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<p>The imbalance of trace elements plays an important role in childhood malnutrition, but previous studies are usually specific to certain elements. We aimed to examine the individual and joint associations between multiple elements and the risk of protein-energy malnutrition (PEM) in young school children. This study measured the serum levels of zinc (Zn), copper (Cu), chromium (Cr), cobalt (Co), vanadium (V), manganese (Mn), and nickel (Ni) in 1832 out of 5152 children aged 6 to 9&#xa0;years by using inductively coupled plasma mass spectrometry (ICP-MS). The individual and joint associations between elements and the risk of PEM were assessed using logistic regression, Restricted Cubic Spline (RCS), Bayesian Kernel Machine Regression (BKMR), and Weighted Quantile Sum Regression (WQS) models, respectively. Serum concentrations of Zn, Cu, Co, V, Mn, and Ni were significantly lower in the PEM group than in controls (all <i>P</i> &lt; <i>0.005</i>). Higher quartile concentrations of Zn (OR = 0.52), Cu (OR = 0.59), V (OR = 0.52), Mn (OR = 0.51), and Ni (OR = 0.68) were associated with lower PEM risk (all<i> P</i><sub>trend</sub> &lt; <i>0.05</i>). RCS model indicated non-linear relationships between Zn, Cu, Cr, Co, V, Mn, and PEM risk. Interactions were found between Zn, Mn, and Co on the risk of PEM. Both BKMR and WQS models revealed a negative joint association between the seven elements and PEM risk (OR =  − 0.102), with Mn (40.4%) and Zn (19.1%) identified as the strongest contributors. Serum concentrations of Zn, Cu, Co, V, and Mn were relatively lower in children with PEM and exhibited non-linear associations with the risk of PEM. The joint association of seven trace elements was negative with the risk of PEM, in which Mn and Zn contribute the most. Additionally, Mn, Zn, and Co exhibited pairwise interactions. These findings highlight the importance of maintaining balanced trace element levels to mitigate PEM in children.</p>

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Combination and Interaction of Seven Trace Elements and the Risk of Protein-Energy Malnutrition in School-Aged Children in Shenzhen, China

  • 期刊论文

  • 发表日期：

    2025年6月24日

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  • Mingtao Yu,
  • Leyun Tan,
  • Yuhui Chen,
  • Jianhui Shang,
  • Yingbin You,
  • Haiming Xie,
  • Nan Pang,
  • Rimei Liang,
  • Qingying Zhang

摘要

The imbalance of trace elements plays an important role in childhood malnutrition, but previous studies are usually specific to certain elements. We aimed to examine the individual and joint associations between multiple elements and the risk of protein-energy malnutrition (PEM) in young school children. This study measured the serum levels of zinc (Zn), copper (Cu), chromium (Cr), cobalt (Co), vanadium (V), manganese (Mn), and nickel (Ni) in 1832 out of 5152 children aged 6 to 9 years by using inductively coupled plasma mass spectrometry (ICP-MS). The individual and joint associations between elements and the risk of PEM were assessed using logistic regression, Restricted Cubic Spline (RCS), Bayesian Kernel Machine Regression (BKMR), and Weighted Quantile Sum Regression (WQS) models, respectively. Serum concentrations of Zn, Cu, Co, V, Mn, and Ni were significantly lower in the PEM group than in controls (all P < 0.005). Higher quartile concentrations of Zn (OR = 0.52), Cu (OR = 0.59), V (OR = 0.52), Mn (OR = 0.51), and Ni (OR = 0.68) were associated with lower PEM risk (all Ptrend < 0.05). RCS model indicated non-linear relationships between Zn, Cu, Cr, Co, V, Mn, and PEM risk. Interactions were found between Zn, Mn, and Co on the risk of PEM. Both BKMR and WQS models revealed a negative joint association between the seven elements and PEM risk (OR =  − 0.102), with Mn (40.4%) and Zn (19.1%) identified as the strongest contributors. Serum concentrations of Zn, Cu, Co, V, and Mn were relatively lower in children with PEM and exhibited non-linear associations with the risk of PEM. The joint association of seven trace elements was negative with the risk of PEM, in which Mn and Zn contribute the most. Additionally, Mn, Zn, and Co exhibited pairwise interactions. These findings highlight the importance of maintaining balanced trace element levels to mitigate PEM in children.