Metals, Micronutrients, and Lifestyle Interactions in Arthritis Risk: Insights from a Nationally Representative U.S. Survey

Arthritis is a prevalent and disabling condition that affects millions of people globally. This study aimed to investigate the associations between blood levels of trace elements (TEs), lifestyle factors, and arthritis. Data from NHANES 2011–2023 were analyzed via a complex survey-weighted design. We assessed the associations between blood concentrations of lead, cadmium, mercury, selenium, and manganese and arthritis status. Logistic regression models were employed, with TEs categorized into quartiles. Dose‒response relationships were evaluated via restricted cubic spline (RCS) modeling. Compared with those without arthritis, individuals with arthritis had significantly higher blood concentrations of lead and cadmium (both P < 0.001) and significantly lower levels of selenium (P = 0.007) and manganese (P < 0.001). After adjusting for confounders, individuals in the highest quartile of blood cadmium had reduced odds of arthritis [OR: 0.80; 95%CI: 0.70–0.90; P < 0.001], although RCS modeling revealed a significant nonlinear dose‒response relationship (P for nonlinearity = 0.001). The highest quartile of selenium was also associated with a reduced risk of arthritis [OR: 0.91; 95%CI: 0.83–0.99; P = 0.048]. Manganese showed a similar inverse association. These findings highlight the potential role of environmental exposure and lifestyle in arthritis development.