Associations of mixed urinary metals exposure with metabolic syndrome in the US adult population

Metals are harmful to human health in many ways. However, the association between metals and metabolic syndrome (MetS) remains unclear. Aims of this study is to discuss the relationship between urinary metal and MetS.This study included 3419 adult participants from the National Health and Nutrition Examination Survey (NHANES) (2005-2018). Logistic regression analysis, Bayesian kernel machine regression (BKMR), weighted quantile sum (WQS), and restricted cubic spline (RCS) were used to explore the associations of nine urinary metal and MetS.BKMR and WQS showed the effects of combined nine urinary metal were negatively correlated with MetS. Logistic regression analysis, WQS, and BKMR all suggested that cesium (Cs) and lead (Pb) were negatively correlated with MetS (all PFDCR <0.05). And RCS suggested log2-transformed Cs (χ2 = 20, P < 0.001) and log2-transformed Pb (χ2 = 19.9, P < 0.001) were negatively and linearly associated with MetS.Existing evidence suggests that urine metal content is related to MetS. Cs and Pb are negatively related to MetS. It is still necessary to study and further discuss the causal relationship and mechanism.