ArticleToxics2023
Independent and Combined Associations of Blood Manganese, Cadmium and Lead Exposures with the Systemic Immune-Inflammation Index in Adults.
Article in Toxics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 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.
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Who cites it
14 citing papers in PubMed, 19 citations in OpenAlex.
- Article
- Overlaps in mammalian iron and manganese homeostasis: recent advances.Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine · 2026Review
- Impact of a prenatal exposure mixture of metals on DNA methylation-derived cell-type composition in cord blood.Environmental epigenetics · 2026Article
- A longitudinal study on the impact of cadmium exposure on quality of life in esophageal squamous cell carcinoma patients in Southern China.Scientific reports · 2025Article
- Article
- Heavy metal exposure and its impact on inflammatory ratios in minors: The mediating role of BMI.PloS one · 2025Article
- Review
- Threshold and combined effects of heavy metals on the risk of phenotypic age acceleration among U.S. adults.Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine · 2024Article
- The mediation effect of Systemic Immunity Inflammation Index between urinary metals and TOFAT among adults in the NHANES dataset.Scientific reports · 2024Article
- Association between multiple-heavy-metal exposures and systemic immune inflammation in a middle-aged and elderly Chinese general population.BMC public health · 2024Article
- Article
- Effect of blood lead levels on periodontitis in American adults: a cross-sectional analysis from the national health and nutrition examination survey.BMC oral health · 2024Article
- The role of serum α-Klotho levels in preventing hearing impairment among middle-aged and older adults: insights from a nationally representative sample.Frontiers in aging neuroscience · 2024Article
- The single and mixed impacts of cadmium, cobalt, lead, and PAHs on systemic immunity inflammation index in male and female.Frontiers in public health · 2024Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
Manganese (Mn), cadmium (Cd) and lead (Pb) have toxic effects on the immune system. However, their independent and combined effects on immune-inflammation responses are unclear. In recent years, the systemic immune-inflammation index (SII) has been developed as an integrated and novel inflammatory indicator. A retrospective cross-sectional study of 2174 adults ≥20 years old from the National Health and Nutrition Examination Survey (NHANES) 2015-2016 was conducted. Generalized linear models were used to evaluate the independent and combined associations of SII with blood Mn, Cd and Pb levels. As continuous variables, both blood Cd and Mn showed dose-dependent relationships with the SII before and after adjusting for all potential confounding factors. Metal concentrations were then converted into categorical variables. Compared with the adults in the lowest Cd or Mn tertile, those in the highest tertile had higher risks of elevated SII. Furthermore, co-exposure to Mn and Cd also showed a positive relationship with the SII after adjusting for all confounding factors. However, the single effect of Pb exposure and the joint effect of Pb and other metal exposures on the SII were not observed. This study provides important epidemiological evidence of the associations of SII with single and co-exposure effects of blood Mn, Cd, and Pb.
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Registered trials
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