Association of lead, mercury and cadmium with diabetes in the Korean population: The Korea National Health and Nutrition Examination Survey (KNHANES) 2009–2010




Despite increasing concern regarding health problems as a result of environmental pollutants, no association of toxic heavy metals with diabetes has been demonstrated in the general population. We investigated the association of heavy metals, including lead, mercury and cadmium, with diabetes in the Korean population.


This cross-sectional study is based on data from the fourth and fifth Korea National Health and Nutritional Examination Surveys, which were conducted in 2009 and 2010 among members of the Korean population. Participants included 1588 men and 1596 women, 30 years of age or older, who were selected from all of the 16 administrative districts of South Korea. Measurements of blood lead, mercury and cadmium levels were performed. Homeostatic model assessment of insulin resistance and homeostatic model assessment of β-cell function were calculated in participants without diabetes.


Blood concentration of lead, mercury and cadmium were slightly higher, but non-significantly, in participants with diabetes, compared with those without. After adjustment for age, sex, region, smoking, alcohol consumption and regular exercise, the prevalence of diabetes did not differ among quartiles of blood heavy metal concentrations. Correlation analysis of heavy metals with homeostatic model assessment of insulin resistance and β-cell function did not indicate a significant relationship. The relationship of sum of heavy metal mixture with prevalent diabetes was also not significant.


Blood lead, mercury and cadmium have no significant relationship with diabetes in the general Korean population.