Associations of serum lithium, nickel, cobalt, and manganese with chronic kidney disease among Chinese older adults: Mediating role of lipid metabolism and moderating effect of lifestyle.

Serum lithium, nickel, and manganese concentrations, along with LNCM mixture exposure, are positively associated with increased CKD risk in Chinese older adults, with lithium contributing most strongly.

• Why it matters: Understanding how environmental metal exposure affects CKD risk in older adults is crucial, as these metals are widespread and their combined effects are not well understood, posing potential public health concerns.
• What they did: The study measured serum levels of Li, Ni, Co, and Mn in 844 older adults using ICP-MS and applied various statistical models, including WQS and BKMR, to assess single and mixture effects, along with network toxicology and mediation analyses to explore mechanisms and lifestyle interactions.
• The result: Higher serum levels of Li, Ni, and Mn, especially within the LNCM mixture, were linked to increased CKD risk, with triglycerides mediating part of this relationship, and healthy lifestyle behaviors potentially reducing the risk associated with metal exposure.