Hu Sihan, Wei Baojian, Zhang Aihua
School of Public Health, Guangxi Medical University, Nanning, China.
School of Nursing, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China.
Front Nutr. 2025 Jul 21;12:1612458. doi: 10.3389/fnut.2025.1612458. eCollection 2025.
Cardiovascular-kidney-metabolic (CKM) syndrome is a complex condition that encompasses cardiovascular, renal, and metabolic disorders. Dietary metal intake plays a crucial role in maintaining normal physiological functions. This study aims to examine the relationship between dietary intake of multiple metals and CKM syndrome.
We analyzed data from 15,233 participants aged 20-79 years in the National Health and Nutrition Examination Survey (NHANES) 2003-2018. Dietary metal intake included nine metals: potassium (K), calcium (Ca), magnesium (Mg), phosphorus (P), iron (Fe), copper (Cu), zinc (Zn), and selenium (Se). CKM syndrome was classified into non-advanced (stages 0-2) and advanced (stages 3-4) stages. We employed weighted logistic regression, restricted cubic splines (RCS) regression, weighted quantile sum (WQS) regression, and quantile-based g computation (qgcomp) models to evaluate the associations between individual metal intake and metal intake mixtures with CKM stages. Subgroup analysis was used to explore potential interaction effect between metal intake and other variables.
Weighted logistic regression models showed that Q2 (≤0.80-1.12 mg/d) (OR = 0.74, 95% CI = 0.60, 0.92), Q3 (≤1.12-1.53 mg/d) (OR = 0.74, 95% CI = 0.58, 0.93) and Q4 (>1.53 mg/d) (OR = 0.73, 95% CI = 0.55, 0.95) groups of Cu intake were significantly associated with a reduced incidence of advanced CKM stages compared with Q1 (≤0.80 mg/d) group. The RCS regression models indicated that higher Cu intake was significantly associated with a lower risk of advanced CKM stages ( for overall < 0.05). WQS regression and qgcomp models did not reveal significant effect of the mixture. Subgroup analysis found that the effect of Cu was robust in various subgroups.
In conclusion, higher dietary intake Cu was linked to a reduced prevalence of advanced CKM stages in the U. S. adult population.
心血管-肾脏-代谢（CKM）综合征是一种复杂的病症，涵盖心血管、肾脏和代谢紊乱。膳食中金属的摄入在维持正常生理功能方面起着至关重要的作用。本研究旨在探讨多种金属的膳食摄入量与CKM综合征之间的关系。
我们分析了2003 - 2018年美国国家健康与营养检查调查（NHANES）中15233名年龄在20 - 79岁的参与者的数据。膳食金属摄入量包括九种金属：钾（K）、钙（Ca）、镁（Mg）、磷（P）、铁（Fe）、铜（Cu）、锌（Zn）和硒（Se）。CKM综合征分为非进展期（0 - 2期）和进展期（3 - 4期）。我们采用加权逻辑回归、受限立方样条（RCS）回归、加权分位数和（WQS）回归以及基于分位数的g计算（qgcomp）模型来评估个体金属摄入量和金属摄入混合物与CKM分期之间的关联。亚组分析用于探索金属摄入量与其他变量之间的潜在交互作用。
加权逻辑回归模型显示，与第一四分位数（≤0.80mg/d）组相比，铜摄入量的第二四分位数（≤0.80 - 1.12mg/d）（OR = 0.74，95%CI = 0.60，0.92）、第三四分位数（≤1.12 - 1.53mg/d）（OR = 0.74，95%CI = 0.58，0.93）和第四四分位数（>1.53mg/d）（OR = 0.73，95%CI = 0.55，0.95）组与进展期CKM分期的发病率降低显著相关。RCS回归模型表明，较高的铜摄入量与进展期CKM分期的较低风险显著相关（总体<0.05）。WQS回归和qgcomp模型未显示混合物的显著影响。亚组分析发现，铜的影响在各个亚组中都很稳健。
总之，在美国成年人群中，较高的膳食铜摄入量与进展期CKM分期的患病率降低有关。
