PMID- 37858011 OWN - NLM STAT- MEDLINE DCOM- 20231123 LR - 20231216 IS - 1614-7499 (Electronic) IS - 0944-1344 (Linking) VI - 30 IP - 53 DP - 2023 Nov TI - Synergistic impact of co-exposures to whole blood metals on chronic kidney disease in general US adults: a cross‑sectional study of the National Health and Nutrition Examination Survey 2011-2020. PG - 113948-113961 LID - 10.1007/s11356-023-30177-5 [doi] AB - The impact of exposure to metals on chronic kidney disease (CKD) has only been investigated in two-way or single metal interactions in previous studies. We investigated the associations between five single metals in blood and their mixed exposure and CKD by using the machine learning approach. Relevant data were extracted from the National Health and Nutrition Examination Survey (NHANES 2011-2020), and the level of five metals in blood detected by inductively coupled plasma mass spectrometry was considered as exposures, namely, cadmium (Cd), lead (Pb), total mercury (Hg), manganese (Mn), and selenium (Se). The correlations between individual metal and metal mixtures and CKD were then evaluated by survey-multivariable logistic regression (SMLR), generalized weighted quantile sum (WQS), and Bayesian kernel machine regression (BKMR). Altogether, our study included 12,412 participants representing 572.6 million non-institutionalized US adults. Several single metals with the high quartile of exposure showed a positive association with the CKD ratio including Cd [(AOR = 1.873, 95% CI: 1.537, 2.284), Q4], Pb [(AOR = 1.559, 95% CI: 1.295, 1.880), Q4], and total Hg [(AOR = 1.169, 95% CI: 1.018, 1.343), Q2], while Mn [(AOR = 0.796, 95% CI: 0.684, 0.927), Q2] and Se [(AOR = 0.805, 95% CI: 0.664, 0.976), Q4] were negatively associated with the CKD ratio. In light of the positive fit of the WQS regression model, a significantly positive correlation was found between mixed metals and CKD (AOR = 1.373, 95% CI: 1.224, 1.539) after full covariate adjustment, and a similar finding was also detected in the BKMR model. Our study revealed that each single metal including Cd, Pb, and total Hg might have a positive association with CKD while this association was negative for both Mn and Se. The five metals might have a positive joint effect on CKD. CI - (c) 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. FAU - Liang, Jing-Hong AU - Liang JH AD - Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China. FAU - Pu, Ying-Qi AU - Pu YQ AD - Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China. FAU - Liu, Mei-Ling AU - Liu ML AD - Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China. FAU - Bao, Wen-Wen AU - Bao WW AD - Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China. FAU - Zhang, Yu-Shan AU - Zhang YS AD - Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China. FAU - Hu, Li-Xin AU - Hu LX AD - Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China. FAU - Huang, Shan AU - Huang S AD - Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China. FAU - Jiang, Nan AU - Jiang N AD - Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China. FAU - Huang, Shao-Yi AU - Huang SY AD - Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China. FAU - Pu, Xue-Ya AU - Pu XY AD - Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China. FAU - Dong, Guang-Hui AU - Dong GH AD - Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China. FAU - Chen, Ya-Jun AU - Chen YJ AUID- ORCID: 0000-0003-3132-2945 AD - Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China. chenyj68@mail.sysu.edu.cn. LA - eng GR - 82273650/National Natural Science Foundation of China/ PT - Journal Article DEP - 20231019 PL - Germany TA - Environ Sci Pollut Res Int JT - Environmental science and pollution research international JID - 9441769 RN - 00BH33GNGH (Cadmium) RN - 2P299V784P (Lead) RN - FXS1BY2PGL (Mercury) RN - 42Z2K6ZL8P (Manganese) RN - H6241UJ22B (Selenium) RN - 0 (Metals, Heavy) SB - IM MH - Adult MH - Humans MH - Nutrition Surveys MH - Cross-Sectional Studies MH - Cadmium MH - Bayes Theorem MH - Lead MH - *Mercury MH - Manganese MH - *Selenium MH - *Renal Insufficiency, Chronic/epidemiology MH - *Metals, Heavy OTO - NOTNLM OT - Chronic kidney disease OT - General US adults OT - Metals exposure OT - NHANES EDAT- 2023/10/20 00:43 MHDA- 2023/11/23 06:42 CRDT- 2023/10/19 23:50 PHST- 2023/07/02 00:00 [received] PHST- 2023/09/26 00:00 [accepted] PHST- 2023/11/23 06:42 [medline] PHST- 2023/10/20 00:43 [pubmed] PHST- 2023/10/19 23:50 [entrez] AID - 10.1007/s11356-023-30177-5 [pii] AID - 10.1007/s11356-023-30177-5 [doi] PST - ppublish SO - Environ Sci Pollut Res Int. 2023 Nov;30(53):113948-113961. doi: 10.1007/s11356-023-30177-5. Epub 2023 Oct 19.