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Joint effects of tobacco smoke exposure and heavy metals on serum sex hormones in adult males

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Abstract

Objective

This study aimed to explore the associations of tobacco smoke exposure (TSE) and heavy metal exposure on sex hormones and the joint effects between them in adult males.

Methods

The study used data of 2244 adult males from the National Health and Nutrition Examination Survey (NHANES, 2013–2016). Weighted linear regression models were used to calculate their beta (β) coefficients and corresponding confidence interval (95% CI), which assessed the joint effects of TSE and heavy metals on sex hormones.

Results

Sex hormone-binding globulin (SHBG) showed a positive association with increased per standard deviation (SD) for cotinine (β=0.024 [0.004, 0.043]; P<0.001), lead (β=0.021 [0.002, 0.039]; P=0.028), and cadmium (β=0.034 [0.015, 0.053]; P<0.001). Manganese was positively associated with estradiol (E2) (β=0.025 [0.009, 0.042]; P=0.002). The subjects with higher cadmium levels were more likely to have higher total testosterone (TT) (β=0.042 [0.023, 0.062]; P<0.001). TSE and lead exerted synergistic effects on TT (p for interaction = 0.015) and E2 (p for interaction = 0.009), as also did TSE and cadmium on SHBG (p for interaction = 0.037). Compared with the reference group, TSE participants who were exposed to high concentrations of lead, cadmium, mercury, and manganese had significantly elevated TT levels, but these high levels presented no significant association with E2 levels. A significantly higher level of SHBG among TSE participants was detected in high concentrations for lead, cadmium, and mercury.

Conclusion

TSE exacerbated sex hormone imbalances when combined with high levels of metal exposure. Smoking cessation is crucial, especially in the case of high levels of occupational exposure to heavy metals.

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Data availability

The data used to support the findings of this study are available from the corresponding author upon request.

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Acknowledgements

The authors thank the National Health and Nutrition Examination Survey for publicly available data.

Funding

This manuscript was supported by the Scientific Research Promotion Plan of Anhui Medical University (2021xkjT013), Project of Anhui Provincial Academic and Technical Leaders for Scientific Research Activities (2022D321), Projects of Anhui Provincial Key Laboratory of Population Health and Aristogenics (JKYS20225), and National Natural Science Foundation of China (No.72374005).

Author information

Author notes

  1. Xiaoguo Hua, Rui Hu and Cai Chen are joint first authors.

Authors and Affiliations

  1. Office of Medical Insurance Management, The Second Affiliated Hospital, Anhui Medical University, 678 Furong Road, Hefei, 230601, China

    Xiaoguo Hua & Xiqiu Feng

  2. Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China

    Xiaoguo Hua & Xiujun Zhang

  3. Department of Health Data Science, School of Health Care Management, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China

    Jiangjie Sun

  4. Department of Clinical Teaching Management, The First Affiliated Hospital, Anhui University of Traditional Chinese Medicine, 117 Meishan Road, Hefei, 230031, China

    Rui Hu

  5. Department of Emergency, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China

    Cai Chen

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  1. Xiaoguo Hua
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Contributions

Xiaoguo Hua performed the data analyses and wrote the manuscript. Rui Hu revised the final typescript. Cai Chen searched for and evaluated the retrieved articles. Xiqiu Feng and Jiangjie Sun contributed to the conception of the study. Xiujun Zhang were responsible for the communication of the paper.

Corresponding author

Correspondence to Xiujun Zhang.

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Ethics approval

The application of every technique followed all applicable rules and regulations. The US National Center for Healthcare Statistics (NCHS) granted permission for the implementation of NHANES for 2013–2016.

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The authors declare that they have no conflict of interest.

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Hua, X., Hu, R., Chen, C. et al. Joint effects of tobacco smoke exposure and heavy metals on serum sex hormones in adult males. Hormones (2024). https://doi.org/10.1007/s42000-024-00600-8

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  • DOI: https://doi.org/10.1007/s42000-024-00600-8

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