Chromium (Cr) and cobalt (Co) are the essential elements for producing metal implants, but might have potential health issues. The research on the correlation between metal implants and blood Cr and Co on a large population is still limited. National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health status of Americans began in the early 1960s. The study was based on the NHANES database from two data collection years (2015–2016 and 2017–2018). The exposure variable of this study was whether the participants had metal objects in the body or not. The outcome variables were blood concentrations of Cr and Co. Age, body mass index, sex, race/ethnicity, income to poverty ratio, tap water behavior, shellfish/fish/tuna/salmon eating habits, level of education, smoking behavior, marital status, blood hemoglobin, and data collection years were included as confounding variables. A total of 4412 participants, aged 40 years or older, were included in this analysis, consisting of the without metal objects group (n = 3150) and the metal objects group (n = 1262). Metal objects was positively correlated to the accumulation of blood Cr (β = 0.072, 95% CI: 0.043–0.102, p < 0.001) and blood Co (β = 0.079, 95% CI: 0.049–0.109, p < 0.001). However, the positive correlation of metal objects with blood Cr was only presented in women (β = 0.112, 95% CI: 0.074–0.151, p < 0.001), but not in men. Meanwhile, the positive relationship between metal objects and blood Cr/Co was not observed in the Asian subgroup. Blood Cr and Co concentrations were statistically higher in people with metal objects, but with race and sex differences. Level IV, cross-sectional study

中文翻译：

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金属物品参与者血液中铬和钴的积累：2015 年至 2018 年国家健康和营养检查调查 (NHANES) 的调查结果

铬 (Cr) 和钴 (Co) 是生产金属植入物的基本元素，但可能存在潜在的健康问题。金属植入物与大人群血Cr、Co相关性的研究还很有限。国家健康和营养检查调查 (NHANES) 是一项旨在评估美国人健康状况的研究计划，始于 1960 年代初期。该研究基于两个数据收集年（2015-2016 年和 2017-2018 年）的 NHANES 数据库。本研究的暴露变量是参与者体内是否有金属物体。结果变量是 Cr 和 Co 的血液浓度。年龄、体重指数、性别、种族/民族、收入与贫困比率、自来水行为、贝类/鱼类/金枪鱼/鲑鱼的饮食习惯、教育水平、吸烟行为、婚姻状况地位，血红蛋白和数据收集年份被列为混杂变量。该分析共包括 4412 名年龄在 40 岁或以上的参与者，包括无金属物体组 (n = 3150) 和金属物体组 (n = 1262)。金属物体与血液 Cr (β = 0.072, 95% CI: 0.043–0.102, p < 0.001) 和血液 Co (β = 0.079, 95% CI: 0.049–0.109, p < 0.001) 的积累呈正相关。然而，金属物体与血液 Cr 的正相关性仅在女性中出现（β = 0.112，95% CI：0.074–0.151，p < 0.001），而在男性中则没有。同时，在亚洲亚组中未观察到金属物体与血液 Cr/Co 之间的正相关关系。有金属物品的人血液中 Cr 和 Co 的浓度在统计学上更高，但存在种族和性别差异。第四级，