Sex differences in the association between heavy metal exposure and frailty in the U.S. adults: A cross-sectional analysis

作者：Xing Liu, Chenyi Yang, Xinyi Wang, Zixuan Wang, Huihui Liao, Huan Liu, Ji Ma, Yi Sun, Haiyun Wang · 发表于：Experimental Gerontology · 年份：2025 · DOI：10.1016/j.exger.2025.112939 · 被引用次数：3 · 研究领域：Frailty in Older Adults、Heavy Metal Exposure and Toxicity、Health, Environment, Cognitive Aging

The frailty index (FI), a key measure of biological aging, reflects decreased physiological reserve and helps assess mortality risks. However, the association between internal heavy metal levels and frailty, including possible sex differences, is not well understood. This study analyzes 2017–2018 NHANES data to calculate a FI from 32 items. Logistic regression, restricted cubic spline (RCS), E -values, and weighted quantile-sum (WQS) regression were used to analyze the association between heavy metal exposure and frailty, considering sex stratification and adjusting for confounding variables. Analysis of frailty levels among 5021 eligible adult participants revealed an overall prevalence of 62 %. Frailty incidence increased with age, especially among women. Compared to the lowest quartile, the highest quartile showed increased frailty risk: blood lead (OR: 1.52, 95 % CI: 1.19–1.96), blood cadmium (OR: 1.48, 95 % CI: 1.14–1.92), urine lead (OR: 1.76, 95 % CI: 1.17–2.65), and urine cadmium (OR: 2.38, 95 % CI: 1.55–3.66). Sex-specific analysis revealed that urinary cadmium was linked to frailty in men, while all metals were associated with frailty in women. Non-linear relationships were observed for blood lead and urine cadmium, while blood cadmium and urine lead showed linear associations, both exclusively in women. WQS regression highlighted urinary cadmium as the primary contributor to frailty. The results demonstrate a notable correlation between exposure to heavy metals, sp...