The associations between mixed blood heavy metal exposure and depressive symptom: a cross-sectional study in Shandong, China

Abstract Background Given the limited research on the effects of heavy metals on depressive symptoms in young adults and the high prevalence of depression within this age group, it is essential to investigate the potential impact of heavy metals on depressive symptoms. Methods This study involved 20...

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Main Authors: Jing Hou, Yi He, Haifeng Lian, Haosen Yan, Jialian Li, Lailai Yan, Wenzhong Huang, Yiwen Zhang, Sen Gao, Hongwei Sun, Peng Lu
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-23522-5
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author Jing Hou
Yi He
Haifeng Lian
Haosen Yan
Jialian Li
Lailai Yan
Wenzhong Huang
Yiwen Zhang
Sen Gao
Hongwei Sun
Peng Lu
author_facet Jing Hou
Yi He
Haifeng Lian
Haosen Yan
Jialian Li
Lailai Yan
Wenzhong Huang
Yiwen Zhang
Sen Gao
Hongwei Sun
Peng Lu
author_sort Jing Hou
collection DOAJ
description Abstract Background Given the limited research on the effects of heavy metals on depressive symptoms in young adults and the high prevalence of depression within this age group, it is essential to investigate the potential impact of heavy metals on depressive symptoms. Methods This study involved 2027 college students from Shandong, China. Blood concentrations of heavy metals were measured, and depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). The Environmental Risk Score (ERS) was used to analyze the relationship between mixed blood heavy metal exposure and depressive symptoms. Sensitivity analyses were conducted using Bayesian Kernel Machine Regression (BKMR) and quantile g-computation (qgcomp) to explore the mixing effect of heavy metals. Results A significant positive association was found between ERS and the risk of depressive symptoms. The main effects of silver (Ag), antimony (Sb), tin (Sn), lanthanum (La), and cerium (Ce) were also positively associated with depressive symptoms. Notably, Ce showed an inverted “U”-shaped nonlinear relationship with depressive symptoms risk. La and Ce exhibited antagonistic effects on the increased risk. Conclusion In summary, mixed exposure to these five metals may be on the relationship between heavy metal exposure and depressive symptoms in young adults.
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spelling doaj-art-72ad6fb6b5d148ebbb2f2999c848099d2025-08-20T03:06:39ZengBMCBMC Public Health1471-24582025-07-0125111110.1186/s12889-025-23522-5The associations between mixed blood heavy metal exposure and depressive symptom: a cross-sectional study in Shandong, ChinaJing Hou0Yi He1Haifeng Lian2Haosen Yan3Jialian Li4Lailai Yan5Wenzhong Huang6Yiwen Zhang7Sen Gao8Hongwei Sun9Peng Lu10School of Public Health, Binzhou Medical UniversityShanghai Municipal Center for Disease Control and PreventionSchool of Public Health, Binzhou Medical UniversitySchool of Public Health, Binzhou Medical UniversityDepartment of Service and Management, School of Public Service, Yantai Preschool Education CollegePeking UniversityDepartment of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash UniversityDepartment of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash UniversitySchool of Public Health, Binzhou Medical UniversitySchool of Public Health, Binzhou Medical UniversitySchool of Public Health, Binzhou Medical UniversityAbstract Background Given the limited research on the effects of heavy metals on depressive symptoms in young adults and the high prevalence of depression within this age group, it is essential to investigate the potential impact of heavy metals on depressive symptoms. Methods This study involved 2027 college students from Shandong, China. Blood concentrations of heavy metals were measured, and depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). The Environmental Risk Score (ERS) was used to analyze the relationship between mixed blood heavy metal exposure and depressive symptoms. Sensitivity analyses were conducted using Bayesian Kernel Machine Regression (BKMR) and quantile g-computation (qgcomp) to explore the mixing effect of heavy metals. Results A significant positive association was found between ERS and the risk of depressive symptoms. The main effects of silver (Ag), antimony (Sb), tin (Sn), lanthanum (La), and cerium (Ce) were also positively associated with depressive symptoms. Notably, Ce showed an inverted “U”-shaped nonlinear relationship with depressive symptoms risk. La and Ce exhibited antagonistic effects on the increased risk. Conclusion In summary, mixed exposure to these five metals may be on the relationship between heavy metal exposure and depressive symptoms in young adults.https://doi.org/10.1186/s12889-025-23522-5Blood heavy metalsMixturesDepressive symptomsYoung adultsEnvironmental risk scores
spellingShingle Jing Hou
Yi He
Haifeng Lian
Haosen Yan
Jialian Li
Lailai Yan
Wenzhong Huang
Yiwen Zhang
Sen Gao
Hongwei Sun
Peng Lu
The associations between mixed blood heavy metal exposure and depressive symptom: a cross-sectional study in Shandong, China
BMC Public Health
Blood heavy metals
Mixtures
Depressive symptoms
Young adults
Environmental risk scores
title The associations between mixed blood heavy metal exposure and depressive symptom: a cross-sectional study in Shandong, China
title_full The associations between mixed blood heavy metal exposure and depressive symptom: a cross-sectional study in Shandong, China
title_fullStr The associations between mixed blood heavy metal exposure and depressive symptom: a cross-sectional study in Shandong, China
title_full_unstemmed The associations between mixed blood heavy metal exposure and depressive symptom: a cross-sectional study in Shandong, China
title_short The associations between mixed blood heavy metal exposure and depressive symptom: a cross-sectional study in Shandong, China
title_sort associations between mixed blood heavy metal exposure and depressive symptom a cross sectional study in shandong china
topic Blood heavy metals
Mixtures
Depressive symptoms
Young adults
Environmental risk scores
url https://doi.org/10.1186/s12889-025-23522-5
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