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ORIGINAL RESEARCH article
Front. Public Health
Sec. Environmental Health and Exposome
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1439325
Urinary Metal Levels and Their Association With Parkinson's Disease Risk: Insights From NHANES 2013-2020
Provisionally accepted- 1 Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- 2 Shanghai Putuo People's Hospital, Putuo, Shanghai, China
Backgr ound: Parkinson's disease (PD) is a global public health problem. Genetic and behavioral factors are involved in the occurrence and development of PD. Although the specific mechanisms of PD remain unclear, environmental factors are increasingly recognized as non-negligible risk factors.This study aimed to evaluate the association between urinary metals and the risk of PD.Methods: Based on the National Health and Nutrition Examination Survey (NHANES), urinary concentrations of barium (Ba), cadmium (Cd), cobalt (Co), cesium (Cs), molybdenum (Mo), lead (Pb), antimony (Sb), thallium (Tl), and uranium (Tu) were measured in 3,148 US adults. Multivariate logistic regression and weighted (WQS) and quantile regression were used to analyze the single and mixed metals associated with the risk of PD. In addition, a Bayesian kernel machine regression (BKMR) was used to assess the joint effect of all metals (the "BKMR" package), taking into account the potential nonlinear and non-additive relationships between metals. At the same time, smooth curve fitting was performed to illustrate the nonlinear relationship between urinary metals and PD.Results: In the single-exposure model, Mo, Tu and Cd were positively correlated with the risk of PD, with odds ratios (OR) ranging from 4.61 to 5.46(all P < 0.05). Mixed-exposure analyses showed a consistent association (OR 1.48, 95% CI 1.06 to 2.06). The metals with the highest weight in the WQS model were Mo (56.79%), Co (34.20%), Ba (3.33%), and Tu(3.27%). In addition, BKMR model analysis showed that most single and mixed metals were positively associated with PD risk. Taken together, the results suggest that metal concentrations can increase the prevalence of PD.In conclusion, this cross-sectional analysis of NHANES data indicates that higher urinary concentrations of metals including Mo, Cd, and Tu are associated with increased odds of PD among US adults. Mixed exposures to several metals may jointly elevate PD risk in a dose-dependent manner.
Keywords: heavy metals, Parkinson's disease, the National Health and Nutrition Examination Survey (NHANES), WQS regression, Bayesian Kernel Machine Regression
Received: 28 May 2024; Accepted: 12 Mar 2025.
Copyright: © 2025 Lv, Li and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jiajie Lv, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Chenghao Yang, Shanghai Putuo People's Hospital, Putuo, Shanghai, China
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