Toxic metals and trace elements, markers of inflammation, and hyperandrogenemia in women and testosterone deficiency in men: Associations and potential mediating factors

There is evidence suggesting that toxic metal and trace element exposure disrupts androgen levels. However, specific effects of such exposure on hyperandrogenemia (HA) in women and testosterone deficiency (TD) in men remain unclear. The study investigated associations between toxic metal and trace e...

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Main Authors: Yingying Lu, Lulu Geng, Dan Zhou, Yan Sun, Haoyi Xu, Xinyi Du, Qing Xu, Miaoxin Chen
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Ecotoxicology and Environmental Safety
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Online Access:http://www.sciencedirect.com/science/article/pii/S0147651325006888
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author Yingying Lu
Lulu Geng
Dan Zhou
Yan Sun
Haoyi Xu
Xinyi Du
Qing Xu
Miaoxin Chen
author_facet Yingying Lu
Lulu Geng
Dan Zhou
Yan Sun
Haoyi Xu
Xinyi Du
Qing Xu
Miaoxin Chen
author_sort Yingying Lu
collection DOAJ
description There is evidence suggesting that toxic metal and trace element exposure disrupts androgen levels. However, specific effects of such exposure on hyperandrogenemia (HA) in women and testosterone deficiency (TD) in men remain unclear. The study investigated associations between toxic metal and trace element exposure and HA in women and TD in men, utilizing data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2013 and 2016, and included 2205 women and 2621 men. Single-exposure analyses found lead (Pb) (adjusted odds ratio [aOR] 1.19, 95 % confidence interval [CI] 1.04–1.36) and cadmium (Cd) (aOR 1.20, 95 % CI 1.03–1.39) were positively associated with HA, especially strong in women over the age of 35. Manganese (Mn) was positively associated with TD (aOR 1.15, 95 % CI 1.03–1.28), especially strong in men aged between 45 and 50 years and obese men. A grouped weighted quantile sum (GWQS) model was performed to assess the effects of combined exposure, and found toxic metal mixture was positively associated with HA, particularly Cd (0.59) and Pb (0.40), and trace element mixture was positively associated with TD, particularly Mn (0.78). Mediation analyses demonstrated inflammation, particularly monocyte count and alkaline phosphatase (ALP) mediated 7.5–11.76 % of the associations. These findings provide insights to inform interventions for reducing exposure.
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spelling doaj-art-d7837e2108024348bf58eb22834c25232025-08-20T02:32:26ZengElsevierEcotoxicology and Environmental Safety0147-65132025-07-0129911835210.1016/j.ecoenv.2025.118352Toxic metals and trace elements, markers of inflammation, and hyperandrogenemia in women and testosterone deficiency in men: Associations and potential mediating factorsYingying Lu0Lulu Geng1Dan Zhou2Yan Sun3Haoyi Xu4Xinyi Du5Qing Xu6Miaoxin Chen7Centre for Assisted Reproduction, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200092, ChinaCentre for Assisted Reproduction, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200092, ChinaCentre for Assisted Reproduction, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200092, ChinaCentre for Assisted Reproduction, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200092, ChinaDepartment of Obstetrics and Gynecology, Women’s Hospital of Nanjing Medical University, Nanjing Women and Children’s Healthcare Hospital, Nanjing 210004, ChinaCentre for Assisted Reproduction, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200092, ChinaDepartment of Obstetrics and Gynecology, Women’s Hospital of Nanjing Medical University, Nanjing Women and Children’s Healthcare Hospital, Nanjing 210004, China; Corresponding author.Centre for Assisted Reproduction, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200092, China; Correspondence to: Centre for Assisted Reproduction, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, 2699 Gaoke West Road, Pudong District, Shanghai 200092, China.There is evidence suggesting that toxic metal and trace element exposure disrupts androgen levels. However, specific effects of such exposure on hyperandrogenemia (HA) in women and testosterone deficiency (TD) in men remain unclear. The study investigated associations between toxic metal and trace element exposure and HA in women and TD in men, utilizing data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2013 and 2016, and included 2205 women and 2621 men. Single-exposure analyses found lead (Pb) (adjusted odds ratio [aOR] 1.19, 95 % confidence interval [CI] 1.04–1.36) and cadmium (Cd) (aOR 1.20, 95 % CI 1.03–1.39) were positively associated with HA, especially strong in women over the age of 35. Manganese (Mn) was positively associated with TD (aOR 1.15, 95 % CI 1.03–1.28), especially strong in men aged between 45 and 50 years and obese men. A grouped weighted quantile sum (GWQS) model was performed to assess the effects of combined exposure, and found toxic metal mixture was positively associated with HA, particularly Cd (0.59) and Pb (0.40), and trace element mixture was positively associated with TD, particularly Mn (0.78). Mediation analyses demonstrated inflammation, particularly monocyte count and alkaline phosphatase (ALP) mediated 7.5–11.76 % of the associations. These findings provide insights to inform interventions for reducing exposure.http://www.sciencedirect.com/science/article/pii/S0147651325006888Toxic metalsTrace elementsInflammationHyperandrogenemiaTestosterone deficiency
spellingShingle Yingying Lu
Lulu Geng
Dan Zhou
Yan Sun
Haoyi Xu
Xinyi Du
Qing Xu
Miaoxin Chen
Toxic metals and trace elements, markers of inflammation, and hyperandrogenemia in women and testosterone deficiency in men: Associations and potential mediating factors
Ecotoxicology and Environmental Safety
Toxic metals
Trace elements
Inflammation
Hyperandrogenemia
Testosterone deficiency
title Toxic metals and trace elements, markers of inflammation, and hyperandrogenemia in women and testosterone deficiency in men: Associations and potential mediating factors
title_full Toxic metals and trace elements, markers of inflammation, and hyperandrogenemia in women and testosterone deficiency in men: Associations and potential mediating factors
title_fullStr Toxic metals and trace elements, markers of inflammation, and hyperandrogenemia in women and testosterone deficiency in men: Associations and potential mediating factors
title_full_unstemmed Toxic metals and trace elements, markers of inflammation, and hyperandrogenemia in women and testosterone deficiency in men: Associations and potential mediating factors
title_short Toxic metals and trace elements, markers of inflammation, and hyperandrogenemia in women and testosterone deficiency in men: Associations and potential mediating factors
title_sort toxic metals and trace elements markers of inflammation and hyperandrogenemia in women and testosterone deficiency in men associations and potential mediating factors
topic Toxic metals
Trace elements
Inflammation
Hyperandrogenemia
Testosterone deficiency
url http://www.sciencedirect.com/science/article/pii/S0147651325006888
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