The mediation effect of Systemic Immunity Inflammation Index between urinary metals and TOFAT among adults in the NHANES dataset.

Systemic Immune Inflammatory Index (SII) is a novel indicator of inflammation. However, no studies have reported the effect of SII on the association between metals and total fat (TOFAT). We aim to investigate the mediated effect of SII on the relationship between urinary metals and TOFAT in a US adult population. This cross-sectional study was conducted among adults with complete information on SII, urine metal concentrations, and TOFAT from the 2011-2018 National Health and Nutrition Examination Survey (NHANES). Multifactorial logistic regression and restricted cubic splines were used to explore the association between urine metal levels and TOFAT. Furthermore, serial mediation analyses were used to investigate the mediating effect of SII on metals and TOFAT. A total of 3324 subjects were included in this study. After adjusting for confounders, arsenic (As), cadmium (Cd), cobalt (Co), cesium (Cs), inorganic mercury (Hg), molybdenum (Mo), manganese (Mn), lead (Pb), antimony (Sb), and thallium(Tl) had negative decreased trends of odds ratios for TOFAT (all P for trend < 0.05). In the total population, we found that Cd, Co, and Tu were positively associated with SII (ß = 29.70, 79.37, and 31.08), whereas As and Hg had a negative association with SII. The mediation analysis showed that SII mediated the association of Co with TOFAT, with the ß of the mediating effect being 0.9% (95%CI: 0.3%, 1.6%). Our findings suggested that exposure to As, Cd, and Hg would directly decrease the level of TOFAT. However, Co would increase TOFAT, completely mediated by SII, mainly exerted in females rather than males.

The single and mixed impacts of cadmium, cobalt, lead, and PAHs on systemic immunity inflammation index in male and female.

Background: Studies on the association between mixed exposure to common pollutants such as cadmium (Cd), cobalt (Co), lead (Pb), and polycyclic aromatic hydrocarbons (PAHs) with Systemic Immune Inflammatory Index (SII), a novel hemocyte-based inflammatory marker, have not been reported. This study explored the relationship between co-exposure to Cd, Co, Pb, PAHs, and SII. Methods: In this study, we used data from the National Health and Nutrition Examination Survey and enrolled adults with complete information on Cd, Co, Pb, PAHs, and SII. The linear regression was used to analyze the association of single pollutants with SII. Furthermore, a Bayesian Kernel Machine Regression analysis and a generalized weighted quantile sum regression analysis were used to analyze the association between mixed exposure to Cd, Co, Pb, and six PAHs and SII. We also separated males and females and analyzed the different effects of pollutants on SII, respectively. Results: 5,176 participants were included in the study. After adjusting for age, gender, race, education, smoking, drinking, physical activity, and sedentary, Cd, Co, 1-OHN, 2-OHN and 2-OHF were positive with SII in the total population. Compared with the 50th percentile, the joint effect of pollutants on SII was positive. In the total population, males, and females, the top contaminant with the highest effect weights on SII were Co, Cd, and 1-OHN, respectively. The result of interaction analysis showed that the low concentrations of Cd had an elevation effect on SII in males. Conclusion: This study found a positive association of mixed exposure to Cd, Co, Pb, and six PAHs with SII, which occurred mainly in females.