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Gao W, Tong L, Zhao S, Sun M, Fang J, Xu Y, Ma Y, Jin L. Exposure to Cadmium, Lead, Mercury, and Arsenic and Uric Acid Levels: Results from NHANES 2007-2016. Biol Trace Elem Res 2023; 201:1659-1669. [PMID: 35809185 DOI: 10.1007/s12011-022-03309-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/30/2022] [Indexed: 11/26/2022]
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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Affiliation(s)
- Wenhui Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, 130021, Jilin, China
| | - Li Tong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, 130021, Jilin, China
| | - Saisai Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, 130021, Jilin, China
| | - Mengzi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, 130021, Jilin, China
| | - Jiaxin Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, 130021, Jilin, China
| | - Yan Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, 130021, Jilin, China
| | - Yanan Ma
- 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.
| | - Lina Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, 130021, Jilin, China.
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