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Exposure to Cadmium, Lead, Mercury, and Arsenic and Uric Acid Levels: Results from NHANES 2007–2016

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Abstract

Mechanisms underlying abnormal uric acid (UA) levels from exposure to toxic metals/metalloids have not been not fully elucidated, especially in the context of mixtures. The aim was to identify major toxic metals/metalloids that affected UA levels with a mixture exposure concept in the association model. From 2007–2016 National Health and Nutrition Examination Survey (NHANES), 4794 adults were involved. Serum UA (SUA) and SUA to serum creatinine ratio (SUA/SCr) were used to estimate the UA levels, and cadmium (Cd), lead (Pb), mercury (Hg), and arsenic (As) in the blood and/or urine were evaluated in the study. We assessed the associations between toxic metals and UA levels using linear regression and Bayesian kernel machine regression (BKMR). The median [P25, P75] SUA/SCr and SUA level were 6.22 [5.27, 7.32] and 0.83 [0.72, 0.98], respectively. There was no difference for SUA/SCr by gender (men, 6.25 [5.39, 7.29]; women, 6.17 [5.17, 7.36], P = 0.162), but men had higher SUA than women (men, 0.95 [0.85, 1.05]; women, 0.72 [0.64, 0.82], P < 0.001). Blood Pb (βmen = 0.651 and βwomen = 1.014) and urinary Cd (βmen = 0.252 and βwomen = 0.613) were positively associated with SUA/SCr, and urinary Pb (βmen =  − 0.462 and βwomen =  − 0.838) was inversely associated with SUA/SCr in multivariate linear regression analysis. However, urinary As (βmen = 0.351) was positively associated with SUA/SCr only in men. BKMR showed that higher concentrations of exposure to a mixture of toxic metals were positively associated with higher UA levels, where Cd, Pb, and urinary As contributed most to the overall mixture effect in men, while Pb and urinary Cd in women. Our study provided the first evidence that mixtures of metals are associated with the UA levels. Increased concentrations of metals, mainly blood Pb, urinary Cd, and As (only in men) may increase the level of UA.

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Data Availability

The data that support the findings of this study are openly available in https://www.cdc.gov/nchs/nhanes/. Information from NHANES is made available through an extensive series of publications and articles in scientific and technical journals. For data users and researchers throughout the world, survey data are available on the Internet and on easy-to-use CD-ROMs.

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Funding

This research work was conducted with the financial support from the Natural Science Foundation of Science and Technology Development of Jilin Province, China (Grant No. 20180101129JC).

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, 130021, Jilin, China

    Wenhui Gao, Li Tong, Saisai Zhao, Mengzi Sun, Jiaxin Fang, Yan Xu & Lina Jin

  2. Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China

    Yanan Ma

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  1. Wenhui Gao
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  2. Li Tong
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  3. Saisai Zhao
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  4. Mengzi Sun
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  6. Yan Xu
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  7. Yanan Ma
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Contributions

Wenhui Gao: Data curation, conceptualization; methodology; software; formal analysis; validation; writing, original draft preparation; writing, review and editing. Li Tong: Writing, review and editing; investigation, resources, supervision. Saisai Zhao: Writing, review and editing; resources; data curation. Mengzi Sun: Writing, review and editing; data curation; visualization. Jiaxin Fang: Writing, review and editing; data curation; visualization. Yan Xu: Writing, review and editing; resources. Yanan Ma: Writing, review and editing; supervision; conceptualization; project administration. Lina Jin: Writing, review and editing; supervision; conceptualization; project administration.

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Correspondence to Yanan Ma or Lina Jin.

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Gao, W., Tong, L., Zhao, S. et al. Exposure to Cadmium, Lead, Mercury, and Arsenic and Uric Acid Levels: Results from NHANES 2007–2016. Biol Trace Elem Res 201, 1659–1669 (2023). https://doi.org/10.1007/s12011-022-03309-0

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