Sex-specific associations between nine metal mixtures in urine and urine flow rate in US adults: NHANES 2009–2018

Frontiers in Public Health · 3 authors, 3 centres

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TL;DR

The central result was a significant negative correlation between the mixture and urine flow rate, with women showing a stronger association than men.

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Researchers used multiple statistical models, including WQS regression, quantile g-computation, and Bayesian kernel machine regression. The main finding was a significant negative correlation between the metal mixture index and UFR in the overall population (β = −0.078) and in women (β = −0.108), but not in men. The study highlights gender-specific effects, with females showing greater sensitivity. Key limitations include the cross-sectional design, which prevents causal inference, and the use of mean UFR rather than measures of direct bladder contractile function. The findings suggest environmental metal exposure may detrimentally affect bladder function, warranting further prospective research.

STUDY TYPE

cross-sectional

SPECIALTY

epidemiology

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AI pipeline

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ORIGINAL PAPER

PMC10420057

Sex-specific associations between nine metal mixtures in urine and urine flow rate in US adults: NHANES 2009–2018

Frontiers in Public Health

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ABSTRACT

Abstract Background The urinary system serves as a crucial pathway for eliminating metallic substances from the body, making it susceptible to the effects of metal exposure. However, limited research has explored the association between metal mixtures and bladder function. This study aims to investigate the relationship between urinary metal mixtures (specifically barium, cadmium, cobalt, cesium, molybdenum, lead, antimony, thallium, and tungsten) and urine flow rate (UFR) in the general population, utilizing multiple mixture analysis models. Methods This study utilizes data obtained from the National Health and Nutrition Examination Survey. After adjusting for relevant covariates, we assessed the correlations between metal mixtures and UFR using three distinct analysis models: weighted quantile sum (WQS), quantile g-computation (qgcomp), and Bayesian kernel machine regression (BKMR). Additionally, a gender-stratified analysis was conducted. Finally, we also performed sensitivity analyses. Results A total of 7,733 subjects were included in this study, with 49% being male. The WQS regression model, when fitted in the positive direction, did not yield any significant correlations in the overall population or in the male and female subgroups. However, when analyzed in the negative direction, the WQS index exhibited a negative correlation with UFR in the overall group (β = −0.078; 95% CI: −0.111, −0.045). Additionally, a significant negative correlation between the WQS index and UFR was observed in the female group (β = −0.108; 95% CI: −0.158, −0.059), while no significant correlation was found in the male group. The results obtained from the qgcomp regression model were consistent with those of the WQS regression model. Similarly, the BKMR regression model revealed a significant negative correlation trend between metal mixtures and UFR, with cadmium and antimony potentially playing key roles. Conclusion Our study revealed a significant negative correlation between urinary metal mixture exposure and mean UFR in US adults, with notable gender differences. Specifically, higher urinary levels of cadmium and antimony were identified as potential key factors contributing to the decrease in mean UFR. These findings significantly contribute to the existing knowledge on the impact of metal mixtures on bladder function and provide valuable insights for safeguarding bladder health and preventing impaired bladder function. Keywords: urine flow rate, metal mixtures, BKMR, WQS, qgcomp, NHANES, US adults

CITATION EXPORT

Shuai Zhang, Hanhan Tang, Minglian Zhou. Sex-specific associations between nine metal mixtures in urine and urine flow rate in US adults: NHANES 2009–2018. Frontiers in Public Health. (2023). https://doi.org/10.3389/fpubh.2023.1241971

AUTHORS

3 · 3 CENTRES

Shuai Zhang, Hanhan Tang, Minglian Zhou

1Department of Male Reproductive Health, Lianyungang Maternal and Child Health Hospital, Lianyungang, China
2Clinical Center of Reproductive Medicine, Lianyungang Maternal and Child Health Hospital, Lianyungang, China
3Graduate School of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China