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

Wenhui Gao; Li Tong; Saisai Zhao; Mengzi Sun; Jiaxin Fang; Yan Xu; Yanan Ma; Lina Jin

doi:10.1007/s12011-022-03309-0

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

Biol Trace Elem Res. 2023 Apr;201(4):1659-1669. doi: 10.1007/s12011-022-03309-0. Epub 2022 Jul 9.

Authors

Wenhui Gao¹, Li Tong¹, Saisai Zhao¹, Mengzi Sun¹, Jiaxin Fang¹, Yan Xu¹, Yanan Ma², Lina Jin³

Affiliations

¹ Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, 130021, Jilin, China.
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. ynma@cmu.edu.cn.
³ Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, 130021, Jilin, China. jinln@jlu.edu.cn.

PMID: 35809185
DOI: 10.1007/s12011-022-03309-0

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 (β_men = 0.651 and β_women = 1.014) and urinary Cd (β_men = 0.252 and β_women = 0.613) were positively associated with SUA/SCr, and urinary Pb (β_men = - 0.462 and β_women = - 0.838) was inversely associated with SUA/SCr in multivariate linear regression analysis. However, urinary As (β_men = 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.

Keywords: Bayesian kernel machine regression (BKMR); Joint effects; Mixtures; Toxic metals/metalloids; Uric acid.

MeSH terms

Adult
Arsenic*
Bayes Theorem
Cadmium
Female
Humans
Lead
Male
Mercury*
Metalloids*
Nutrition Surveys
Uric Acid

Substances

Cadmium
Arsenic
Mercury
Lead
Uric Acid
Metalloids