Metal and Metalloid Exposure Associated With Advanced Cardiovascular-Kidney-Metabolic Syndrome: Study

A recent study published in the BMC Public Health revealed higher urinary levels of metals and metalloids are significantly associated with increased risk and more advanced stages of cardiovascular-kidney-metabolic (CKM) syndrome. The study highlights that exposure to specific metal mixtures may drive progression across CKM stages, which illuminates environmental metal exposure as an emerging and potentially modifiable risk factor for cardiometabolic and renal disease.

Using nearly 2 decades of National Health and Nutrition Examination Survey (NHANES) data, this research analyzed urine samples from 6,650 adults across the United States to measure 9 metals and metalloids frequently encountered through food, water, air, and consumer products. These included barium, cadmium, cobalt, cesium, molybdenum, lead, antimony, thallium, and tungsten.

The results revealed that the CKM syndrome severity increased, along with the levels of most of these metals in the body. With the exception of lead, higher concentrations of nearly all measured metals were consistently linked to greater odds of having CKM syndrome.

Among all substances examined, barium, thallium, and antimony emerged as the strongest contributors to early-stage CKM syndrome. Barium carried the greatest overall influence, meaning people with higher barium levels were more likely to have CKM even before severe symptoms developed. For more advanced disease stages, antimony became the dominant contributor, followed by tungsten and cobalt which pointed to a potential cumulative or progressive toxic effect as the syndrome worsens.

The study also uncovered important demographic differences. Associations between metal exposure and CKM syndrome varied significantly by sex, age group, and race, suggesting that biological susceptibility and environmental inequities may shape how these pollutants affect health. To better understand how metals contribute to disease, this study explored biological pathways that might mediate the damage. They found that inflammation, oxidative stress, and accelerated biological aging partially explained the metal-CKM connection.

In a separate sensitivity analysis that included arsenic, inorganic arsenic stood out as the single strongest risk factor, contributing more than any other metal to CKM syndrome development. Overall, the findings highlight that everyday environmental metals may be silently accelerating cardio-metabolic disease burden of US.

Source:

Zhang, S., Tang, H., Pan, L., & Zhou, M. (2025). Association of metal and metalloid exposure with cardiovascular-kidney-metabolic syndrome: mediation by inflammation, oxidative stress, and aging. BMC Public Health. https://doi.org/10.1186/s12889-025-25894-0