Geographical Variations in Metal Exposure and Its Impact on Metabolic Disorders: An Exposome- Based Analysis of Chile's 2016-17 National Health Survey

Exposure to metals may disrupt metabolic pathways, contributing to metabolic disorders. Local environmental factors may modulate these effects, emphasizing the importance of territorial disaggregation. This population-based study evaluated geographic variations in exposure to four metals and their associations with obesity, diabetes, metabolic syndrome, and hypertension in Chile. Data from 3,822 participants in the National Health Survey (2016-17) were analyzed. Biomarkers included inorganic arsenic, cadmium, mercury in urine, and lead in serum. Metal exposure was classified according to the 50th percentile distribution. Spatial simultaneous autoregressive models accounted for territorial disaggregation and spatial dependencies. 42.4% of individuals were exposed to arsenic, 13.6% to lead, and 1.7% to mercury and cadmium. Elevated arsenic exposure was observed in northern areas, with lead exposure peaking at 29.9%. Adjusted models revealed no associations at the national level. Geographical disaggregation revealed that arsenic exposure was linked to obesity across most areas and to diabetes and metabolic syndrome in the northern and central zones. Mercury was associated with all conditions in the central macrozone, whereas cadmium exposure was linked to diabetes in the southern. These findings underscore critical regional differences in metal exposure and metabolic disorders, highlighting the need for geographically targeted public health interventions considering contextual factors.