ORIGINAL RESEARCH article
Front. Public Health
Sec. Environmental Health and Exposome
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1577413
Association between Urinary Heavy Metal Mixtures and Overactive Bladder Risk in the U.S. Adult Population: A Cross-Sectional Study
Provisionally accepted
- 1School of Medicine, Bengbu Medical University, Bengbu, China
- 2School of Anesthesiology, Zunyi Medical University, Zunyi, China
- 3Department of Urology, First Affiliated Hospital of Bengbu Medical University, Bengbu, China
- 4Department of Gynecology and Obstetrics, Affiliated Hospital of Zunyi Medical University, Zunyi, China
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The existing body of literature consistently underscores the adverse health implications associated with exposure to toxic metals among humans. There is still a substantial knowledge gap about how concurrent exposure to metal combinations affects the prevalence of overactive bladder (OAB). Our detailed examination focused on the complex associations between simultaneous heavy metal exposure and OAB in adults. By utilizing data from 7,719 adults in the National Health and Nutrition Examination Survey (NHANES), we assessed both individual and combined effects. From all participants, 1574 (20.39%)were diagnosed with OAB. The research found that elevated urinary levels of cadmium, cobalt, lead, and antimony were associated with a higher risk of OAB. Conversely, urinary barium exhibited a noteworthy protective effect against OAB. Additionally, the weighted quantile sum regression and BKMR models consistently underscored the positive influence of being exposed to multiple urinary metals at the same time on the risk of OAB. The impact was more evident among young and middle-aged people and those who have consumed alcohol, as opposed to older adults and abstainers. The BKMR analysis additionally unveiled potential interactions among specific components of metal mixtures contributing to OAB. The g computation model based on quantiles verified the harmful impacts of metal combinations on OAB. Furthermore, the risk of OAB was positively correlated with Cd and Co, as revealed by restricted cubic spline regression.The research reveals that being exposed to various heavy metals simultaneously significantly boosts the risk of OAB. To thoroughly validate these results, prospective studies are essential due to the limitations of the NHANES study design.Informed consent was obtained from all individual participants included in the study.Patients signed informed consent regarding publishing their data.
Keywords: heavy metal, OAB, WQS model, BKMR model, RCS
Received: 15 Feb 2025; Accepted: 05 Jun 2025.
Copyright: © 2025 Liu, Guo, Su, Xue and Xiong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Sheng Xue, Department of Urology, First Affiliated Hospital of Bengbu Medical University, Bengbu, China
Bing Xiong, Department of Gynecology and Obstetrics, Affiliated Hospital of Zunyi Medical University, Zunyi, China
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