Association between urinary trace metals and multiple health outcomes

Objective To explore the association between trace metals and multiple health outcomes. Methods The cross-sectional study was from eight cycles of National Health and Nutrition Examination Survey (NHANES) from 2005 to 2020. We evaluated the relationship between 11 types of urinary trace metals and multiple health outcomes. Results A total of 3051 participants were included in this study. The levels of barium, cesium, molybdenum, lead, antimony, thallium were significantly reduced in women, while cobalt was increased (p<0.01). Except for kidney stones and sleep disorders, there were significant difference in at least one type of trace metals among the participants with or without diseases. Cadmium was the most common trace metal had significant differences. Antimony could significantly increase the risk of thyroid problem and sleep disorders in women, while cobalt and manganese were just related to the risk of arthritis in man. There was a nonlinear (L-shaped) relationship between tin and heart disease, cadmium and stroke, cadmium and emphysema respectively. Conclusions Urinary trace metals, particularly cadmium, are modifiable risk factors for multisystem health outcomes, with effects modulated by biological sex and metal co-exposure patterns.