School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
Public Health Service Center, Bao'an District, Shenzhen 518126, China.
Nutrients. 2024 Oct 9;16(19):3424. doi: 10.3390/nu16193424.
Anemia significantly contributes to the global disease burden, with its incidence potentially influenced by the trace metal content within the body.
This study aims to examine the associations between trace metals and anemia risk, with a particular focus on investigating the potential mediating roles of iron status and inflammation in these associations.
Five trace metals (Ni, Co, Mn, Se, and Mo) were examined in 1274 US adults, utilizing data from the National Health and Nutrition Examination Survey (NHANES) 2017-2020. The individual and combined effects of these metals on anemia were assessed using logistic regression, quantile g-computation (QGC), and Bayesian kernel machine regression (BKMR). A sex-stratified analysis was conducted to discern any gender-specific susceptibilities. Additionally, mediation analysis was employed to explore the potential mediating roles of iron status and inflammation in the associations between these metals and anemia.
Increased risks of anemia were positively associated with Co and Ni levels but negatively correlated with Se and Mn levels (all with < 0.05). The trace metal mixture was negatively associated with anemia, with the highest weights of Co and Se in different directions in both the QGC and BKMR models. In the sex-specific analysis, we observed less pronounced protective effects from trace metals in females. Moreover, the mediating proportion of the iron status and inflammation in these relationships ranged from 10.29% to 58.18%.
Our findings suggest that the trace element mixture was associated with decreased anemia risk, among which Se was a protective factor while Co was a risk factor, and females were more susceptible. The effects of these trace metals on anemia may be mediated by the iron status and inflammation.
贫血症显著影响全球疾病负担，其发病率可能受体内微量元素含量的影响。
本研究旨在探讨微量元素与贫血风险之间的关联，特别关注铁状态和炎症在这些关联中的潜在中介作用。
利用 2017-2020 年国家健康和营养调查（NHANES）的数据，在 1274 名美国成年人中检查了 5 种微量元素（镍、钴、锰、硒和钼）。使用逻辑回归、分位数广义估计方程（QGC）和贝叶斯核机器回归（BKMR）评估这些金属对贫血的个体和综合影响。进行了性别分层分析，以辨别任何性别特异性易感性。此外，还进行了中介分析，以探讨铁状态和炎症在这些金属与贫血之间的关联中的潜在中介作用。
贫血的风险与 Co 和 Ni 水平呈正相关，与 Se 和 Mn 水平呈负相关（均<0.05）。微量元素混合物与贫血呈负相关，在 QGC 和 BKMR 模型中，Co 和 Se 的权重在不同方向上均为负。在性别特异性分析中，我们观察到女性中微量元素的保护作用不太明显。此外，铁状态和炎症在这些关系中的中介比例范围为 10.29%至 58.18%。
我们的研究结果表明，微量元素混合物与降低贫血风险相关，其中 Se 是保护因素，而 Co 是风险因素，女性更易受影响。这些微量元素对贫血的影响可能通过铁状态和炎症来介导。
