Independent correlates of the toenail chromium level and the association between the chromium level and dyslipidemia

Yeji Kang; Yujin Lee; Jakyung Son; Kyong Park

doi:10.4163/jnh.2018.51.1.40

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Kang, Lee, Son, and Park: Independent correlates of the toenail chromium level and the association between the chromium level and dyslipidemia

Research Article

Journal of Nutrition and Health 2018; 51(1): 40-49.

Published online: 28 February 2018

DOI: https://doi.org/10.4163/jnh.2018.51.1.40

Independent correlates of the toenail chromium level and the association between the chromium level and dyslipidemia

Yeji Kang^**, Yujin Lee^**, Jakyung Son, Kyong Park

Department of Food and Nutrition, Yeungnam University, Gyeongsan, Gyeongbuk 38541, Republic of Korea.

To whom correspondence should be addressed. tel: +82-53-810-2879, kypark@ynu.ac.kr

Equal contributor:

**These authors contributed equally to this article.

Received 24 October 2017 Revised 25 November 2017 Accepted 8 February 2018

The Korean Nutrition Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The number of patients with dyslipidemia have been increasing steadily over the past few decades in South Korea. The association between the chromium level and chronic disease has attracted considerable interest, but few studies have been conducted on the Korean population. The aim of this study was to identify the dietary and non-dietary correlates of the toenail chromium level, and evaluate the association between the toenail chromium level and dyslipidemia.

Methods

The baseline data of an ongoing prospective cohort study in Yeungnam area in South Korea were analyzed. A total of 500 participants aged 35 years or older who completed questionnaires on their demographics, lifestyle characteristics, and medical information were included. The toenail chromium level was analyzed by neutron activation analysis. The dietary intake was assessed using a validated 146-item semi-quantitative food frequency questionnaire. The blood lipid profiles were obtained from medical examinations conducted by the Korean National Health Insurance Service or medical institutions.

Results

Higher chromium levels were associated with the residential area (urban), higher education level, higher intakes of noodles and vegetables, and lower intake of fruits. Multiple logistic regression analysis showed that the toenail chromium levels were not associated significantly with the prevalence of dyslipidemia (odds ratio: 0.99, 95% confidence interval: 0.61 ~ 1.60).

Conclusion

This study is the first study in Korea to determine the independent correlates of the toenail chromium levels and the association between chromium exposure and dyslipidemia. These findings provide useful scientific evidence for the development of chromium intake guidelines for the Korean population.

Keywords: chromium, dyslipidemia, toenail, correlates, Korea

Figures and Tables

Table 1

General characteristics of the study participants according to tertiles of toenail chromium levels

Values are mean ± SE or n (%). T, tertiles; KRW, Korea Republic Won; METs, metabolic equivalents; LDL, low density lipoprotein; HDL, high density lipoprotein.

1) p values were derived from a chi-square test for categorical variables, and p for trends was derived from generalized linear regression analysis for continuous variables. 2) Body mass index was categorized into < 23 kg/m² as underweight/normal, 23–24.9 kg/m² as overweight, and ≥ 25 kg/m² as obese based on BMI cut-offs for Asians by the World Health Organization.21 3) Physical activity level was calculated as a weekly METs-hour, and it was categorized into < 20 METs-h/week as low, 20–39 METs-h/week as moderate, and ≥ 40 METs-h/week as high. 4) Values are age and sex-adjusted mean ± SE.

Statistical significance is defined as ^*p < 0.05, ^**p < 0.01, ^***p < 0.001, and NS stands for not significant.

Table 2

General characteristics of the study participants with and without dyslipidemia

Values are mean ± SE or n (%). KRW, Korea Republic Won; METs, metabolic equivalents.

1) p values were derived from a chi-square test for categorical variables, and p for trends was derived from generalized linear regression analysis for continuous variables. 2) Body mass index was into < 23 kg/m² as underweight/normal, 23–24.9 kg/m² as overweight, and ≥ 25 kg/m² as obese based on BMI cut-offs for Asians by the World Health Organization.21 3) Physical activity level was calculated as a weekly METs-hour, and it was categorized into < 20 METs-h/week as low, 20–39 METs-h/week as moderate, and ≥ 40 METs-h/week as high. Statistical significance level is defined as ^*p < 0.05, ^**p < 0.01, ^***p < 0.001, and NS stands for not significant.

Table 3

Dietary and non-dietary correlates of toenail chromium levels

Multivariable-adjusted findings including each of the variables in the table. Independent dietary predictors were identified using stepwise regression. KRW, Korea Republic Won; METs, metabolic equivalents.

1) Body mass index was into < 23 kg/m² as underweight/normal, 23–24.9 kg/m² as overweight, and ≥ 25 kg/m² as obese based on BMI cut-offs for Asians by the World Health Organization.21 2) Physical activity level was calculated as a weekly METs-hour, and it was categorized into < 20 METs-h/week as low, 20–39 METs-h/week as moderate, and ≥ 40 METs-h/week as high.

Statistical significance level is defined as ^*p < 0.05, ^**p < 0.01, ^***p < 0.001, and NS stands for not significant.

Table 4

Odds ratio and 95% confidence interval for dyslipidemia and its components according to toenail chromium levels

T, tertiles; LDL, low density lipoprotein; HDL, high density lipoprotein. Model 1: unadjusted; Model 2: adjusted age, sex, and body mass index; Model 3: additionally adjusted for education level, smoking status, alcohol consumption, physical activity, monthly household income, residential area, and total energy intake; Model 4: additionally adjusted for family history of hypertension and diabetes.

Statistical significance level is defined as ^*p < 0.05, ^**p < 0.01, ^***p < 0.001, and NS stands for not significant.

Notes

This work was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (NRF-2017R1A1A3A04069759). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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