Non-linear associations between serum manganese with chronic kidney disease: results from two nationwide studies in the United States and China

Introduction This study aimed to better evaluate the association between serum manganese (Mn) and chronic kidney disease (CKD) by using data from the United States National Health and Nutrition Examination Survey (NHANES) and the Chinese Longitudinal Healthy Longevity Study (CLHLS).Materials and met...

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Main Authors: Jiliang Zhang, Yimei Wang, Shi Jin, Nana Song, Shuan Zhao, Yi Fang, Hao Zhang, Yang Li, Xiaoqiang Ding
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2025.2512049
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author Jiliang Zhang
Yimei Wang
Shi Jin
Nana Song
Shuan Zhao
Yi Fang
Hao Zhang
Yang Li
Xiaoqiang Ding
author_facet Jiliang Zhang
Yimei Wang
Shi Jin
Nana Song
Shuan Zhao
Yi Fang
Hao Zhang
Yang Li
Xiaoqiang Ding
author_sort Jiliang Zhang
collection DOAJ
description Introduction This study aimed to better evaluate the association between serum manganese (Mn) and chronic kidney disease (CKD) by using data from the United States National Health and Nutrition Examination Survey (NHANES) and the Chinese Longitudinal Healthy Longevity Study (CLHLS).Materials and methods A total of 15411 and 451 participants were selected from NHANES and CLHLS, respectively. The primary diagnosis of CKD was defined as eGFR <60 mL/min/1.73 m2 and urinary albumin-creatinine-ratio (ACR) ≥30 mg/g. Multivariable regression and threshold analyses were used to assess the associations between Mn level and CKD.Results The prevalence of CKD was estimated to be 8.1% in NHANES and 47.7% in CLHLS. After adjusting for covariates, participants with the highest quartile (Q4) of Mn had an increased likelihood of CKD than those with Q1 (OR = 0.69, 95% CI 0.56–0.84 in NHANES, and OR = 0.32, 95% CI 0.17–0.59 in CLHLS). The non-linear associations revealed that the OR values of CKD were decreased with Mn before reaching the threshold (OR = 0.65 per 1 μg/L increase of Mn in NHANES and 0.98 in CLHLS). Beyond the threshold, further increases in Mn levels were no longer associated with a statistically significant protective effect against CKD risk. This association remained robust by using the continuity of eGFR and ACR as the outcome. Exploration analysis showed that superoxide dismutase (SOD) mediated 6.7% of the effect of Mn levels on CKD.Conclusions The higher Mn concentration was significantly associated with a lower prevalence of CKD through different non-linear patterns.
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spelling doaj-art-984e9e6fea694daa9a0b193410fb81572025-08-20T03:24:47ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492025-12-0147110.1080/0886022X.2025.2512049Non-linear associations between serum manganese with chronic kidney disease: results from two nationwide studies in the United States and ChinaJiliang Zhang0Yimei Wang1Shi Jin2Nana Song3Shuan Zhao4Yi Fang5Hao Zhang6Yang Li7Xiaoqiang Ding8Clinical Laboratory, Lishui People’s Hospital, The Sixth Affiliated Hospital of Wenzhou Medical University, Lishui, ChinaDepartment of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Preventive Dentistry, Shanghai Stomatological Hospital &amp; School of Stomatology, Fudan University, Shanghai, ChinaDepartment of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, ChinaIntroduction This study aimed to better evaluate the association between serum manganese (Mn) and chronic kidney disease (CKD) by using data from the United States National Health and Nutrition Examination Survey (NHANES) and the Chinese Longitudinal Healthy Longevity Study (CLHLS).Materials and methods A total of 15411 and 451 participants were selected from NHANES and CLHLS, respectively. The primary diagnosis of CKD was defined as eGFR <60 mL/min/1.73 m2 and urinary albumin-creatinine-ratio (ACR) ≥30 mg/g. Multivariable regression and threshold analyses were used to assess the associations between Mn level and CKD.Results The prevalence of CKD was estimated to be 8.1% in NHANES and 47.7% in CLHLS. After adjusting for covariates, participants with the highest quartile (Q4) of Mn had an increased likelihood of CKD than those with Q1 (OR = 0.69, 95% CI 0.56–0.84 in NHANES, and OR = 0.32, 95% CI 0.17–0.59 in CLHLS). The non-linear associations revealed that the OR values of CKD were decreased with Mn before reaching the threshold (OR = 0.65 per 1 μg/L increase of Mn in NHANES and 0.98 in CLHLS). Beyond the threshold, further increases in Mn levels were no longer associated with a statistically significant protective effect against CKD risk. This association remained robust by using the continuity of eGFR and ACR as the outcome. Exploration analysis showed that superoxide dismutase (SOD) mediated 6.7% of the effect of Mn levels on CKD.Conclusions The higher Mn concentration was significantly associated with a lower prevalence of CKD through different non-linear patterns.https://www.tandfonline.com/doi/10.1080/0886022X.2025.2512049Chronic kidney diseasemanganesethreshold analysisNHANESCLHLS
spellingShingle Jiliang Zhang
Yimei Wang
Shi Jin
Nana Song
Shuan Zhao
Yi Fang
Hao Zhang
Yang Li
Xiaoqiang Ding
Non-linear associations between serum manganese with chronic kidney disease: results from two nationwide studies in the United States and China
Renal Failure
Chronic kidney disease
manganese
threshold analysis
NHANES
CLHLS
title Non-linear associations between serum manganese with chronic kidney disease: results from two nationwide studies in the United States and China
title_full Non-linear associations between serum manganese with chronic kidney disease: results from two nationwide studies in the United States and China
title_fullStr Non-linear associations between serum manganese with chronic kidney disease: results from two nationwide studies in the United States and China
title_full_unstemmed Non-linear associations between serum manganese with chronic kidney disease: results from two nationwide studies in the United States and China
title_short Non-linear associations between serum manganese with chronic kidney disease: results from two nationwide studies in the United States and China
title_sort non linear associations between serum manganese with chronic kidney disease results from two nationwide studies in the united states and china
topic Chronic kidney disease
manganese
threshold analysis
NHANES
CLHLS
url https://www.tandfonline.com/doi/10.1080/0886022X.2025.2512049
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