Associations of multiple metals with inflammatory markers in US adults: NHANES 2013-2016

Abstract Exposure to metals can disrupt the human immune system. However, few studies have explored the potential effects of multiple metals co-exposure on immune function related to inflammation markers in human. This study examined the associations between metals exposure and inflammatory markers.The Data were gathered from the 2013–2016 period of National Health and Nutrition Examination Survey (NHANES). Inflammatory markers included platelet count (PLT), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), the ratios of MPV to PLT (MPVP), white blood cell (WBC), and neutrophil-to-lymphocyte ratio (NLR). Associations between 13 urinary metals and inflammatory markers were estimated. Generalized linear model showed urinary barium, cadmium, lead, thallium and cobalt concentrations were associated with MPV, PLR, and NLR. In quantile g-computation, urinary metal mixture was negatively associated with MPV, but positively associated with PLR and NLR. Overall, our study demonstrated that metal mixture was associated with inflammation markers including MPV, PLR, and NLR, which enhancing the inflammatory response.