fourth quartiles were 0.63 (0.41–0.99) and 0.57 (0.36–0.91), respectively, in the femur neck after adjusting for the same co-variables.
High blood Hg levels were associated with reduced odds of decreased femur neck BMD in Korean men. However, subgroup analysis did not show a significant protective effect of blood Hg on osteoporotic fractures. Further research is necessary to clarify the association between blood Hg and BMD.
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Abnormal serum gamma-glutamyltransferase (γ-GT) may be an early and sensitive marker for oxidative stress. This study was performed to evaluate the association between serum heavy metals and γ-GT concentration.
This study is a cross-sectional analysis based on data from Korean National Health and Nutrition Examination Survey (V-1, 2, 2010, 2011) regarding serum heavy metal concentrations (lead, mercury, and cadmium) as well as serum γ-GT. Serum heavy metals were categorized into tertiles, and serum γ-GT concentration was compared using an analysis of covariance test after relevant variable adjustments. In addition, we evaluated the odds ratio (OR) of having the highest tertile of serum γ-GT in each heavy metal tertile using logistic regression.
The mean serum lead, mercury, and cadmium concentrations were 2.67, 5.08, and 1.02 µg/dL in men and 1.95, 3.60, and 1.21 µg/dL in women, respectively. Partial correlation showed a significant positive relation between each heavy metal and serum γ-GT concentration. Comparing serum γ-GT concentration by the tertile of each heavy metal, serum γ-GT concentration showed a significant increase as the tertiles of serum mercury and cadmium in men and that of serum mercury in women increased, but not with lead. The OR of having the highest tertile of serum γ-GT was significant for cadmium in men (OR, 4.02; 95% confidence interval [CI], 2.54 to 6.35) and mercury in women (OR, 2.00; 95% CI, 1.29 to 3.10) in the top tertile of each heavy metal.
Higher serum heavy metal concentration may be related with higher serum γ-GT concentration. In particular, serum cadmium in men and mercury in women showed significant correlation with serum γ-GT concentration.
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Clinical manifestations of chronic exposure to organic mercury usually have a gradual onset. As the primary target is the nervous system, chronic mercury exposure can cause symptoms such as fatigue, weakness, headache, and poor recall and concentration. In severe cases chronic exposure leads to intellectual deterioration and neurologic abnormality. Recent outbreaks of bovine spongiform encephalopathy and pathogenic avian influenza have increased fish consumption in Korea. Methyl-mercury, a type of organic mercury, is present in higher than normal ranges in the general Korean population. When we examine a patient with chronic fatigue, we assess his/her methyl-mercury concentrations in the body if environmental exposure such as excessive fish consumption is suspected. In the current case, we learned the patient had consumed many slices of raw tuna and was initially diagnosed with chronic fatigue syndrome. Therefore, we suspected that he was exposured to methyl-mercury and that the mercury concentration in his hair would be below the poisoning level identified by World Health Organization but above the normal range according to hair toxic mineral assay. Our patient's toxic chronic fatigue symptoms improved after he was given mercury removal therapy, indicating that he was correctly diagnosed with chronic exposure to organic mercury.
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