Jul 2026· Joint Bone Spine· pp.
106119
· 0 citations
Medicine
TL;DR
This study demonstrates a significant positive association between blood lead levels and the risk of HU and no significant association is found between blood levels of cadmium, manganese, and mercury and the risk of HU.
Abstract
Exposure to heavy metals is regarded as a potential contributor to the development of hyperuricemia (HU). However, related research findings are inconsistent. This systematic review and meta-analysis aimed to explore the association between blood concentrations of heavy metals (such as lead, cadmium, manganese, mercury) and HU. PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched to collect related studies up to June 2024. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated utilizing a random-effects model or a fixed-effects model. Sensitivity analysis was conducted, while publication bias was assessed using funnel plots and Egger's test. A total of 19 eligible studies were included. The meta-analysis indicated a significant association between blood lead levels and the risk of HU (OR: 1.88; 95% CI: 1.22-2.92; P<0.005). Blood levels of cadmium (OR: 1.31; 95% CI: 0.68-2.52; non-significant), manganese (OR: 1.04; 95% CI: 0.88-1.22; non-significant), and mercury (OR: 1.55; 95% CI: 0.70-3.44; non-significant) were not significantly associated with the risk of HU. In conclusion, this study demonstrates a significant positive association between blood lead levels and the risk of HU. No significant association is found between blood levels of cadmium, manganese, and mercury and the risk of HU.
The findings suggest that lead exhibits threshold-free linear toxicity, while manganese may have a protective effect, supporting preventive strategies for environmentally induced hypertension.
Yunzhen Lei, J. Diao, Ming Xu et al.· Ecotoxicology and Environmen...· 0 citations
OBJECTIVES
This study aims to systematically assess the association between exposure to endocrine-disrupting heavy metals (Pb, Hg, or Cr) and the risk of polycystic ovary syndrome (PCOS) through a meta-analysis of observational studies.
DESIGN
Meta analysis Materials, Setting, Methods: We thoroughly explored PubMed, Embase, and the Cochrane Library for studies released until April 2023, using MeSH terms and keywords related to heavy metals and PCOS. Inclusion criteria encompassed observational studies reporting blood or urinary concentrations of Pb, Hg, or Cr in PCOS cases versus healthy controls.
RESULTS
Seven Asian studies involving 897 reproductive-aged women were included. Whole-blood levels of Pb were significantly higher in PCOS (SMD=0.494, 95% CI: 0.227-0.761, p = 0.0003; I² = 99%), while serum or urinary levels showed no difference. Whole blood analysis provided more biologically relevant data for Pb exposure assessment due to its high binding affinity for hemoglobin. No statistically significant associations were observed for Hg exposure across biological matrices: serum (SMD = 2.047, 95% CI: -2.382 to 6.476, p = 0.365), whole blood (SMD = 0.831, 95% CI: -0.740 to 2.401, p = 0.300), or urine (SMD = 0.110, 95% CI: -0.253 to 0.473, p = 0.553). PCOS women had significant increased Cr across biological matrices (serum: SMD=0.287, 95%CI: 0.085-0.632, p <0.001; whole blood: SMD=0.506, 95% CI: 0.184-0.828, p =0.002) with minimal heterogeneity (I² = 0%).
CONCLUSIONS
This meta-analysis identifies Pb and Cr exposure as a potential risk factor for PCOS in Asian populations. In contrast, Hg exhibited no statistically significant associations. These findings highlight the need for metal-specific prevention strategies in reproductive health.
Xiaodan Zhu, Xiaolin Chu, Yun-Zhi Zhao et al.· Gynecologic and Obstetric In...· 0 citations
OBJECTIVE
To systematically compare circulating concentrations of iron (Fe), magnesium (Mg), manganese (Mn), and selenium (Se) between women with spontaneous pregnancy loss (SPL) or recurrent pregnancy loss (RPL) and pregnant controls.
METHODS
We searched PubMed, Embase, the Cochrane Library, and Web of Science from inception to 25th May 2025 for observational studies comparing circulating metal concentrations between women with SPL/RPL and pregnant controls. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were pooled using random-effects models. Subgroup, sensitivity, and influence analyses were performed. Meta-regression and assessments of small-study effects were considered exploratory. The certainty of evidence was assessed using GRADE.
RESULTS
Eighteen studies were included (10 on Fe, 7 on Mg, 9 on Mn, and 8 on Se), encompassing 879 women with pregnancy loss (647 with SPL and 232 with RPL) and 2355 pregnant controls from 11 countries. No statistically significant overall differences in circulating metal concentrations were identified between women with pregnancy loss and pregnant controls. The pooled SMD was -0.05 for Fe (95% CI: -0.44-0.34; I² = 91.3%), -0.38 for Mg (95% CI: -1.02-0.27; I² = 93.5%), 0.17 for Mn (95% CI: -0.38-0.72; I² = 93.6%), and 0.29 for Se (95% CI: -0.73-1.32; I² = 97.2%). Findings were also not statistically significant within the SPL and RPL subgroups. Substantial heterogeneity persisted despite subgroup and exploratory meta-regression analyses. Influence and sensitivity analyses indicated limited robustness for Mg, while the Se estimate remained highly imprecise and heterogeneous. Small-study effect assessment was inconclusive because of the limited number of studies. GRADE assessment rated the certainty of evidence as very low for all metal-outcome comparisons.
CONCLUSION
Available observational evidence does not demonstrate consistent differences in circulating Fe, Mg, Mn, or Se concentrations between women with SPL or RPL and pregnant controls. However, the evidence remains inconclusive because of substantial heterogeneity, possible reverse causality, residual confounding, variation in outcome and control-group definitions, and very low certainty of evidence. Well-designed prospective studies using standardized outcome definitions and pre-event metal measurements are needed. These findings should not be interpreted as evidence for or against routine essential-metal supplementation to prevent pregnancy loss.
Li Wen, Mei-Qi Ren, Lian-Tong Wang et al.· Journal of Trace Elements in...· 0 citations
Emerging evidence highlights a link between heavy metal exposure and semen quality, but discrepancies persist regarding the effects of metals like lead and cadmium across different biological matrices. This systematic review and meta-analysis aimed to explore the association between heavy metal exposure in blood, urine, and seminal plasma and male semen quality. A comprehensive search was conducted across four databases (PubMed, Embase, Scopus, and Cochrane Library), and a bibliometric analysis was performed using the Web of Science Core Collection. Based on this analysis, a systematic literature review and meta-analyses were conducted. Database searches were updated until November 2024. A total of 10 qualitative and 14 quantitative studies were included. Exposure to lead and cadmium in seminal plasma was significantly correlated with progressive sperm motility, with odds ratio (OR) of 2.27 (95% confidence interval [CI]: 1.18 to 4.34) for lead and of 2.55 (95% CI: 1.29 to 5.03) for cadmium. Arsenic exposure was significantly linked to total sperm motility (OR = 2.88, 95% CI: 1.35 to 6.17), while zinc deficiency in seminal plasma was associated with reduced total sperm motility (OR = 1.77, 95% CI: 1.17 to 2.66). Given the widespread exposure to heavy metals, assessing their impact on male reproductive health should be prioritized as a public health concern. This study highlights the reprotoxicity of heavy metals in seminal plasma, blood, and urine, with seminal plasma emerging as the most sensitive biomarker for reproductive risk.
Nai-Yun Li, Lu Zhang, Yong-Han Li et al.· Asian Journal of Andrology· 0 citations
Insulin resistance might be a crucial mediated pathway between Se and outcomes and three multi-pollutant models revealed positive associations between metal mixtures and SUA as well as HUA, with Se being the primary contributor.
Jing-Fu Lai, Ya-qin Zhang, Yun-Ting Zhang et al.· Frontiers in Public Health· 0 citations
Background Uric acid is considered a potential risk factor for stroke; However, whether the association between hyperuricemia and stroke outcomes follows a linear or nonlinear pattern remains unclear. Therefore, this study conducted a dose–response meta-analysis based on cohort studies to investigate the association between hyperuricemia and stroke outcomes. Methods We systematically searched PubMed, the Cochrane Library, Embase, Web of Science, CNKI, Wanfang, VIP, and the Chinese Biomedical Literature Database from inception to April 2026. Cohort studies reporting the associations of uric acid with stroke incidence and mortality outcomes were included. Dose–response meta-analyses were performed by generalized least-squares estimation and restricted cubic splines with three knots located at the 10th, 50th, and 90th percentiles. Results A total of 25 cohort studies involving 1,300,263 participants were included. Conventional meta-analysis showed that hyperuricemia was significantly associated with stroke incidence (RR = 1.20, 95%CI: 1.11–1.29) and mortality (RR = 1.36, 95%CI: 1.17–1.58). Subgroup analysis indicated that hyperuricemia significantly increased the risks of stroke incidence (RR = 1.22, 95%CI: 1.08–1.38) and mortality (RR = 1.42, 95%CI: 1.15–1.77) among women. Regarding stroke subtype, hyperuricemia was significantly associated with the incidence (RR = 1.21, 95%CI: 1.03–1.42) and mortality (RR = 1.23, 95%CI: 1.01–1.49) of ischemic stroke. A J shaped dose–response relationship was found between uric acid and stroke incidence (p = 0.0023), with risk rising across uric acid levels from104 to 764.5 μmol/L and a nadir at 225 μmol/L, whereas no significant nonlinear relationship was observed for stroke mortality. Conclusion Hyperuricemia is associated with increased risks of stroke incidence and mortality, especially in women and ischemic stroke. A J-shaped dose–response relationship was observed for stroke incidence, but not for stroke mortality. Monitoring uric acid levels and their longitudinal changes may be valuable in stroke prevention strategies. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420261394403, identifier PROSPERO (CRD420261394403).
Yue-Ning Liu, Jie Wang, Sai-Wei Bai et al.· Frontiers in Neurology· 0 citations
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