Association between metal implants and urinary chromium levels in US adults: a cross-sectional study from NHANES

Metal implants play a significant role in orthopedics, commonly used for treating fractures, joint replacement surgeries, spinal procedures, and more. Chromium (Cr), crucial in these implants, may raises health concerns. However, the relationship between metal implants and urine Cr levels remains uncertain. We aimed to evaluate this relationship. We conducted a cross-sectional study on 1419 individuals aged 40 years or older using data from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2017 to 2020. Multivariate linear regression models and subgroup analysis were applied to assess associations between metal implants and urine Cr levels. Among the 1419 participants, 402 [28.3%] self-reported having metal objects in their bodies. After adjusting for potential confounding factors, metal implants were positively correlated with the accumulation of urine Cr (β = 0.41, 95% CI 0.04-0.77, p = 0.028). However, the positive correlation of metal implants with urine Cr was only present in females (β = 0.81, 95% CI 0.08-1.53, p = 0.029), but not in males. Our study revealed higher urine Cr levels in individuals with metal implants, with noticeable gender differences. Additionally, those with metal implants exhibited a more pronounced elevation in urine Cr levels with increasing age compared to individuals without implants.