Associations of urinary metal concentrations with anemia: A cross-sectional study of Chinese community-dwelling elderly

Guojie Qiao; Zhuoheng Shen; Siyu Duan; Rui Wang; Pei He; Zhongyuan Zhang; Yuqing Dai; Meiyan Li; Yue Chen; Xiaoyu Li; Yi Zhao; Zhihong Liu; Huifang Yang; Rui Zhang; Suzhen Guan; Jian Sun

Ecotoxicology and Environmental Safety (Jan 2024)

Associations of urinary metal concentrations with anemia: A cross-sectional study of Chinese community-dwelling elderly

Guojie Qiao,
Zhuoheng Shen,
Siyu Duan,
Rui Wang,
Pei He,
Zhongyuan Zhang,
Yuqing Dai,
Meiyan Li,
Yue Chen,
Xiaoyu Li,
Yi Zhao,
Zhihong Liu,
Huifang Yang,
Rui Zhang,
Suzhen Guan,
Jian Sun

Affiliations

Guojie Qiao: Radioimmunity Center, Shaanxi Provincial People’s Hospital, Xi’an, 710069, Shaanxi, P.R. China; Correspondence to: No.256, Youyi West Road, Beilin District, Xi’an, 710069, Shaanxi, P.R. China.
Zhuoheng Shen: School of Public Health, Ningxia Medical University, Yinchuan, 750004, Ningxia, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia, P.R. China
Siyu Duan: School of Public Health, Ningxia Medical University, Yinchuan, 750004, Ningxia, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia, P.R. China
Rui Wang: School of Public Health, Ningxia Medical University, Yinchuan, 750004, Ningxia, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia, P.R. China
Pei He: School of Public Health, Ningxia Medical University, Yinchuan, 750004, Ningxia, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia, P.R. China
Zhongyuan Zhang: School of Public Health, Ningxia Medical University, Yinchuan, 750004, Ningxia, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia, P.R. China
Yuqing Dai: School of Public Health, Ningxia Medical University, Yinchuan, 750004, Ningxia, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia, P.R. China
Meiyan Li: School of Public Health, Ningxia Medical University, Yinchuan, 750004, Ningxia, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia, P.R. China
Yue Chen: School of Public Health, Ningxia Medical University, Yinchuan, 750004, Ningxia, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia, P.R. China
Xiaoyu Li: School of Public Health, Ningxia Medical University, Yinchuan, 750004, Ningxia, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia, P.R. China
Yi Zhao: School of Public Health, Ningxia Medical University, Yinchuan, 750004, Ningxia, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia, P.R. China
Zhihong Liu: School of Public Health, Ningxia Medical University, Yinchuan, 750004, Ningxia, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia, P.R. China
Huifang Yang: School of Public Health, Ningxia Medical University, Yinchuan, 750004, Ningxia, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia, P.R. China
Rui Zhang: School of Public Health, Ningxia Medical University, Yinchuan, 750004, Ningxia, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia, P.R. China; Ningxia Key Laboratory of Cerebrocranial Disease, Incubation Base of National Key Laboratory, Ningxia Medical University, Yinchuan, 750004, Ningxia, P.R. China
Suzhen Guan: School of Public Health, Ningxia Medical University, Yinchuan, 750004, Ningxia, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia, P.R. China; Correspondence to: No.1160, Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, P.R. China
Jian Sun: School of Public Health, Ningxia Medical University, Yinchuan, 750004, Ningxia, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia, P.R. China; Correspondence to: No.1160, Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, P.R. China

Journal volume & issue: Vol. 270
p. 115828

Abstract

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Background: Anemia seriously affects the health and quality of life of the older adult population and may be influenced by various types of environmental metal exposure. Current studies on metals and anemia are mainly limited to single metals, and the association between polymetals and their mixtures and anemia remains unclear. Methods: We determined 11 urinary metal concentrations and hemoglobin levels in 3781 participants. Binary logistic regression and restricted cubic spline (RCS) model were used to estimate the association of individual metals with anemia. We used Bayesian kernel machine regression (BKMR) and Quantile g-computation (Q-g) regression to assess the overall association between metal mixtures and anemia and identify the major contributing elements. Stratified analyses were used to explore the association of different metals with anemia in different populations. Results: In a single-metal model, nine urinary metals significantly associated with anemia. RCS analysis further showed that the association of arsenic (As) and copper (Cu) with anemia was linear, while cobalt, molybdenum, thallium, and zinc were non-linear. The BKMR model revealed a significant positive association between the concentration of metal mixtures and anemia. Combined Q-g regression analysis suggested that metals such as Cu, As, and tellurium (Te) were positively associated with anemia, with Te as the most significant contributor. Stratified analyses showed that the association of different metals with anemia varied among people of different sexes, obesity levels, lifestyle habits, and blood pressure levels. Conclusions: Multiple metals are associated with anemia in the older adult population. A significant positive association was observed between metal mixture concentrations and anemia, with Te being the most important factor. The association between urinary metal concentrations and anemia is more sensitive in the non-hypertensive populations.

Published in Ecotoxicology and Environmental Safety

ISSN: 0147-6513 (Print); 1090-2414 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Technology: Environmental technology. Sanitary engineering: Environmental pollution; Geography. Anthropology. Recreation: Environmental sciences
Website: https://www.journals.elsevier.com/ecotoxicology-and-environmental-safety

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