PMID- 37817047 OWN - NLM STAT- MEDLINE DCOM- 20240506 LR - 20240506 IS - 1559-0720 (Electronic) IS - 0163-4984 (Linking) VI - 202 IP - 7 DP - 2024 Jul TI - Association of Exposure to Heavy Metal Mixtures with Systemic Immune-Inflammation Index Among US Adults in NHANES 2011-2016. PG - 3005-3017 LID - 10.1007/s12011-023-03901-y [doi] AB - In reality, people are often co-exposed to multiple heavy metals; however, current research has focused on the association between individual heavy metals and inflammation. Therefore, it is more relevant to explore the combined effects of multiple heavy metal exposure on inflammation. The study included data from the National Health and Nutrition Examination Survey (NHANES), 2011-2016. The systemic immune-inflammation index (SII) was used to reflect systemic immune-inflammation status. In this study, single variable models were used to assess the linear and non-linear relationships between single heavy metal exposures and SII. To analyze the combined effect of mixed heavy metals exposure on SII, we constructed three statistical models, including weighted quantile sum (WQS) regression, quantile-based g computation (qgcomp), and Bayesian kernel machine regression (BKMR). The single-exposure analysis found positive associations between multiple heavy metals and SII, while mercury in blood was negatively associated with SII, and U-shaped correlations were observed between blood lead, urine barium and strontium, and SII. In the WQS model, SII increased significantly with increasing concentrations of mixed heavy metals, while consistent results in the qgcomp model, but not statistically significant. In the BKMR model, exposure to heavy metal mixtures was positively associated with SII, with mercury, cadmium, and cobalt in urine contributing the most to the mixed exposure. In addition, synergistic and antagonistic effects between heavy metals on increasing SII were found in our study. In summary, our results reveal that combined exposure to multiple heavy metals is positively associated with SII in the US adults. CI - (c) 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. FAU - Sun, Xiaoya AU - Sun X AD - Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Rd, Hefei, 230032, Anhui, China. AD - The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China. FAU - Deng, Yujie AU - Deng Y AD - Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Rd, Hefei, 230032, Anhui, China. AD - The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China. FAU - Fang, Lanlan AU - Fang L AD - Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Rd, Hefei, 230032, Anhui, China. AD - The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China. FAU - Ni, Man AU - Ni M AD - Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Rd, Hefei, 230032, Anhui, China. AD - The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China. FAU - Wang, Xinqi AU - Wang X AD - Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Rd, Hefei, 230032, Anhui, China. AD - The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China. FAU - Zhang, Tao AU - Zhang T AD - Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Rd, Hefei, 230032, Anhui, China. AD - The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China. FAU - Chen, Yuting AU - Chen Y AD - Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Rd, Hefei, 230032, Anhui, China. AD - The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China. FAU - Cai, Guoqi AU - Cai G AD - Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Rd, Hefei, 230032, Anhui, China. AD - The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China. FAU - Pan, Faming AU - Pan F AD - Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Rd, Hefei, 230032, Anhui, China. famingpan@ahmu.edu.cn. AD - The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China. famingpan@ahmu.edu.cn. LA - eng GR - 82073655/National Natural Science Foundation of China/ GR - 2017D140/academic and technical leaders in Anhui province/ GR - 2021lcxk043/Clinical Medicine Discipline construction project of Anhui Medical University/ PT - Journal Article DEP - 20231010 PL - United States TA - Biol Trace Elem Res JT - Biological trace element research JID - 7911509 RN - 0 (Metals, Heavy) SB - IM MH - Humans MH - *Metals, Heavy/blood/urine/adverse effects MH - *Nutrition Surveys MH - Adult MH - *Inflammation/chemically induced/immunology/blood MH - United States/epidemiology MH - Female MH - Male MH - Middle Aged MH - Environmental Exposure/adverse effects MH - Bayes Theorem MH - Young Adult OTO - NOTNLM OT - Cadmium OT - Combined effect OT - Heavy metals OT - Mercury OT - NHANES OT - Systemic immune-inflammation index EDAT- 2023/10/11 00:42 MHDA- 2024/05/06 12:45 CRDT- 2023/10/10 23:46 PHST- 2023/06/16 00:00 [received] PHST- 2023/09/30 00:00 [accepted] PHST- 2024/05/06 12:45 [medline] PHST- 2023/10/11 00:42 [pubmed] PHST- 2023/10/10 23:46 [entrez] AID - 10.1007/s12011-023-03901-y [pii] AID - 10.1007/s12011-023-03901-y [doi] PST - ppublish SO - Biol Trace Elem Res. 2024 Jul;202(7):3005-3017. doi: 10.1007/s12011-023-03901-y. Epub 2023 Oct 10.