Uncertainty remains regarding the association between blood lead levels (BLL) and serum uric acid (SUA) with relatively low BLL exposure because of limited data in the adolescent population. We examined the association between BLL and SUA in U.S. adolescents. In this cross-sectional study, 8303 adolescents aged 12–19 years from NHANES 1999–2006 were analyzed. BLL was Ln-transformed for analysis for the skewed distribution. Elevated SUA was defined as ≥5.5 mg/dL. Multivariate linear and multiple logistic regression analyses were performed to evaluate the association of BLL with SUA and elevated SUA. Moreover, a generalized additive model (GAM) and a fitted smoothing curve (penalized spline method) were conducted. The overall mean BLL was 1.3 μg/dL. Multivariate linear regression analyses showed that LnBLL was independently and positively correlated with SUA level (β = 0.13, 95%CI: 0.09–0.17). Multiple logistic analyses showed that LnBLL was associated with a 24% increased prevalence of elevated SUA (OR = 1.24; 95% CI, 1.11–1.38). Analyses using restricted cubic spline confirmed that the associations of LnBLL with SUA and elevated SUA were linear. Subgroup analyses showed that stronger associations between LnBLL and SUA were detected in adolescents with lower levels of education and estimated glomerular filtration rate (eGFR) (all P for interaction < 0.05). BLL was independently and positively correlated with SUA level and elevated SUA among U.S. adolescents, particularly with lower levels of education and eGFR. The data suggest that there is no “safe” threshold level of exposure to lead.

中文翻译：

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低血铅与美国青少年血清尿酸的关联：一项横断面研究

由于青少年人群中的数据有限，因此血铅水平（BLL）与血清尿酸（SUA）之间的相关性仍存在不确定性，因为BLL暴露量相对较低。我们研究了美国青少年中BLL和SUA之间的关联。在这项横断面研究中，分析了NHANES 1999-2006年的8303名12-19岁的青少年。对BLL进行了Ln转换，以分析偏斜分布。SUA升高定义为≥5.5mg / dL。进行了多元线性和多元logistic回归分析，以评估BLL与SUA和升高的SUA的关联。此外，进行了广义加性模型（GAM）和拟合的平滑曲线（惩罚样条法）。总体平均BLL为1.3μg/ dL。多元线性回归分析显示，LnBLL与SUA水平呈独立正相关（β= 0.13，95％CI：0.09–0.17）。多项逻辑分析表明，LnBLL与SUA升高的患病率增加24％相关（OR = 1.24； 95％CI，1.11-1.38）。使用限制性三次样条的分析证实，LnBLL与SUA和升高的SUA的关联是线性的。亚组分析显示，在教育水平较低和估计的肾小球滤过率（eGFR）较低的青少年中，LnBLL与SUA之间存在更强的关联（相互作用的所有P <0.05）。BLL与美国青少年的SUA水平和SUA升高呈独立正相关，特别是与较低的教育水平和eGFR呈正相关。数据表明没有铅的“安全”阈值水平。