Abstract
Background: People come into contact with heavy metals in various ways in their daily lives. Accumulating evidence shows that toxic metal exposure is hazardous to human health. However, limited information is available regarding the impact of metal mixtures on stress urinary incontinence (SUI).
Methods: In this specific survey, data from the National Health and Nutrition Examination Survey (NHANES) for eight cycles from 2003 to 2018. Logistic regression, weighted quantile sum (WQS) regression, quantile-based g-computation (qgcomp), Bayesian kernel machine regression (BKMR) analyses, and Restricted cubic spline (RCS) analysis were used to explore the independent and comprehensive associations of heavy metal exposure with SUI risk.
Results: A total of 10622 U.S. adults were included, and 2455 (23.11%) were diagnosed with SUI. In the single-exposure model, blood cadmium (Cd), lead (Pb), mercury (Hg), urinary Cd, Pb, and cesium (Cs) were found to be positively connected with SUI risk. Moreover, WQS, qgcomp, and BKMR models consistently demonstrated blood and urinary metals-mixed exposure were positively associated with the risk of SUI, and emphasized that blood Pb and Cd and urinary Cd and Cs were the main positive drivers, respectively. This association was more pronounced in the young and middle-aged group (20-59 years old) and the female group.
Conclusions: Using large-scale national data, we found that even after adjusting for twelve confounding factors, heavy metal exposure significantly increases the risk of SUI in the general population.