Associations of blood and urinary heavy metals with rheumatoid arthritis risk among adults in NHANES, 1999–2018

• Published in: Chemosphere (Oxford) 2022-02, Vol.289, p.133147-133147, Article 133147
• Main Authors: Chen, Li, Sun, Qiuzi, Peng, Shufen, Tan, Tianqi, Mei, Guibin, Chen, Huimin, Zhao, Ying, Yao, Ping, Tang, Yuhan
• Format: Article
• Language: English
• Subjects: Adult; Arthritis, Rheumatoid - chemically induced; Arthritis, Rheumatoid - epidemiology; Bayes Theorem; Cadmium; Heavy metals; Humans; Joint exposure; Metals, Heavy; Middle Aged; NHANES; Nutrition Surveys; Rheumatoid arthritis; Uranium
• ISSN: 0045-6535; 1879-1298
• DOI: 10.1016/j.chemosphere.2021.133147

Heavy metals exposure has been widely recognized as a risk factor for human health. However, limited information is available about the impacts of heavy metals on rheumatoid arthritis (RA). Herein, we estimated the associations of 3 blood and 11 urinary metals with the risk of RA among 49830 U.S. adults from the National Health and Nutrition Examination Survey (NHANES), 1999–2018. In the single-exposure model, blood cadmium (Cd) and lead (Pb), urinary Cd, Pb, antimony (Sb), tungsten (Tu), and uranium (Ur) were identified to be positively associated with RA risk. Furthermore, weighted quantile sum (WQS) regression, quantile-based g computation (qgcomp), and Bayesian kernel machine regression (BKMR) analyses consistently showed that both blood and urinary metals-mixed exposure were positively correlated with the risk of RA, and highlighted that Cd and Pb were responsible for the outcomes. Such associations were more evident in the young and middle-aged population. These findings indicated that exposure to heavy metals increased RA risk, and advanced the identification of risk factors for RA. [Display omitted] •Single-exposure and mixed-exposure models to explore the role of heavy metals in RA.•Blood Cd and Pb, urine Cd, Pb, Sb, Tu and Ur were positively related to RA risk.•WQS, qgcomp and BKMR models consistently showed toxic effect of mixed metals on RA.•Cd and Pb were identified as the major contributor to RA risk.•More evident association of heavy metals and RA risk in young and middle-aged people.