Lead exposure associated with vitamin D metabolic imbalance mediated by chronic inflammation in children

Highlights

	● First study on relationships among Pb exposure, inflammatory state, and vitamin levels.
	● High Pb exposure was associated with lower vitamin D levels.
	● Chronic exposure to Pb may disturb the absorption vitamin D through altering inflammatory state.

Abstract

Lead (Pb) exposure and vitamin D deficiency have been independently linked to adverse health outcomes, but the relationship between Pb toxicity and vitamin D remains unclear. Therefore, this retrospective study evaluated this relationship in childr,en and explored the potential mediating role of immune inflammation. 653 children were enrolled in this study. The multivariable-adjusted linear regression model was employed to evaluate the does-effect associations among Pb exposure on inflammatory biomarkers and serum vitamin D levels. Concomitantly, mediating effect models were applied to identify the potential role of inflammation in the relationships between Pb exposure and vitamin D malabsorption. Our findings revealed lower vitamin D levels and elevated inflammatory markers in children with Pb exposure. We observed a dose-dependent relationship between serum Pb levels and vitamin D status, mediated by inflammatory responses. Specifically, SII demonstrated a complete mediating effect on the association between serum Pb and vitamin D3 levels (effect value: −0.280; 95% CI: −0.774, −0.021). These findings suggest that Pb-induced chronic inflammation may contribute to vitamin D malabsorption in children, which subsequently facilitates the occurrence of immune diseases. This therefore highlights the need for interventions to reduce Pb exposure and protect children from immunological diseases and detrimental health outcomes.

Graphical abstract

Keywords

Serum Pb levels / Vitamin D / Innate immune cells / Inflammation / Children

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CRediT Authorship Contribution Statement

Shaocheng Zhang: conceptualization, validation, writing-original draft, project administration, and funded the study; Xi Zhan: formal analysis, and writing-original draft; Jing Wang: investigation, data collection, and resources. Hanhan Xie and Hui Quan: formal analysis; Huanhuan Wang: conceptualization, methodology, validation, data curation, writing-review and editing, supervision, project administration, and funded the study. All authors read and approved the final manuscript.

Conflict of Interests

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Ethics Approval

All protocols of this study were approved by the Medical Ethics Committee of the Second Affiliated Hospital of Chengdu Medical College (Nuclear Industry 416 Hospital), China (No. YJ-2024-017) and the Biomedical Ethics committee of Mianyang Central Hospital, China (No. S202403177-01).

Acknowledgements

This work was supported by the High-level Talent Cultivation Project of Chengdu Medical College, China (No. KYPY22-08), the Clinical Science Research Project of Chengdu Medical College, China (No. 24LHBBYY1-03), the Special Scientific Research Project of Sichuan Medical Association, China (No. 2024HR21), and the Talent Introduction Project of the Second Affiliated Hospital of Chengdu Medical College (Nuclear Industry 416 Hospital), China (No. SYL2024RCYJ003). We acknowledge all the recruited children for participating in this project. We also thank LetPub for its linguistic assistance during the preparation of this manuscript.

Electronic Supplementary Material

Supplementary material is available in the online version of this article at https://doi.org/10.1007/s11783-025-1988-5 and is accessible for authorized users.

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