ArticleFrontiers in public health2025
The independent and combined effects of blood heavy metal concentrations on all-cause mortality and cardiovascular mortality in adult patients with diabetes mellitus.
Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
4 citing papers in PubMed.
- Combined Effects and Potential Mechanisms of Multiple Metals Exposure on Coronary Artery Disease in the US Population: An Integrated Epidemiological and Network Toxicology Study.Biological trace element research · 2026Article
- Toxic Metal-Essential Trace Element Imbalance in Cardiometabolic Disease: Ferroptosis as a Mechanistic Link Between Environmental Exposure and Vascular Injury.Cardiovascular toxicology · 2026Review
- Review
- Environmental Exposure to Cadmium and Lead Exacerbates Kidney Function in People with Diabetes.Journal of xenobiotics · 2025Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Most epidemiological studies have focused on the association between single metal exposure and cardiovascular disease risk, utilizing a single-pollutant model for analysis. However, multiple metals may interact with each other, leading to misjudgment of health risks. This study sought to ascertain both the independent and combined effects of various blood heavy metal concentrations on all-cause mortality and cardiovascular mortality in patients with DM. Methods: Patients (≥20 years) with DM from the NHANES (2011-2018) were selected. To explore the relationships of exposure to individual metals, including cadmium (Cd), mercury (Hg), manganese (Mn), lead (Pb), and selenium (Se), with all-cause mortality and cardiovascular mortality, weighted logistic regression and RCS analysis were leveraged. The WQS model was utilized to estimate the effects of combined blood metal exposures. Results: 1,798 patients with DM were included. In the unadjusted model, ln-transformed blood Pb level (OR = 2.3, 95% CI: 1.70-3.10, Conclusion: According to this study, a high blood concentration of a combination of heavy metals is a significant risk factor for both cardiovascular disease and all-cause mortality of patients with diabetes, with Pb contributing a relatively higher proportion to these risks.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.