Background: Lead is a toxic metal for human health, but its carcinogenicity is controversial, and the effect on bladder cancer is still unknown. The object of this study was to demonstrate the link between blood lead and bladder cancer. Objectives: We investigated associations of lead exposures with bladder cancer. Methods: We used the database from the National Health and Nutrition Examination Survey (NHANES, 1999-2018) to perform a cross-sectional study. We performed Weighted multivariate logistic regression to examine the association between blood lead level with bladder cancer, and then a subgroup analysis was performed. The nonlinear association between BLL and bladder cancer was described using fitted smoothing curves. Results: A total of 40,486 participants were included in this study, the mean (SD) BMI was 28.71 ± 6.68 kg/m2. A fully adjusted model showed that BLL was parallel associated with bladder cancer (Odds ratio [OR] = 2.946, 95% Confidence interval [CI] = 1.025 to 8.465, P = 0.047) in people with BMI < 28kg/m2. However, no difference was found in BMI≥28kg/m2 subgroup and in General population. In subgroup analysis of participants with BMI < 28kg/m2, blood lead was associated with bladder cancer in the male, non-hypertensive, < 70 year old subgroup (p < 0.05), but was not significantly different from the other subgroups. Additionally, we discovered a non-linear association between BLL and bladder cancer using a linear regression model. Discussion: In this cross-sectional study, we identified higher BLL level was independently associated with Bladder cancer in People with BMI<28kg/m2.The results compensated for earlier investigations, but more large-scale prospective cohorts were required for validation. Keywords: Blood lead level (BLL), Bladder cancer, NHANES (National Health and Nutrition Examination Survey)

中文翻译：

---

美国参与者的血铅水平和膀胱癌：NHANES 1999-2018

背景：铅是对人体健康有毒的金属，但其致癌性存在争议，对膀胱癌的影响尚不清楚。这项研究的目的是证明血铅与膀胱癌之间的联系。目的：我们调查了铅暴露与膀胱癌的关联。方法：我们使用国家健康和营养检查调查（NHANES，1999-2018）的数据库进行横断面研究。我们进行加权多变量逻辑回归来检查血铅水平与膀胱癌之间的关联，然后进行亚组分析。使用拟合平滑曲线描述了 BLL 和膀胱癌之间的非线性关联。结果：本研究共纳入 40,486 名参与者，平均 (SD) BMI 为 28.71 ± 6.68 kg/m2。完全调整的模型显示，在 BMI < 28kg/m2 的人群中，BLL 与膀胱癌平行相关（比值比 [OR] = 2.946，95% 置信区间 [CI] = 1.025 至 8.465，P = 0.047）。然而，BMI≥28kg/m2的亚组和一般人群没有发现差异。在 BMI < 28kg/m2 参与者的亚组分析中，在男性、非高血压、< 70 岁亚组中，血铅与膀胱癌相关 (p < 0.05)，但与其他亚组没有显着差异。此外，我们使用线性回归模型发现了 BLL 和膀胱癌之间的非线性关联。讨论：在这项横断面研究中，我们发现 BMI<28kg/m2 的人群中较高的 BLL 水平与膀胱癌独立相关。结果补偿了早期的研究，但需要更大规模的前瞻性队列进行验证。关键词：血铅水平 (BLL)、膀胱癌、NHANES（国家健康和营养检查调查）