Relationship between blood heavy metals and female stress urinary incontinence from NHANES 2013–2018

Background: Research has demonstrated that heavy metals and cholesterol are associated with stress urinary incontinence (SUI) in women and that heavy metal exposure can cause dyslipidemia in humans. However, the potential mediating role of cholesterol in the relationship between heavy metals and fem...

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Main Authors: Yan-zhen Wu, Xi-meng Chen
Format: Article
Language:English
Published: Komiyama Printing Co. Ltd 2025-05-01
Series:Environmental Health and Preventive Medicine
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Online Access:https://www.jstage.jst.go.jp/article/ehpm/30/0/30_25-00021/_html/-char/en
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author Yan-zhen Wu
Xi-meng Chen
author_facet Yan-zhen Wu
Xi-meng Chen
author_sort Yan-zhen Wu
collection DOAJ
description Background: Research has demonstrated that heavy metals and cholesterol are associated with stress urinary incontinence (SUI) in women and that heavy metal exposure can cause dyslipidemia in humans. However, the potential mediating role of cholesterol in the relationship between heavy metals and female SUI remains unexplored. Methods: The study utilized data from the National Health and Nutrition Examination Survey database from 2013–2018. Blood lead (Pb), cadmium (Cd), total mercury (Hg), manganese (Mn), selenium (Se), and methyl mercury (MeHg) were included in the study. The single and combined effects of the six metals exposure on SUI were examined using logistic analysis, restricted cubic spline (RCS) curves, weighted quantile sum (WQS) regression, and bayesian kernel machine regression (BKMR). The mediating effects of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were investigated through mediation analysis. Results: The study included 2241 females, with 42.66% experiencing SUI. Initial analysis of six heavy metals revealed the associations between MeHg, Pb, Cd, total Hg, and SUI (all P < 0.05). WQS regression identified that Cd, Se, and Pb were major contributors to the mixed effect causing SUI. BKMR results indicated a positive mixed effect between six heavy metals and SUI. TC partially mediated the relationship of Pb, MeHg, and total Hg with SUI, and LDL-C partially mediated the association of Pb with SUI (all P for mediation < 0.05). Conclusions: Blood heavy metal concentrations influence the development of female SUI, with blood cholesterol mediating the association between different heavy metals and SUI.
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spelling doaj-art-a424c6e526ac4cf48fcdd17b96c49d672025-08-20T03:12:36ZengKomiyama Printing Co. LtdEnvironmental Health and Preventive Medicine1342-078X1347-47152025-05-0130454510.1265/ehpm.25-00021ehpmRelationship between blood heavy metals and female stress urinary incontinence from NHANES 2013–2018Yan-zhen Wu0Xi-meng Chen1Department of gynecology and obstetrics, Wenzhou Central HospitalDepartment of urology, Wenzhou Central HospitalBackground: Research has demonstrated that heavy metals and cholesterol are associated with stress urinary incontinence (SUI) in women and that heavy metal exposure can cause dyslipidemia in humans. However, the potential mediating role of cholesterol in the relationship between heavy metals and female SUI remains unexplored. Methods: The study utilized data from the National Health and Nutrition Examination Survey database from 2013–2018. Blood lead (Pb), cadmium (Cd), total mercury (Hg), manganese (Mn), selenium (Se), and methyl mercury (MeHg) were included in the study. The single and combined effects of the six metals exposure on SUI were examined using logistic analysis, restricted cubic spline (RCS) curves, weighted quantile sum (WQS) regression, and bayesian kernel machine regression (BKMR). The mediating effects of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were investigated through mediation analysis. Results: The study included 2241 females, with 42.66% experiencing SUI. Initial analysis of six heavy metals revealed the associations between MeHg, Pb, Cd, total Hg, and SUI (all P < 0.05). WQS regression identified that Cd, Se, and Pb were major contributors to the mixed effect causing SUI. BKMR results indicated a positive mixed effect between six heavy metals and SUI. TC partially mediated the relationship of Pb, MeHg, and total Hg with SUI, and LDL-C partially mediated the association of Pb with SUI (all P for mediation < 0.05). Conclusions: Blood heavy metal concentrations influence the development of female SUI, with blood cholesterol mediating the association between different heavy metals and SUI.https://www.jstage.jst.go.jp/article/ehpm/30/0/30_25-00021/_html/-char/enfemalestress urinary incontinenceheavy metalscholesterol
spellingShingle Yan-zhen Wu
Xi-meng Chen
Relationship between blood heavy metals and female stress urinary incontinence from NHANES 2013–2018
Environmental Health and Preventive Medicine
female
stress urinary incontinence
heavy metals
cholesterol
title Relationship between blood heavy metals and female stress urinary incontinence from NHANES 2013–2018
title_full Relationship between blood heavy metals and female stress urinary incontinence from NHANES 2013–2018
title_fullStr Relationship between blood heavy metals and female stress urinary incontinence from NHANES 2013–2018
title_full_unstemmed Relationship between blood heavy metals and female stress urinary incontinence from NHANES 2013–2018
title_short Relationship between blood heavy metals and female stress urinary incontinence from NHANES 2013–2018
title_sort relationship between blood heavy metals and female stress urinary incontinence from nhanes 2013 2018
topic female
stress urinary incontinence
heavy metals
cholesterol
url https://www.jstage.jst.go.jp/article/ehpm/30/0/30_25-00021/_html/-char/en
work_keys_str_mv AT yanzhenwu relationshipbetweenbloodheavymetalsandfemalestressurinaryincontinencefromnhanes20132018
AT ximengchen relationshipbetweenbloodheavymetalsandfemalestressurinaryincontinencefromnhanes20132018