Investigating the correlation between blood manganese concentrations and anemia in U.S. adults: a nationally representative study

Background The health implications of trace elements have become increasingly concerning, yet the connection between blood manganese levels and anemia remains insufficiently examined. This research endeavors to explore the potential linkage between blood manganese concentrations and anemia.Methods U...

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Main Authors: Wei Shui, Yuanyuan Niu, Changran Zhang, Qianying Pan
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Hematology
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Online Access:https://www.tandfonline.com/doi/10.1080/16078454.2025.2460895
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author Wei Shui
Yuanyuan Niu
Changran Zhang
Qianying Pan
author_facet Wei Shui
Yuanyuan Niu
Changran Zhang
Qianying Pan
author_sort Wei Shui
collection DOAJ
description Background The health implications of trace elements have become increasingly concerning, yet the connection between blood manganese levels and anemia remains insufficiently examined. This research endeavors to explore the potential linkage between blood manganese concentrations and anemia.Methods Utilizing data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018, this study examines the correlation between blood manganese levels and anemia among U.S. adults, offering a comprehensive national perspective. The study included 11,300 adults aged 20 and above, with both blood manganese and hemoglobin levels measured. Generalized Additive Model (GAM) was applied to delineate smooth curves, and threshold effect analysis was performed to identify the inflection points of these curves. Subsequently, unconditional logistic regression was employed to assess the risk.Results Our research involved a total of 11,300 individuals, among which 1,143 (10.1%) were identified with anemia. The curve fitting analysis indicated a U-shaped relationship between blood manganese levels and the risk of anemia. Specifically, when blood manganese levels were below 8.69 µg/L, increasing concentrations were linked to a decreased risk of anemia, with an adjusted OR of 0.838 (95% CI: 0.735–0.954), indicating a protective effect of this level of blood manganese against anemia. Conversely, when blood manganese levels were at or above 8.69 µg/L, further elevations were strongly associated with an increased risk of anemia, with the adjusted OR rising to 1.160 (95% CI: 1.124–1.196), suggesting that excessively high blood manganese levels significantly raised the risk of developing anemia.Conclusion This study provides novel insights into the association between blood manganese levels and anemia. Further extensive, population-based cohort studies are necessary to validate the causality and to uncover the intrinsic toxicological mechanisms.
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spelling doaj-art-6f23a4cdfb814321b8fcf0b176368e7d2025-08-20T03:05:29ZengTaylor & Francis GroupHematology1607-84542025-12-0130110.1080/16078454.2025.2460895Investigating the correlation between blood manganese concentrations and anemia in U.S. adults: a nationally representative studyWei Shui0Yuanyuan Niu1Changran Zhang2Qianying Pan3Department of General Practice, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaDepartment of General Practice, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaDepartment of General Practice, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaDepartment of Hematology, the Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, ChinaBackground The health implications of trace elements have become increasingly concerning, yet the connection between blood manganese levels and anemia remains insufficiently examined. This research endeavors to explore the potential linkage between blood manganese concentrations and anemia.Methods Utilizing data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018, this study examines the correlation between blood manganese levels and anemia among U.S. adults, offering a comprehensive national perspective. The study included 11,300 adults aged 20 and above, with both blood manganese and hemoglobin levels measured. Generalized Additive Model (GAM) was applied to delineate smooth curves, and threshold effect analysis was performed to identify the inflection points of these curves. Subsequently, unconditional logistic regression was employed to assess the risk.Results Our research involved a total of 11,300 individuals, among which 1,143 (10.1%) were identified with anemia. The curve fitting analysis indicated a U-shaped relationship between blood manganese levels and the risk of anemia. Specifically, when blood manganese levels were below 8.69 µg/L, increasing concentrations were linked to a decreased risk of anemia, with an adjusted OR of 0.838 (95% CI: 0.735–0.954), indicating a protective effect of this level of blood manganese against anemia. Conversely, when blood manganese levels were at or above 8.69 µg/L, further elevations were strongly associated with an increased risk of anemia, with the adjusted OR rising to 1.160 (95% CI: 1.124–1.196), suggesting that excessively high blood manganese levels significantly raised the risk of developing anemia.Conclusion This study provides novel insights into the association between blood manganese levels and anemia. Further extensive, population-based cohort studies are necessary to validate the causality and to uncover the intrinsic toxicological mechanisms.https://www.tandfonline.com/doi/10.1080/16078454.2025.2460895ManganeseanemiaNHANES
spellingShingle Wei Shui
Yuanyuan Niu
Changran Zhang
Qianying Pan
Investigating the correlation between blood manganese concentrations and anemia in U.S. adults: a nationally representative study
Hematology
Manganese
anemia
NHANES
title Investigating the correlation between blood manganese concentrations and anemia in U.S. adults: a nationally representative study
title_full Investigating the correlation between blood manganese concentrations and anemia in U.S. adults: a nationally representative study
title_fullStr Investigating the correlation between blood manganese concentrations and anemia in U.S. adults: a nationally representative study
title_full_unstemmed Investigating the correlation between blood manganese concentrations and anemia in U.S. adults: a nationally representative study
title_short Investigating the correlation between blood manganese concentrations and anemia in U.S. adults: a nationally representative study
title_sort investigating the correlation between blood manganese concentrations and anemia in u s adults a nationally representative study
topic Manganese
anemia
NHANES
url https://www.tandfonline.com/doi/10.1080/16078454.2025.2460895
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