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Environ Res. 2017 Jul;156:747-760. doi: 10.1016/j.envres.2017.04.038. Epub 2017 May 5.

Is mercury exposure causing diabetes, metabolic syndrome and insulin resistance? A systematic review of the literature.

Author information

1
Centre de Toxicologie du Québec, Institut national de santé publique du Québec (INSPQ), 945 Wolfe, Québec, QC, Canada G1V 5B3; Axe santé publique et pratiques optimales en santé, Centre de recherche du CHU de Québec, 2875 boul. Laurier, Édifice Delta 2, Bureau 600, Québec, QC, Canada G1V 2M2. Electronic address: cynthia.roy@inspq.qc.ca.
2
Centre de Toxicologie du Québec, Institut national de santé publique du Québec (INSPQ), 945 Wolfe, Québec, QC, Canada G1V 5B3; Axe santé publique et pratiques optimales en santé, Centre de recherche du CHU de Québec, 2875 boul. Laurier, Édifice Delta 2, Bureau 600, Québec, QC, Canada G1V 2M2.
3
Centre de Toxicologie du Québec, Institut national de santé publique du Québec (INSPQ), 945 Wolfe, Québec, QC, Canada G1V 5B3; Axe santé publique et pratiques optimales en santé, Centre de recherche du CHU de Québec, 2875 boul. Laurier, Édifice Delta 2, Bureau 600, Québec, QC, Canada G1V 2M2; Département de médecine préventive et sociale, Université Laval, Pavillon Ferdinand-Vandry, Québec, QC, Canada G1V 0A6.

Abstract

INTRODUCTION:

Several populations are exposed to mercury (Hg) via their environment, occupation or diet. It is hypothesized that Hg exposure can lead to the development of diabetes mellitus (DM). Metabolic syndrome (MS) is also a possible outcome as its symptoms are closely linked to those of DM.

METHOD:

We conducted a systematic review of the literature by screening Web of Science, MEDLINE, SciFinder and Embase and we included original studies pertaining to the relationship of total Hg exposure (elemental, inorganic or organic) to DM, MS or insulin resistance. The studies were selected based on the PICOS (patients, intervention, comparator, outcomes and study design) criteria and their quality assessed using a nine-point scale. Study characteristics and results were extracted and presented in structured tables. We also extracted covariates entered as confounding factors to evaluate possible biases in selected studies. Finally, a weight of evidence approach was used to assess the causality of the relationship.

RESULTS:

A total of 34 studies were included in the present review. Epidemiological data assessment suggests a possible association between total Hg concentrations in different biological matrices and incidence of DM or MS, but the relationship is not consistent. In vivo and in vitro studies support the biological plausibility of the relation between Hg exposure and DM or MS. Five out of nine of Bradford Hill's criteria were fulfilled: strength, temporality, plausibility, coherence and analogy.

CONCLUSION:

Increased total Hg exposure may augment the risk of DM and MS, but the lack of consistency of the epidemiological evidence prevents inference of a causal relationship. Additional prospective cohort studies and careful consideration of confounding variables and interactions are required to conclude on the causal relationship of total Hg exposure on the development of DM or MS.

KEYWORDS:

Diabetes; Mercury; Metabolic syndrome; Methylmercury; Systematic review

PMID:
28482296
DOI:
10.1016/j.envres.2017.04.038
[Indexed for MEDLINE]

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