Relationship between urinary and water fluoride with cardiovascular risk factors in children and adolescents in Yazd city

Background Although the prevalence of cardiovascular diseases is low during childhood and adolescence, behavioral and biological risk factors and lifestyle associated with noncommunicable diseases are formed during this period and persist into adulthood. The present study aimed to investigate urinary fluoride levels and their relationship with risk factors for cardiovascular diseases in children and adolescents in Yazd city in 2024. Methods This cross-sectional study was conducted on 161 children and adolescents aged 6 to 18 years in Yazd city. Water fluoride was measured at 56 points of the drinking water network. Demographic information, physical activity, and fluoride exposure factors were collected through a questionnaire. Physical examinations included measurements of height, weight, body mass index (BMI), waist circumference, and systolic blood pressure (SBP) and diastolic blood pressure (DBP). Blood samples were taken from participants to measure lipid profiles (TC, HDL, LDL, and TG), fasting blood sugar (FBS), magnesium, and calcium, and urine samples were taken to measure fluoride and creatinine. Urinary fluoride was measured using an ion-selective electrode. Results The mean age of the participants was 11.95 ± 3.74 years, and the largest age group was adolescents aged 12 to 18 years (50.9%). The mean urinary fluoride (mg/L) was reported to be 0.49 ± 0.29. Lack of calcium supplementation was significantly associated with higher urinary fluoride (mg/g cr) levels (p = 0.004). Water fluoride was associated with a decrease in BMI in the total participants, especially in adolescents, and an increase in SBP and DBP z-score in the total participants. Urinary fluoride was significantly associated with a decrease in BMI and SBP z-score in children, a decrease in BMI and waist circumference in the general population, and a decrease in TC, HDL, and TG in the general population and adolescents. These results showed changes after adjustment for demographic, behavioral, nutritional, and metabolic factors, which indicates the importance of considering moderating variables in examining the effect of fluoride exposure. Conclusion The study findings showed that water and urine fluoride levels are associated with some anthropometric indices and cardiovascular risk factors in children and adolescents. Longitudinal studies are necessary to confirm these findings and determine the causal relationship between fluoride exposure and cardiovascular risk factors.