Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China, 510080.
Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.
Environ Sci Pollut Res Int. 2023 Sep;30(42):96604-96616. doi: 10.1007/s11356-023-28903-0. Epub 2023 Aug 14.
With little knowledge on the joint effects of metal exposure on dyslipidemia, we aimed to investigate the relationship between exposure to metal and dyslipidemia among US adults based on the National Health and Nutrition Examination Survey (NHANES). Based on the five NHANES waves (2011-2020), we selected five metals in blood as exposure, namely, cadmium (Cd), lead (Pb), total mercury (Hg), manganese (Mn), and selenium (Se), which were detected by inductively coupled plasma mass spectrometry. Survey-multivariable logistic regression, generalized weighted quantile sum (WQS), and Bayesian kernel machine regression (BKMR) were performed to determine whether dyslipidemia was associated with single metals or mixed metals. Our study included 12,526 participants aged from 20 to 80, representing 577.1 million non-institutionalized US adults. We found a positive association between several metals including Pb [adjusted odds ratio (AOR) = 1.332, 95%CI: 1.165, 1.522], total Hg (AOR = 1.264, 95%CI: 1.120, 1.427), Mn (AOR = 1.181, 95%CI: 1.046, 1.334), and Se (AOR = 1.771, 95%CI: 1.576, 1.992) and dyslipidemia. According to the WQS approach, metal mixtures were positively associated with dyslipidemia (AOR: 1.310, 95%CI: 1.216, 1.411) after a full-model adjustment. As is shown in the BKMR model, mixed metals tended to be positively associated with dyslipidemia ratios in a significant manner. Females, non-Hispanic White populations, people aged over 60, and those who did a little physical activity had a greater risk for dyslipidemia. Our findings suggest metals including Cd, Pb, Hg, Mn, and Se and their combinations may adversely affect dyslipidemia among US adults. Due to the cross-sectional nature of the study, it is possible that reverse causation may exist.
由于对金属暴露对血脂异常的联合影响知之甚少，我们旨在根据国家健康和营养检查调查（NHANES）研究美国成年人中金属暴露与血脂异常之间的关系。基于五次 NHANES 波（2011-2020 年），我们选择了血液中的五种金属作为暴露因素，即镉（Cd）、铅（Pb）、总汞（Hg）、锰（Mn）和硒（Se），这些金属是通过电感耦合等离子体质谱法检测的。采用多变量调查逻辑回归、广义加权总量和（WQS）以及贝叶斯核机器回归（BKMR）来确定血脂异常是否与单一金属或混合金属有关。我们的研究包括了 12526 名年龄在 20 至 80 岁之间的参与者，代表了 5.771 亿非机构化的美国成年人。我们发现一些金属之间存在正相关关系，包括 Pb[调整后的优势比（AOR）=1.332，95%置信区间（CI）：1.165，1.522]、总 Hg（AOR=1.264，95%CI：1.120，1.427）、Mn（AOR=1.181，95%CI：1.046，1.334）和 Se（AOR=1.771，95%CI：1.576，1.992）与血脂异常之间存在正相关。根据 WQS 方法，在全模型调整后，金属混合物与血脂异常呈正相关（AOR：1.310，95%CI：1.216，1.411）。在 BKMR 模型中，混合金属与血脂异常比值呈显著正相关。女性、非西班牙裔白人、60 岁以上人群和体力活动较少的人群血脂异常的风险更高。我们的研究结果表明，包括 Cd、Pb、Hg、Mn 和 Se 及其组合的金属可能会对美国成年人的血脂异常产生不利影响。由于研究的横断面性质，可能存在反向因果关系。
