Association between heavy metal exposure and chronic cough: the mediating roles of inflammation

Background Right now, epidemiological research examining the connection between blood heavy metal exposure and chronic coughing is still deficient. Therefore, the survey was aimed at the effects of multiple heavy metals on chronic cough.Method In this investigation, 2647 individuals from NHANES were...

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Main Authors: Jun Wen, Rongjuan Zhuang, Qin Zhang, Changfen Wang, Jing Chi
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Annals of Medicine
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Online Access:https://www.tandfonline.com/doi/10.1080/07853890.2025.2524089
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author Jun Wen
Rongjuan Zhuang
Qin Zhang
Changfen Wang
Jing Chi
author_facet Jun Wen
Rongjuan Zhuang
Qin Zhang
Changfen Wang
Jing Chi
author_sort Jun Wen
collection DOAJ
description Background Right now, epidemiological research examining the connection between blood heavy metal exposure and chronic coughing is still deficient. Therefore, the survey was aimed at the effects of multiple heavy metals on chronic cough.Method In this investigation, 2647 individuals from NHANES were included. This study applied multiple statistical models to systematically explore the associations between single and mixed blood metal with the prevalence of chronic cough, including logistic regression, weighted quantile sum (WQS) regression, bayesian kernel machine regression (BKMR), and the Shapley Additive Explanations (SHAP) model. Finally, this research conducted mediation analyses to investigate the mediated effects of inflammation on the association between metal and chronic cough.Result In the logistic regression model of single exposure, blood cadmium was positively associated with the prevalence of chronic cough (OR: 3.17; 95% CI: 2.08–4.83). Consistent findings from the WQS, BKMR, and SHAP models revealed that cumulative exposure to multiple blood metals was positively linked to chronic cough, with cadmium emerging as the predominant contributor among the five examined metals. Mediation analyses indicated that WBC and neutrophils, with a proportion of 2.74% and 5.06%, respectively, mediated the link of cadmium in blood with chronic cough.Conclusion Exposure to heavy metal mixtures was linked to an increase in the prevalence of chronic cough. And blood cadmium may primarily drive this association, with activated inflammation partially mediating it. Our findings offer novel insights into the impact of blood cadmium to chronic cough.
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spelling doaj-art-e05ad566815947c39952960db054e1352025-08-20T03:31:46ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2524089Association between heavy metal exposure and chronic cough: the mediating roles of inflammationJun Wen0Rongjuan Zhuang1Qin Zhang2Changfen Wang3Jing Chi4Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, ChinaDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, ChinaDepartment of Cardiology, Xi Chang People’s Hospital, Xi Chang, Sichuan Province, ChinaDepartment of Cardiology, People’s Hospital of Qianxinan Prefecture, Guizhou Province, ChinaDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, ChinaBackground Right now, epidemiological research examining the connection between blood heavy metal exposure and chronic coughing is still deficient. Therefore, the survey was aimed at the effects of multiple heavy metals on chronic cough.Method In this investigation, 2647 individuals from NHANES were included. This study applied multiple statistical models to systematically explore the associations between single and mixed blood metal with the prevalence of chronic cough, including logistic regression, weighted quantile sum (WQS) regression, bayesian kernel machine regression (BKMR), and the Shapley Additive Explanations (SHAP) model. Finally, this research conducted mediation analyses to investigate the mediated effects of inflammation on the association between metal and chronic cough.Result In the logistic regression model of single exposure, blood cadmium was positively associated with the prevalence of chronic cough (OR: 3.17; 95% CI: 2.08–4.83). Consistent findings from the WQS, BKMR, and SHAP models revealed that cumulative exposure to multiple blood metals was positively linked to chronic cough, with cadmium emerging as the predominant contributor among the five examined metals. Mediation analyses indicated that WBC and neutrophils, with a proportion of 2.74% and 5.06%, respectively, mediated the link of cadmium in blood with chronic cough.Conclusion Exposure to heavy metal mixtures was linked to an increase in the prevalence of chronic cough. And blood cadmium may primarily drive this association, with activated inflammation partially mediating it. Our findings offer novel insights into the impact of blood cadmium to chronic cough.https://www.tandfonline.com/doi/10.1080/07853890.2025.2524089Heavy metalchronic coughinflammationShapley additive explanations (SHAP)Bayesian kernel machine regression (BKMR)mediation
spellingShingle Jun Wen
Rongjuan Zhuang
Qin Zhang
Changfen Wang
Jing Chi
Association between heavy metal exposure and chronic cough: the mediating roles of inflammation
Annals of Medicine
Heavy metal
chronic cough
inflammation
Shapley additive explanations (SHAP)
Bayesian kernel machine regression (BKMR)
mediation
title Association between heavy metal exposure and chronic cough: the mediating roles of inflammation
title_full Association between heavy metal exposure and chronic cough: the mediating roles of inflammation
title_fullStr Association between heavy metal exposure and chronic cough: the mediating roles of inflammation
title_full_unstemmed Association between heavy metal exposure and chronic cough: the mediating roles of inflammation
title_short Association between heavy metal exposure and chronic cough: the mediating roles of inflammation
title_sort association between heavy metal exposure and chronic cough the mediating roles of inflammation
topic Heavy metal
chronic cough
inflammation
Shapley additive explanations (SHAP)
Bayesian kernel machine regression (BKMR)
mediation
url https://www.tandfonline.com/doi/10.1080/07853890.2025.2524089
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