OBJECTIVE: Increased fluoride levels can lead to numerous complications, including
skeletal effects, cardiotoxicity, endocrine dysfunction, neurotoxicity, hepatotoxicity
and nephrotoxicity. The aim of this study was to analyze the relationship between serum fluoride levels and MetS or its individual components, and to assess the diagnostic usefulness of fluoride as a factor contributing to MetS.
PATIENTS AND METHODS: The study included a group of 475 women (mean age of 52.9 years), living in the West Pomeranian Voivodeship in Poland. The study involved data collection and biochemical analysis.
RESULTS: Analysis of the relationship between the levels of fluoride and the presence of
MetS or its components showed that the mean fluoride level was statistically significantly higher in patients with hypertriglyceridemia (dCohen = 0.39; 95% CI; confidence limits: 0.13, 0.63) and hypertension (dCohen = 0.25; 95% CI; confidence limits: 0.07, 0.44). Moreover, the mean fluoride level was significantly higher in women who met the diagnostic criteria for MetS than in the remaining subjects (dCohen = 0.40; 95% CI; confidence limits: 0.17, 0.64).
CONCLUSIONS: Elevated serum fluoride levels may be associated with an increased incidence of MetS among perimenopasal women, although its diagnostic value as a marker of MetS is limited.
Metabolic syndrome (MetS) is defined as a cluster of symptoms whose coexistence significantly contributes to cardiovascular disease, type 2 diabetes, stroke, and other conditions, thus increasing the risk of premature death1. The definition of MetS has evolved over time into its current form, adopted in 2009. The components of this disorder include: reduced high-density lipoprotein cholesterol, and increased waist circumference, triglycerides (TG), blood pressure and fasting plasma glucose. The presence of three out of the five above-mentioned criteria qualifies for the diagnosis of MetS. Attempts are still made to define the causes of this disorder, the most important of which are lifestyle, genetic factors, insulin resistance, chronic inflammation, the disturbed circadian rhythm, and sleep disorders2. A high incidence of metabolic disorders in the general population, and the risk they pose, make MetS a serious public health problem3. Women in the perimenopausal period are especially likely to develop MetS components due to changes that then occur in their bodies. They include the changed distribution of adipose tissue, a potential increase in insulin resistance, changes in serum lipid levels, and a higher incidence of arterial hypertension4.
The likelihood of developing metabolic disorders in perimenopausal women may be enhanced by many factors, of which nutritional factors (balanced diet, exposure to xenobiotics) appear to be of key importance. Xenobiotics include fluorides characterized by a very narrow safety range between the optimal dose (beneficial in the prevention of dental caries) and the chronic poisoning with this element, regarded as a cumulative toxin5. Excessive fluoride levels can lead to numerous complications, including skeletal effects, cardiotoxicity, and endocrine dysfunction6, as well as neurotoxicity, hepatotoxicity and nephrotoxicity7.
Fluorides are commonly found in a wide range of concentrations in the natural environment – in soil, water, air, rocks, plants and animals8. They are absorbed by the human body to the
greatest extent along with water, oral hygiene products, chemicals and pharmaceuticals, as well as through smoking and exposure to industrial emissions. Among all food products, tea is considered to be one of the main contributors to an increase in the daily intake of fluorides7. So far, neither the key role of fluoride for the human body, nor the symptoms of its deficiency in humans have been observed. Fluorides are used in prevention of dental caries. Therefore, in some countries they are added to water and food products, although there is evidence that using them locally in the form of toothpaste is a more effective method of protecting teeth5.
It is essential for public health to understand the impact of relatively low levels of fluoride
(mainly from food and oral care products) on bodily function and the reasons behind the sharp increase in the incidence of metabolic disorders in humans. Hence, the aim of this study was to analyze the relationship between serum fluoride levels and MetS or its individual components, and to assess the diagnostic usefulness of fluoride as a factor contributing to MetS.
Patients and Methods
The study included a group of 475 perimenopausal women, living in the West Pomeranian
Voivodeship in Poland. They were recruited through the dissemination of information in the
local community. Information posters with an invitation to participate in the study were put up in public places, such as schools, offices, health care clinics and others, and published in the local press. People with neoplastic, infectious and psychiatric diseases were excluded from the study.
References [cited above]
1) Saklayen MG. The global epidemic of the metabolic syndrome. Curr Hypertens Rep 2018; 20: 12.
2) Nilsson PM, Tuomilehto J, Rydén L. The Metabolic Syndrome – What Is It and How Should It Be Managed? Eur J Prev Cardiol 2019; 26: 33-46.
3) Sherling DH, Perumareddi P, Hennekens CH. Metabolic syndrome. J Cardiovasc Pharmacol Ther 2017; 22: 365-367.
4) Mumusoglu S, Yildiz BO. Metabolic syndrome during menopause. Curr Vasc Pharmacol 2019; 17: 595-603.
5) Waugh DT, Potter W, Limeback H, Godfrey M. Risk Assessment of fluoride intake from tea in the republic of ireland and its implications for public health and water fluoridation. Int J Environ Res Public Health 2016; 13: 259.
6) Skórka-Majewicz M, Goschorska M, ?wiere??o W, Baranowska-Bosiacka I, Styburski D, Kapczuk P, Gutowska I. Effect of fluoride on endocrine tissues and their secretory functions – review. Chemosphere 2020; 127565.
7) National Research Council. Review of Fluoride in Drinking Water. Washington: U.S. The National Academic Press; 2006.
v8) Sowers M, Whitford GM, Clark MK, Jannausch ML. Elevated Serum Fluoride Concentrations in Women Are Not Related to Fractures and Bone Mineral Density. J Nutr 2005; 135: 2247-52.