Associations Between Blood Metal Exposure and Hypertriglyceridemia Among Adults in NHANES, 2011-2018

Growing evidence indicates associations between blood metal exposure and dyslipidemia. However, the relationships between hypertriglyceridemia (HTG), the most prevalent form of dyslipidemia, and blood metal exposure remain unclear. Our study aimed to evaluate both single and combined effects of blood metals on HTG risk. This study included 4182 adults from the 2011-2018 National Health and Nutrition Examination Survey. We assessed single and combined associations between blood metals (cadmium, mercury, lead, selenium, and manganese) and HTG. In single metal analysis, elevated blood selenium concentrations were significantly associated with increased HTG risk and triglyceride (TG) levels, with OR (95% CI) and β (95% CI) of 1.78 (1.36, 2.32) and 0.21 (0.13, 0.29), respectively, in the highest tertile group. Restricted cubic splines revealed a positive linear correlation between selenium and HTG. No significant associations were observed between HTG and blood cadmium, mercury, lead, or manganese in the overall population. In metal mixture analysis, blood metal co-exposure was positively related to HTG risk across WQS, qgcomp, and BKMR models, particularly in females and individuals under 60 years old. Furthermore, selenium was identified as the primary contributor to the overall mixture effect. The positive directional influence of selenium was further confirmed on the overall effect. Collectively, these findings indicate that elevated blood selenium concentrations are associated with increased HTG risk and higher TG levels. The results provide novel epidemiological evidence for the associations between multi-metal co-exposure and HTG risk, particularly in females and individuals under 60 years old.