Iron is needed for normal development in adolescence. Exposure to individual environmental metals (e.g., lead) has been associated with altered iron status in adolescence, but little is known about the cumulative associations of multiple metals with Fe status. We used data from the 2017-2018 National Health and Nutrition Examination Survey (NHANES) to examine associations between a metal mixture (lead, manganese, cadmium, selenium) and iron status in 588 U.S. adolescents (12-17 years). We estimated cumulative and interactive associations of the metal mixture with five iron status metrics using Bayesian Kernel Machine Regression (BKMR). Higher concentrations of manganese and cadmium were associated with lower log-transformed ferritin concentrations. Interactions were observed between manganese, cadmium, and lead for ferritin and the transferrin receptor, where iron status tended to be worse at higher concentrations of all metals. These results may reflect competition between environmental metals and iron for cellular uptake. Mixed metal exposures may alter normal iron function, which has implications for adolescent development.

中文翻译：

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美国青少年金属混合物与铁状态的关联：来自国家健康和营养检查调查的证据。

青春期的正常发育需要铁。暴露于个别环境金属（例如，铅）与青春期铁状态改变有关，但对于多种金属与铁状态的累积关联知之甚少。我们使用 2017-2018 年全国健康和营养检查调查 (NHANES) 的数据来检查 588 名美国青少年（12-17 岁）的金属混合物（铅、锰、镉、硒）与铁状态之间的关联。我们使用贝叶斯核机器回归 (BKMR) 估计了金属混合物与五种铁状态指标的累积和交互关联。较高浓度的锰和镉与较低的对数转化铁蛋白浓度相关。观察到锰、镉、以及铁蛋白和转铁蛋白受体的铅，在所有金属浓度较高的情况下，铁的状态往往更差。这些结果可能反映了环境金属和铁之间对细胞摄取的竞争。混合金属暴露可能会改变正常的铁功能，这对青少年发育有影响。