Department of Male Reproductive Health, Lianyungang Maternal and Child Health Hospital, Lianyungang, China.
Clinical Center of Reproductive Medicine, Lianyungang Maternal and Child Health Hospital, Lianyungang, China.
Front Public Health. 2023 Jul 28;11:1241971. doi: 10.3389/fpubh.2023.1241971. eCollection 2023.
The urinary system serves as a crucial pathway for eliminating metallic substances from the body, making it susceptible to the effects of metal exposure. However, limited research has explored the association between metal mixtures and bladder function. This study aims to investigate the relationship between urinary metal mixtures (specifically barium, cadmium, cobalt, cesium, molybdenum, lead, antimony, thallium, and tungsten) and urine flow rate (UFR) in the general population, utilizing multiple mixture analysis models.
This study utilizes data obtained from the National Health and Nutrition Examination Survey. After adjusting for relevant covariates, we assessed the correlations between metal mixtures and UFR using three distinct analysis models: weighted quantile sum (WQS), quantile g-computation (qgcomp), and Bayesian kernel machine regression (BKMR). Additionally, a gender-stratified analysis was conducted. Finally, we also performed sensitivity analyses.
A total of 7,733 subjects were included in this study, with 49% being male. The WQS regression model, when fitted in the positive direction, did not yield any significant correlations in the overall population or in the male and female subgroups. However, when analyzed in the negative direction, the WQS index exhibited a negative correlation with UFR in the overall group (β = -0.078; 95% CI: -0.111, -0.045). Additionally, a significant negative correlation between the WQS index and UFR was observed in the female group (β = -0.108; 95% CI: -0.158, -0.059), while no significant correlation was found in the male group. The results obtained from the qgcomp regression model were consistent with those of the WQS regression model. Similarly, the BKMR regression model revealed a significant negative correlation trend between metal mixtures and UFR, with cadmium and antimony potentially playing key roles.
Our study revealed a significant negative correlation between urinary metal mixture exposure and mean UFR in US adults, with notable gender differences. Specifically, higher urinary levels of cadmium and antimony were identified as potential key factors contributing to the decrease in mean UFR. These findings significantly contribute to the existing knowledge on the impact of metal mixtures on bladder function and provide valuable insights for safeguarding bladder health and preventing impaired bladder function.
泌尿系统是人体排出金属物质的重要途径，因此容易受到金属暴露的影响。然而，目前关于金属混合物与膀胱功能之间的关系的研究还很有限。本研究旨在利用多种混合物分析模型，探讨一般人群中尿中金属混合物（具体为钡、镉、钴、铯、钼、铅、锑、铊和钨）与尿流率（UFR）之间的关系。
本研究使用了来自国家健康和营养检查调查的数据。在调整了相关协变量后，我们使用三种不同的分析模型：加权分位数总和（WQS）、分位数 g 计算（qgcomp）和贝叶斯核机器回归（BKMR），评估了金属混合物与 UFR 之间的相关性。此外，还进行了性别分层分析。最后，我们还进行了敏感性分析。
本研究共纳入了 7733 名受试者，其中 49%为男性。当 WQS 回归模型正向拟合时，在总体人群或男性和女性亚组中均未发现显著相关性。然而，当以负向拟合时，WQS 指数与总体组的 UFR 呈负相关（β=-0.078；95%CI：-0.111，-0.045）。此外，在女性组中，WQS 指数与 UFR 呈显著负相关（β=-0.108；95%CI：-0.158，-0.059），而在男性组中则没有发现显著相关性。qgcomp 回归模型的结果与 WQS 回归模型的结果一致。同样，BKMR 回归模型显示金属混合物与 UFR 之间存在显著的负相关趋势，其中镉和锑可能起着关键作用。
本研究在美国成年人中发现，尿中金属混合物暴露与平均 UFR 之间存在显著的负相关，且存在显著的性别差异。具体而言，较高的尿镉和锑水平被认为是导致平均 UFR 下降的潜在关键因素。这些发现为金属混合物对膀胱功能的影响提供了新的认识，并为保护膀胱健康和预防膀胱功能障碍提供了有价值的信息。
