Yu Mingtao, Tan Leyun, Chen Yuhui, Shang Jianhui, You Yingbin, Xie Haiming, Pang Nan, Liang Rimei, Zhang Qingying
Department of Preventive Medicine, Shantou University Medical College, No.22, Xinling Road, Shantou, 515041, Guangdong, People's Republic of China.
Baoan Central Hospital of Shenzhen, No. 233, Xixiang Section, Guangshen Road, Baoan District, Shenzhen, 518102, Guangdong, People's Republic of China.
Biol Trace Elem Res. 2025 Jun 24. doi: 10.1007/s12011-025-04721-y.
The imbalance of trace elements plays an important role in childhood malnutrition, but previous studies are usually specific to certain elements. We aimed to examine the individual and joint associations between multiple elements and the risk of protein-energy malnutrition (PEM) in young school children. This study measured the serum levels of zinc (Zn), copper (Cu), chromium (Cr), cobalt (Co), vanadium (V), manganese (Mn), and nickel (Ni) in 1832 out of 5152 children aged 6 to 9 years by using inductively coupled plasma mass spectrometry (ICP-MS). The individual and joint associations between elements and the risk of PEM were assessed using logistic regression, Restricted Cubic Spline (RCS), Bayesian Kernel Machine Regression (BKMR), and Weighted Quantile Sum Regression (WQS) models, respectively. Serum concentrations of Zn, Cu, Co, V, Mn, and Ni were significantly lower in the PEM group than in controls (all P < 0.005). Higher quartile concentrations of Zn (OR = 0.52), Cu (OR = 0.59), V (OR = 0.52), Mn (OR = 0.51), and Ni (OR = 0.68) were associated with lower PEM risk (all P < 0.05). RCS model indicated non-linear relationships between Zn, Cu, Cr, Co, V, Mn, and PEM risk. Interactions were found between Zn, Mn, and Co on the risk of PEM. Both BKMR and WQS models revealed a negative joint association between the seven elements and PEM risk (OR = - 0.102), with Mn (40.4%) and Zn (19.1%) identified as the strongest contributors. Serum concentrations of Zn, Cu, Co, V, and Mn were relatively lower in children with PEM and exhibited non-linear associations with the risk of PEM. The joint association of seven trace elements was negative with the risk of PEM, in which Mn and Zn contribute the most. Additionally, Mn, Zn, and Co exhibited pairwise interactions. These findings highlight the importance of maintaining balanced trace element levels to mitigate PEM in children.
微量元素失衡在儿童营养不良中起着重要作用，但以往的研究通常局限于某些特定元素。我们旨在研究多种元素与学龄儿童蛋白质 - 能量营养不良（PEM）风险之间的个体关联和联合关联。本研究采用电感耦合等离子体质谱法（ICP - MS）测量了5152名6至9岁儿童中1832名儿童的血清锌（Zn）、铜（Cu）、铬（Cr）、钴（Co）、钒（V）、锰（Mn）和镍（Ni）水平。分别使用逻辑回归、受限立方样条（RCS）、贝叶斯核机器回归（BKMR）和加权分位数和回归（WQS）模型评估元素与PEM风险之间的个体关联和联合关联。PEM组儿童的血清Zn、Cu、Co、V、Mn和Ni浓度显著低于对照组（所有P < 0.005）。较高四分位数浓度的Zn（OR = 0.52）、Cu（OR = 0.59）、V（OR = 0.52）、Mn（OR = 0.51）和Ni（OR = 0.68）与较低的PEM风险相关（所有P < 0.05）。RCS模型表明Zn、Cu、Cr、Co、V、Mn与PEM风险之间存在非线性关系。发现Zn、Mn和Co在PEM风险上存在相互作用。BKMR和WQS模型均显示这七种元素与PEM风险之间存在负向联合关联（OR = - 0.102），其中Mn（40.4%）和Zn（19.1%）被确定为最强贡献因素。PEM儿童的血清Zn、Cu、Co、V和Mn浓度相对较低，且与PEM风险呈非线性关联。七种微量元素的联合关联与PEM风险呈负相关，其中Mn和Zn贡献最大。此外，Mn、Zn和Co表现出两两相互作用。这些发现凸显了维持微量元素水平平衡以减轻儿童PEM的重要性。
