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Environmental Chemistry Environmental Chemistry Society
Environmental problems - Chemical approaches
RESEARCH ARTICLE

Association of plasma antimony concentration with markers of liver function in Chinese adults

Xiaomin You A , Yang Xiao A , Kang Liu A , Yanqiu Yu A , Yiyi Liu A , Pinpin Long A , Hao Wang A , Lue Zhou A , Qifei Deng B , Yuhui Lin A , Xiaomin Zhang A , Meian He A , Tangchun Wu A and Yu Yuan https://orcid.org/0000-0001-6932-6920 A C
+ Author Affiliations
- Author Affiliations

A Department of Occupational and Environmental Health Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.

B Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Faculty of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China.

C Corresponding author. Email: yuyuan8hust@163.com

Environmental Chemistry 17(4) 304-313 https://doi.org/10.1071/EN19195
Submitted: 30 June 2019  Accepted: 9 September 2019   Published: 23 October 2019

Environmental context. Antimony pollution has become a global issue given its wide distribution in the environment and its potential threat to human health. This large population-based study demonstrated that exposure to high levels of antimony may impair liver function in adults. The study highlights the potential hazard to liver function of antimony exposure, and provides convincing evidence of the need to monitor and control antimony exposure in the prevention of liver dysfunction.

Abstract. The association of antimony exposure with serum liver enzymes and bilirubin levels remains unknown. We aimed to prospectively evaluate the associations of the plasma antimony concentration with serum liver enzymes [alkaline phosphatase (ALP), alanine aminotransferase (ALT) and aspartate aminotransferase (AST)] and bilirubin [total (TBil), direct (DBil) and indirect bilirubin (IBil)] levels among the Chinese middle-aged and elderly population. A total of 4733 participants who were free of cardiovascular disease (CVD), cancer and chronic hepatitis at the baseline survey (2008–2010) of the Dongfeng-Tongji cohort were included in the current study. We measured the baseline plasma antimony concentration by inductively coupled plasma mass spectrometry (ICP-MS), and the serum liver enzymes and bilirubin levels at the resurvey visit (2013) by using an automatic analyser. In the fully adjusted generalised linear models, we observed that an increased plasma antimony concentration was significantly associated with higher bilirubin levels. Moreover, we found that plasma antimony was positively associated with the elevation of DBil (≥7.0 μmol L−1), where the adjusted odds ratios (ORs) comparing the extreme tertiles was 1.35 (95 % CI: 1.06, 1.70, P trend = 0.01). Spline regression analyses indicated that the plasma antimony concentration was linearly associated with the elevation of TBil and DBil (overall P = 0.004 and P = 0.002 respectively). Our study suggested that exposure to high levels of antimony may impair liver function in adults. Further investigations are warranted to confirm these findings in other populations.

Additional keywords: bilirubin, liver enzymes, prospective study.


References

Al-Gubory KH (2014). Environmental pollutants and lifestyle factors induce oxidative stress and poor prenatal development. Reproductive Biomedicine Online 29, 17–31.
Environmental pollutants and lifestyle factors induce oxidative stress and poor prenatal developmentCrossref | GoogleScholarGoogle Scholar | 24813750PubMed |

Asrani SK, Devarbhavi H, Eaton J, Kamath PS (2019). Burden of liver diseases in the world. Journal of Hepatology 70, 151–171.
Burden of liver diseases in the worldCrossref | GoogleScholarGoogle Scholar | 30266282PubMed |

Cavallo D, Iavicoli I, Setini A, Marinaccio A, Perniconi B, Carelli G, Iavicoli S (2002). Genotoxic risk and oxidative DNA damage in workers exposed to antimony trioxide. Environmental and Molecular Mutagenesis 40, 184–189.
Genotoxic risk and oxidative DNA damage in workers exposed to antimony trioxideCrossref | GoogleScholarGoogle Scholar | 12355552PubMed |

Cesbron A, Saussereau E, Mahieu L, Couland I, Guerbet M, Goulle JP (2013). Metallic profile of whole blood and plasma in a series of 106 healthy volunteers. Journal of Analytical Toxicology 37, 401–405.
Metallic profile of whole blood and plasma in a series of 106 healthy volunteersCrossref | GoogleScholarGoogle Scholar | 23794607PubMed |

Drummond GS, Kappas A (1981). Potent heme-degrading action of antimony and antimony-containing parasiticidal agents. The Journal of Experimental Medicine 153, 245–256.
Potent heme-degrading action of antimony and antimony-containing parasiticidal agentsCrossref | GoogleScholarGoogle Scholar | 6894611PubMed |

Feng W, He X, Chen M, Deng S, Qiu G, Li X, Liu C, Li J, Deng Q, Huang S, Wang T, Dai X, Yang B, Yuan J, He M, Zhang X, Chen W, Kan H, Wu T (2015). Urinary metals and heart rate variability: a cross-sectional study of urban adults in Wuhan, China. Environmental Health Perspectives 123, 217–222.
Urinary metals and heart rate variability: a cross-sectional study of urban adults in Wuhan, ChinaCrossref | GoogleScholarGoogle Scholar | 25356836PubMed |

Fevery J (2008). Bilirubin in clinical practice: a review. Liver International 28, 592–605.
Bilirubin in clinical practice: a reviewCrossref | GoogleScholarGoogle Scholar | 18433389PubMed |

Giannini EG, Testa R, Savarino V (2005). Liver enzyme alteration: a guide for clinicians. Canadian Medical Association Journal 172, 367–379.
Liver enzyme alteration: a guide for cliniciansCrossref | GoogleScholarGoogle Scholar | 15684121PubMed |

Guo J, Lv N, Tang J, Zhang X, Peng L, Du X, Li S, Luo Q, Zhang D, Chen G (2018). Associations of blood metal exposure with thyroid hormones in Chinese pregnant women: A cross-sectional study. Environment International 121, 1185–1192.
Associations of blood metal exposure with thyroid hormones in Chinese pregnant women: A cross-sectional studyCrossref | GoogleScholarGoogle Scholar | 30385064PubMed |

He M, Wang X, Wu F, Fu Z (2012). Antimony pollution in China. The Science of the Total Environment 421–422, 41–50.
Antimony pollution in ChinaCrossref | GoogleScholarGoogle Scholar | 21741676PubMed |

He M, Wang N, Long X, Zhang C, Ma C, Zhong Q, Wang A, Wang Y, Pervaiz A, Shan J (2019). Antimony speciation in the environment: Recent advances in understanding the biogeochemical processes and ecological effects. Journal of Environmental Sciences (China) 75, 14–39.
Antimony speciation in the environment: Recent advances in understanding the biogeochemical processes and ecological effectsCrossref | GoogleScholarGoogle Scholar |

Herath I, Vithanage M, Bundschuh J (2017). Antimony as a global dilemma: Geochemistry, mobility, fate and transport. Environmental Pollution 223, 545–559.
Antimony as a global dilemma: Geochemistry, mobility, fate and transportCrossref | GoogleScholarGoogle Scholar | 28190688PubMed |

Hu X, Kong L, He M (2014). Kinetics and mechanism of photopromoted oxidative dissolution of antimony trioxide. Environmental Science & Technology 48, 14266–14272.
Kinetics and mechanism of photopromoted oxidative dissolution of antimony trioxideCrossref | GoogleScholarGoogle Scholar |

Jiang X, An Z, Lu C, Chen Y, Du E, Qi S, Yang K, Zhang Z, Xu Y (2016). The protective role of Nrf2-Gadd45b against antimony-induced oxidative stress and apoptosis in HEK293 cells. Toxicology Letters 256, 11–18.
The protective role of Nrf2-Gadd45b against antimony-induced oxidative stress and apoptosis in HEK293 cellsCrossref | GoogleScholarGoogle Scholar | 27208483PubMed |

Kew MC (2000). Serum aminotransferase concentration as evidence of hepatocellular damage. Lancet 355, 591–592.
Serum aminotransferase concentration as evidence of hepatocellular damageCrossref | GoogleScholarGoogle Scholar | 10696975PubMed |

Koch B, Maser E, Hartwig A (2017). Low concentrations of antimony impair DNA damage signaling and the repair of radiation-induced DSB in HeLa S3 cells. Archives of Toxicology 91, 3823–3833.
Low concentrations of antimony impair DNA damage signaling and the repair of radiation-induced DSB in HeLa S3 cellsCrossref | GoogleScholarGoogle Scholar | 28612261PubMed |

Kupsco A, Kioumourtzoglou MA, Just AC, Amarasiriwardena C, Estrada-Gutierrez G, Cantoral A, Sanders AP, Braun JM, Svensson K, Brennan KJM, Oken E, Wright RO, Baccarelli AA, Tellez-Rojo MM (2019). Prenatal metal concentrations and childhood cardiometabolic risk using Bayesian Kernel Machine Regression to assess mixture and interaction effects. Epidemiology 30, 263–273.
Prenatal metal concentrations and childhood cardiometabolic risk using Bayesian Kernel Machine Regression to assess mixture and interaction effectsCrossref | GoogleScholarGoogle Scholar | 30720588PubMed |

Kwo PY, Cohen SM, Lim JK (2017). ACG Clinical Guideline: Evaluation of Abnormal Liver Chemistries. The American Journal of Gastroenterology 112, 18–35.
ACG Clinical Guideline: Evaluation of Abnormal Liver ChemistriesCrossref | GoogleScholarGoogle Scholar | 27995906PubMed |

Li J, Zheng B, He Y, Zhou Y, Chen X, Ruan S, Yang Y, Dai C, Tang L (2018). Antimony contamination, consequences and removal techniques: A review. Ecotoxicology and Environmental Safety 156, 125–134.
Antimony contamination, consequences and removal techniques: A reviewCrossref | GoogleScholarGoogle Scholar | 29549735PubMed |

Luedde T, Kaplowitz N, Schwabe RF (2014). Cell death and cell death responses in liver disease: mechanisms and clinical relevance. Gastroenterology 147, 765–783.
Cell death and cell death responses in liver disease: mechanisms and clinical relevanceCrossref | GoogleScholarGoogle Scholar | 25046161PubMed |

Ma YC, Zuo L, Chen JH, Luo Q, Yu XQ, Li Y, Xu JS, Huang SM, Wang LN, Huang W, Wang M, Xu GB, Wang HY (2006). Modified glomerular filtration rate estimating equation for Chinese patients with chronic kidney disease. Journal of the American Society of Nephrology 17, 2937–2944.
Modified glomerular filtration rate estimating equation for Chinese patients with chronic kidney diseaseCrossref | GoogleScholarGoogle Scholar | 16988059PubMed |

Menke A, Guallar E, Cowie CC (2016). Metals in urine and diabetes in U.S. adults. Diabetes 65, 164–171.
Metals in urine and diabetes in U.S. adultsCrossref | GoogleScholarGoogle Scholar | 26542316PubMed |

Pierart A, Shahid M, Sejalon-Delmas N, Dumat C (2015). Antimony bioavailability: knowledge and research perspectives for sustainable agricultures. Journal of Hazardous Materials 289, 219–234.
Antimony bioavailability: knowledge and research perspectives for sustainable agriculturesCrossref | GoogleScholarGoogle Scholar | 25726907PubMed |

Poon R, Chu I, Lecavalier P, Valli VE, Foster W, Gupta S, Thomas B (1998). Effects of antimony on rats following 90-day exposure via drinking water. Food and Chemical Toxicology 36, 21–35.
Effects of antimony on rats following 90-day exposure via drinking waterCrossref | GoogleScholarGoogle Scholar | 9487361PubMed |

Quiroz W, Aguilar L, Barria M, Veneciano J, Martinez D, Bravo M, Lobos MG, Mercado L (2013). Sb(V) and Sb(III) distribution in human erythrocytes: speciation methodology and the influence of temperature, time and anticoagulants. Talanta 115, 902–910.
Sb(V) and Sb(III) distribution in human erythrocytes: speciation methodology and the influence of temperature, time and anticoagulantsCrossref | GoogleScholarGoogle Scholar | 24054681PubMed |

Saravanabhavan G, Werry K, Walker M, Haines D, Malowany M, Khoury C (2017). Human biomonitoring reference values for metals and trace elements in blood and urine derived from the Canadian Health Measures Survey 2007–2013. International Journal of Hygiene and Environmental Health 220, 189–200.
Human biomonitoring reference values for metals and trace elements in blood and urine derived from the Canadian Health Measures Survey 2007–2013Crossref | GoogleScholarGoogle Scholar | 27776932PubMed |

Tian H, Zhou J, Zhu C, Zhao D, Gao J, Hao J, He M, Liu K, Wang K, Hua S (2014). A comprehensive global inventory of atmospheric antimony emissions from anthropogenic activities, 1995–2010. Environmental Science & Technology 48, 10235–10241.
A comprehensive global inventory of atmospheric antimony emissions from anthropogenic activities, 1995–2010Crossref | GoogleScholarGoogle Scholar |

Tian J, Zhong R, Liu C, Tang Y, Gong J, Chang J, Lou J, Ke J, Li J, Zhang Y, Yang Y, Zhu Y, Gong Y, Xu Y, Liu P, Yu X, Xiao L, Du M, Yang L, Yuan J, Wang Y, Chen W, Wei S, Liang Y, Zhang X, He M, Wu T, Yao P, Miao X (2016). Association between bilirubin and risk of non-alcoholic fatty liver disease based on a prospective cohort study. Scientific Reports 6, 31006
Association between bilirubin and risk of non-alcoholic fatty liver disease based on a prospective cohort studyCrossref | GoogleScholarGoogle Scholar | 27484402PubMed |

Tylenda CA, Sullivan DW, Fowler BA (2015). Antimony. In ‘Handbook on the toxicology of metals, 4th edn’. (Eds GF Nordberg, BA Fowler, M Nordberg) Chapter 27, pp. 565–579. (Academic Press: San Diego, CA)

Varrica D, Bardelli F, Dongarrà G, Tamburo E (2013). Speciation of Sb in airborne particulate matter, vehicle brake linings, and brake pad wear residues. Atmospheric Environment 64, 18–24.
Speciation of Sb in airborne particulate matter, vehicle brake linings, and brake pad wear residuesCrossref | GoogleScholarGoogle Scholar |

Wang F, Zhu J, Yao P, Li X, He M, Liu Y, Yuan J, Chen W, Zhou L, Min X, Fang W, Liang Y, Wang Y, Wei S, Liu J, Miao X, Lang M, Jiang X, Zhang P, Li D, Lu C, Wang X, Shi W, Zheng J, Guo H, Zhang X, Yang H, Hu FB, Wu T (2013). Cohort Profile: the Dongfeng-Tongji cohort study of retired workers. International Journal of Epidemiology 42, 731–740.
Cohort Profile: the Dongfeng-Tongji cohort study of retired workersCrossref | GoogleScholarGoogle Scholar | 22531126PubMed |

Wang FS, Fan JG, Zhang Z, Gao B, Wang HY (2014). The global burden of liver disease: the major impact of China. Hepatology 60, 2099–2108.
The global burden of liver disease: the major impact of ChinaCrossref | GoogleScholarGoogle Scholar | 25164003PubMed |

Wang YX, Pan A, Feng W, Liu C, Huang LL, Ai SH, Zeng Q, Lu WQ (2019). Variability and exposure classification of urinary levels of non-essential metals aluminum, antimony, barium, thallium, tungsten and uranium in healthy adult men. Journal of Exposure Science & Environmental Epidemiology 29, 424–434.
Variability and exposure classification of urinary levels of non-essential metals aluminum, antimony, barium, thallium, tungsten and uranium in healthy adult menCrossref | GoogleScholarGoogle Scholar |

Wu F, Fu Z, Liu B, Mo C, Chen B, Corns W, Liao H (2011). Health risk associated with dietary co-exposure to high levels of antimony and arsenic in the world’s largest antimony mine area. The Science of the Total Environment 409, 3344–3351.
Health risk associated with dietary co-exposure to high levels of antimony and arsenic in the world’s largest antimony mine areaCrossref | GoogleScholarGoogle Scholar | 21684578PubMed |

Xiao L, Zhou Y, Ma J, Sun W, Cao L, Wang B, Zhu C, Yang S, Wang D, Yuan J, Chen W (2018). Oxidative DNA damage mediates the association between urinary metals and prevalence of type 2 diabetes mellitus in Chinese adults. The Science of the Total Environment 627, 1327–1333.
Oxidative DNA damage mediates the association between urinary metals and prevalence of type 2 diabetes mellitus in Chinese adultsCrossref | GoogleScholarGoogle Scholar | 30857096PubMed |

Xiao Y, Yuan Y, Liu Y, Yu Y, Jia N, Zhou L, Wang H, Huang S, Zhang Y, Yang H, Li X, Hu FB, Liang L, Pan A, Zhang X, He M, Cheng J, Wu T (2019). Circulating multiple metals and incident stroke in Chinese adults. Stroke 50, 1661–1668.
Circulating multiple metals and incident stroke in Chinese adultsCrossref | GoogleScholarGoogle Scholar | 31167624PubMed |

Yang H, He M, Wang X (2015). Concentration and speciation of antimony and arsenic in soil profiles around the world’s largest antimony metallurgical area in China. Environmental Geochemistry and Health 37, 21–33.
Concentration and speciation of antimony and arsenic in soil profiles around the world’s largest antimony metallurgical area in ChinaCrossref | GoogleScholarGoogle Scholar | 24969304PubMed |

Yang Z, Yan C, Liu G, Niu Y, Zhang W, Lu S, Li X, Zhang H, Ning G, Fan J, Qin L, Su Q (2016). Plasma selenium levels and nonalcoholic fatty liver disease in Chinese adults: a cross-sectional analysis. Scientific Reports 6, 37288
Plasma selenium levels and nonalcoholic fatty liver disease in Chinese adults: a cross-sectional analysisCrossref | GoogleScholarGoogle Scholar | 27853246PubMed |

Yuan Y, Xiao Y, Feng W, Liu Y, Yu Y, Zhou L, Qiu G, Wang H, Liu B, Liu K, Yang H, Li X, Min X, Zhang C, Xu C, Zhang X, He M, Hu FB, Pan A, Wu T (2017). Plasma metal concentrations and incident coronary heart disease in Chinese adults: The Dongfeng-Tongji Cohort. Environmental Health Perspectives 125, 107007
Plasma metal concentrations and incident coronary heart disease in Chinese adults: The Dongfeng-Tongji CohortCrossref | GoogleScholarGoogle Scholar | 29064788PubMed |

Yuan Y, Xiao Y, Yu Y, Liu Y, Feng W, Qiu G, Wang H, Liu B, Wang J, Zhou L, Liu K, Xu X, Yang H, Li X, Qi L, Zhang X, He M, Hu FB, Pan A, Wu T (2018). Associations of multiple plasma metals with incident type 2 diabetes in Chinese adults: The Dongfeng-Tongji Cohort. Environmental Pollution 237, 917–925.
Associations of multiple plasma metals with incident type 2 diabetes in Chinese adults: The Dongfeng-Tongji CohortCrossref | GoogleScholarGoogle Scholar | 29429611PubMed |

Zhao X, Xing F, Cong Y, Zhuang Y, Han M, Wu Z, Yu S, Wei H, Wang X, Chen G (2017). Antimony trichloride induces a loss of cell viability via reactive oxygen species-dependent autophagy in A549 cells. The International Journal of Biochemistry & Cell Biology 93, 32–40.
Antimony trichloride induces a loss of cell viability via reactive oxygen species-dependent autophagy in A549 cellsCrossref | GoogleScholarGoogle Scholar |

Zhuang X, Cui AM, Wang Q, Cheng XY, Shen Y, Cai WH, Li HB, Zhang S, Qin G (2017). Liver dysfunction during pregnancy and its association with preterm birth in China: A prospective cohort study. EBioMedicine 26, 152–156.
Liver dysfunction during pregnancy and its association with preterm birth in China: A prospective cohort studyCrossref | GoogleScholarGoogle Scholar | 29174520PubMed |