Associations of plasma multiple metals with risk of hyperuricemia: A cross-sectional study in a mid-aged and older population of China

Background Metal exposures are suspected to associate with the risk of hyperuricemia (HUA), but the current results are still conflicting. Objective To investigate the associations between multiple plasma metal exposures and HUA risk. Methods A cross-sectional study was conducted in 1406 Chinese Han adults who underwent routine physical examination in the Eighth Affiliated Hospital of Sun Yat-Sen University in Shenzhen. The plasma levels of 13 metals were measured by the inductively coupled plasma mass spectrometry (ICP-MS). Multivariable logistic, linear regression models, least absolute shrinkage and selection operator (LASSO) penalized regression analysis, and restricted cubic spline (RCS) models were applied to assess the associations. Results The median plasma uric acid concentration in HUA group (434 μmol/L) was significantly higher than that in non-HUA group (305 μmol/L). The multivariate-adjusted odds ratios (95% confidence intervals) of HUA were 1.62(1.08–2.43) for magnesium, 1.61(1.05–2.47) for copper, 1.62(1.06–2.49) for zinc, 1.87(1.26–2.81) for arsenic, 1.50(1.01–2.23) for selenium, and 1.70(1.16–2.49) for thallium based on the single-metal logistic regression models, comparing the highest versus the lowest quartile of metal levels. Further multi-metal logistic, linear regression models and the LASSO analysis all indicated positive associations of zinc, arsenic with HUA risk or uric acid levels. RCS model indicated an inverted V-shaped positive association between zinc levels and HUA risk (p for non-linearity = 0.048, p for overall association = 0.022), while arsenic levels showed a positive and linear dose-response relationship with HUA risk (p for non-linearity = 0.892, p for overall association<0.001). Conclusions Higher plasma levels of zinc and arsenic might increase HUA risk and showed positive dose-response relationships. Further cohort studies in larger population are required to testify our findings.