Association between fluoride exposure and the risk of serum CK and CK-MB elevation in adults: a cross-sectional study in China

TL;DR

This study found that higher fluoride exposure is linked to increased levels of certain heart-related enzymes in adults in China.

Contribution

The study identifies a novel association between fluoride exposure and elevated CK and CK-MB levels in adults.

Findings

Higher urinary fluoride was associated with increased odds of serum CK and CK-MB elevation.

The association was stronger in younger villagers, females, and those with obesity or alcohol/smoking habits.

Fluoride exposure was not linked to myocardial ischemia, arrhythmia, or other enzyme levels like LDH or AST.

Abstract

This study aimed to investigate the relationship between urinary fluoride concentration and myocardial disease.

This is a cross-sectional study that was conducted in three villages in Wenshui County, Shanxi Province. A total of 737 villagers were included in this analysis. Urinary fluoride was detected using a fluoride-ion selective electrode. Myocardial enzymes were detected using an automatic biochemical analyzer. Myocardial ischemia and arrhythmia were diagnosed using 12-lead electrocardiogram.

The median level of urinary fluoride concentration was 1.32 mg/L. Urinary fluoride was associated with serum creatine kinase (CK) elevation (odds ratio [OR] = 1.39 [95% confidence interval (CI)]: 1.09–1.78) and CK isoenzyme (CK-MB) elevation (OR = 1.49 [95% CI: 1.12–1.97]). Stratified analysis revealed that urinary fluoride concentration was associated with CK elevation in villagers under the age of 60 years (OR = 1.80 [95% CI: 1.26–2.59]). This study found that there was a positive association between urinary fluoride concentration and the risk of CK-MB elevation in participants under the age of 60 years(OR = 2.18 [95% CI: 1.39–3.42]), those who were of female gender (OR = 1.53 [95% CI: 1.07–2.19]), those who were overweight/obese (OR = 1.96 [95% CI: 1.28–2.99]), those who had central obesity (OR = 1.59 [95% CI: 1.12–2.25]), consumed alcohol (OR = 1.49 [95% CI: 1.09–2.05]), and smoked (OR = 1.50 [95% CI: 1.10–2.04]).

Our study suggests that fluoride exposure is associated with the risk of serum CK and CK-MB elevation; however, it is not associated with myocardial ischemia, arrhythmia, serum lactate dehydrogenase (LDH), serum alpha-hydroxybutyrate dehydrogenase (α-HBD), or serum aspartate aminotransferase (AST). Further investigations are needed to substantiate our findings and explore the potential underlying mechanisms.