PMID- 37690549 OWN - NLM STAT- MEDLINE DCOM- 20230927 LR - 20230927 IS - 1879-1298 (Electronic) IS - 0045-6535 (Linking) VI - 341 DP - 2023 Nov TI - Associations between urinary heavy metals and anxiety among adults in the National Health and Nutrition Examination Survey (NHANES), 2007-2012. PG - 140085 LID - S0045-6535(23)02355-X [pii] LID - 10.1016/j.chemosphere.2023.140085 [doi] AB - BACKGROUND: Few studies have investigated the associations between heavy metals and anxiety. The purpose of this study was to examine the associations between single and combined exposure to heavy metals and anxiety. METHODS: This study employed data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2012. Anxiety was assessed by patients self-reporting the number of anxious days per month. First, we evaluated the associations between 10 heavy metals single exposure and anxiety by multivariable logistic regression. We then selected 5 heavy metals (cadmium, antimony, cobalt, tungsten, and uranium) for further analysis by elastic net regression. Subsequently, principal component analysis (PCA), weighted quantile regression (WQS), and Bayesian kernel machine regression (BKMR) were utilized to evaluate the associations between 5 heavy metals co-exposure and anxiety. RESULTS: This study included 4512 participants, among whom 1206 participants were in an anxiety state. Urinary cadmium and antimony were separately related to an increased risk of anxiety (p for trend <0.01 and < 0.01, respectively). In PCA analysis, PC1 was associated with an increased risk of anxiety (p for trend <0.001). In WQS analysis, the positive WQS index was substantially linked with the risk of anxiety (OR (95%CI): 1.23 (1.04,1.39)). In BKMR analysis, the overall effects of co-exposure to heavy metals were positively connected with anxiety. CONCLUSION: Our study identified a positive correlation between individual exposure to cadmium and antimony and the risk of anxiety. Additionally, the co-exposure to cadmium, antimony, cobalt, tungsten, and uranium was associated with an increased risk of anxiety. CI - Copyright (c) 2023 Elsevier Ltd. All rights reserved. FAU - Gui, Jianxiong AU - Gui J AD - Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China. FAU - Ding, Ran AU - Ding R AD - Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China. FAU - Huang, Dishu AU - Huang D AD - Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China. FAU - Wang, Lingman AU - Wang L AD - Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China. FAU - Han, Ziyao AU - Han Z AD - Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China. FAU - Yang, Xiaoyue AU - Yang X AD - Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China. FAU - Yang, Jiaxin AU - Yang J AD - Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China. FAU - Luo, Hanyu AU - Luo H AD - Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China. FAU - Jiang, Li AU - Jiang L AD - Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China. Electronic address: dr_jiangcqmu@163.com. LA - eng PT - Journal Article DEP - 20230909 PL - England TA - Chemosphere JT - Chemosphere JID - 0320657 RN - 9IT35J3UV3 (Antimony) RN - 00BH33GNGH (Cadmium) RN - V9306CXO6G (Tungsten) RN - 4OC371KSTK (Uranium) RN - 3G0H8C9362 (Cobalt) SB - IM MH - Humans MH - Adult MH - Nutrition Surveys MH - *Antimony MH - Cadmium MH - Tungsten MH - *Uranium MH - Bayes Theorem MH - Anxiety/epidemiology MH - Cobalt OTO - NOTNLM OT - Anxiety OT - Co-exposure OT - Cross-sectional study OT - Heavy metals OT - NHANES COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2023/09/11 00:42 MHDA- 2023/09/27 06:43 CRDT- 2023/09/10 19:24 PHST- 2023/04/08 00:00 [received] PHST- 2023/09/01 00:00 [revised] PHST- 2023/09/04 00:00 [accepted] PHST- 2023/09/27 06:43 [medline] PHST- 2023/09/11 00:42 [pubmed] PHST- 2023/09/10 19:24 [entrez] AID - S0045-6535(23)02355-X [pii] AID - 10.1016/j.chemosphere.2023.140085 [doi] PST - ppublish SO - Chemosphere. 2023 Nov;341:140085. doi: 10.1016/j.chemosphere.2023.140085. Epub 2023 Sep 9.