Association between heavy metal exposure and diabetic retinopathy related homeostatic dysregulation value in Type 2 diabetic population: A cross-sectional study of NHANES 2003–2016
Objective: Our study aimed to assess the association between heavy metal exposure and Diabetic Retinopathy-Related Homeostatic Dysregulation (DRHD) values, a novel prognostic marker for diabetes and its complications, and to examine the mediating role of DRHD in the relationship between heavy metal...
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| Language: | English |
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Elsevier
2025-07-01
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| Series: | Ecotoxicology and Environmental Safety |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0147651325007018 |
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| author | Yuchen Zhou Jiuming Zhang Daizai Lei Yuanjun Qin Qi Chen Ningning Tang Fen Tang Shanshan Huang Peng Lu Li Jiang Wenjing He Chaolan Shen Wenxiang Li Fan Xu Xin Liang |
| author_facet | Yuchen Zhou Jiuming Zhang Daizai Lei Yuanjun Qin Qi Chen Ningning Tang Fen Tang Shanshan Huang Peng Lu Li Jiang Wenjing He Chaolan Shen Wenxiang Li Fan Xu Xin Liang |
| author_sort | Yuchen Zhou |
| collection | DOAJ |
| description | Objective: Our study aimed to assess the association between heavy metal exposure and Diabetic Retinopathy-Related Homeostatic Dysregulation (DRHD) values, a novel prognostic marker for diabetes and its complications, and to examine the mediating role of DRHD in the relationship between heavy metal exposure and diabetic mortality. Method: We used data from National Health and Nutrition Examination Survey (NHANES) 2003–2016, focusing on type 2 diabetes (T2D) patients. Urinary concentrations of 12 metals were measured, and DRHD values were calculated from 14 biomarkers of patients with T2D. Multivariate linear regression, weighted quantile sum regression, and quantile g-computation were applied. Principal component analysis (PCA) identified exposure patterns, and mediation analysis evaluated the role of DRHD in mortality risk. Results: Among 1590 diabetic patients, cadmium (β: 0.104), antimony (β: 0.191), and tungsten (β: 0.136) significantly increased DRHD values, while cesium was negatively associated (β: −0.145). Mixed metal exposures (β: 0.123) had notable contributions from tungsten (0.279), cadmium (0.213), and antimony (0.137). PCA showed positive associations for molybdenum, tungsten, uranium (β: 0.063) and cadmium, lead, antimony (β: 0.098), while barium, cobalt, cesium, thallium (β: −0.050) were negatively associated. The mediation proportion of DRHD value for overall mortality and diabetes-cause mortality was 27.5 % and 10.8 % respectively. Meanwhile, DRHD value significantly mediated the mix-heavy metal exposures and diabetic-relative survival time. Conclusions: Our findings highlight the relationship between heavy metal exposures and DRHD values and demonstrate the mediating role of DRHD in mortality risk and survival time for diabetic patients. |
| format | Article |
| id | doaj-art-ded699a87a864b8e9c0495d8a0f229eb |
| institution | Kabale University |
| issn | 0147-6513 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Ecotoxicology and Environmental Safety |
| spelling | doaj-art-ded699a87a864b8e9c0495d8a0f229eb2025-08-20T03:24:33ZengElsevierEcotoxicology and Environmental Safety0147-65132025-07-0129911836510.1016/j.ecoenv.2025.118365Association between heavy metal exposure and diabetic retinopathy related homeostatic dysregulation value in Type 2 diabetic population: A cross-sectional study of NHANES 2003–2016Yuchen Zhou0Jiuming Zhang1Daizai Lei2Yuanjun Qin3Qi Chen4Ningning Tang5Fen Tang6Shanshan Huang7Peng Lu8Li Jiang9Wenjing He10Chaolan Shen11Wenxiang Li12Fan Xu13Xin Liang14Department of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region & Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences & Guangxi Key Laboratory of Eye Health & Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Nanning 530021, ChinaDepartment of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region & Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences & Guangxi Key Laboratory of Eye Health & Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Nanning 530021, ChinaDepartment of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region & Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences & Guangxi Key Laboratory of Eye Health & Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Nanning 530021, ChinaDepartment of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region & Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences & Guangxi Key Laboratory of Eye Health & Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Nanning 530021, ChinaDepartment of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region & Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences & Guangxi Key Laboratory of Eye Health & Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Nanning 530021, ChinaDepartment of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region & Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences & Guangxi Key Laboratory of Eye Health & Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Nanning 530021, ChinaDepartment of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region & Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences & Guangxi Key Laboratory of Eye Health & Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Nanning 530021, ChinaDepartment of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region & Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences & Guangxi Key Laboratory of Eye Health & Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Nanning 530021, ChinaDepartment of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region & Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences & Guangxi Key Laboratory of Eye Health & Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Nanning 530021, ChinaDepartment of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region & Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences & Guangxi Key Laboratory of Eye Health & Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Nanning 530021, ChinaDepartment of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region & Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences & Guangxi Key Laboratory of Eye Health & Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Nanning 530021, ChinaDepartment of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region & Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences & Guangxi Key Laboratory of Eye Health & Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Nanning 530021, ChinaSchool of Public Health, Guangdong Medical University, Dongguan 523808, ChinaDepartment of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region & Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences & Guangxi Key Laboratory of Eye Health & Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Nanning 530021, China; Correspondence to: Department of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Road, Qingxiu District, Nanning 530021, ChinaDepartment of Publicity, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning 530021, China; Correspondence to: Department of Publicity, The People's Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Road, Qingxiu District, Nanning 530021, ChinaObjective: Our study aimed to assess the association between heavy metal exposure and Diabetic Retinopathy-Related Homeostatic Dysregulation (DRHD) values, a novel prognostic marker for diabetes and its complications, and to examine the mediating role of DRHD in the relationship between heavy metal exposure and diabetic mortality. Method: We used data from National Health and Nutrition Examination Survey (NHANES) 2003–2016, focusing on type 2 diabetes (T2D) patients. Urinary concentrations of 12 metals were measured, and DRHD values were calculated from 14 biomarkers of patients with T2D. Multivariate linear regression, weighted quantile sum regression, and quantile g-computation were applied. Principal component analysis (PCA) identified exposure patterns, and mediation analysis evaluated the role of DRHD in mortality risk. Results: Among 1590 diabetic patients, cadmium (β: 0.104), antimony (β: 0.191), and tungsten (β: 0.136) significantly increased DRHD values, while cesium was negatively associated (β: −0.145). Mixed metal exposures (β: 0.123) had notable contributions from tungsten (0.279), cadmium (0.213), and antimony (0.137). PCA showed positive associations for molybdenum, tungsten, uranium (β: 0.063) and cadmium, lead, antimony (β: 0.098), while barium, cobalt, cesium, thallium (β: −0.050) were negatively associated. The mediation proportion of DRHD value for overall mortality and diabetes-cause mortality was 27.5 % and 10.8 % respectively. Meanwhile, DRHD value significantly mediated the mix-heavy metal exposures and diabetic-relative survival time. Conclusions: Our findings highlight the relationship between heavy metal exposures and DRHD values and demonstrate the mediating role of DRHD in mortality risk and survival time for diabetic patients.http://www.sciencedirect.com/science/article/pii/S0147651325007018DiabetesHeavy metal exposureDiabetic retinopathy related homeostatic dysregulation (DRHD)Metabolic imbalanceEnvironmental pollutants |
| spellingShingle | Yuchen Zhou Jiuming Zhang Daizai Lei Yuanjun Qin Qi Chen Ningning Tang Fen Tang Shanshan Huang Peng Lu Li Jiang Wenjing He Chaolan Shen Wenxiang Li Fan Xu Xin Liang Association between heavy metal exposure and diabetic retinopathy related homeostatic dysregulation value in Type 2 diabetic population: A cross-sectional study of NHANES 2003–2016 Ecotoxicology and Environmental Safety Diabetes Heavy metal exposure Diabetic retinopathy related homeostatic dysregulation (DRHD) Metabolic imbalance Environmental pollutants |
| title | Association between heavy metal exposure and diabetic retinopathy related homeostatic dysregulation value in Type 2 diabetic population: A cross-sectional study of NHANES 2003–2016 |
| title_full | Association between heavy metal exposure and diabetic retinopathy related homeostatic dysregulation value in Type 2 diabetic population: A cross-sectional study of NHANES 2003–2016 |
| title_fullStr | Association between heavy metal exposure and diabetic retinopathy related homeostatic dysregulation value in Type 2 diabetic population: A cross-sectional study of NHANES 2003–2016 |
| title_full_unstemmed | Association between heavy metal exposure and diabetic retinopathy related homeostatic dysregulation value in Type 2 diabetic population: A cross-sectional study of NHANES 2003–2016 |
| title_short | Association between heavy metal exposure and diabetic retinopathy related homeostatic dysregulation value in Type 2 diabetic population: A cross-sectional study of NHANES 2003–2016 |
| title_sort | association between heavy metal exposure and diabetic retinopathy related homeostatic dysregulation value in type 2 diabetic population a cross sectional study of nhanes 2003 2016 |
| topic | Diabetes Heavy metal exposure Diabetic retinopathy related homeostatic dysregulation (DRHD) Metabolic imbalance Environmental pollutants |
| url | http://www.sciencedirect.com/science/article/pii/S0147651325007018 |
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