What question did this study set out to answer?

To assess the effects of metal mixtures on CKM syndrome and identify key toxic drivers.

Cobalt Mediates Stage-Specific Toxicity of Metal Mixtures in Cardiovascular-Kidney-Metabolic Syndrome

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Advanced mixture analysis demonstrates cobalt's toxicity impact on CKM progression, highlighting immune and lipid metabolism disruption.

To assess the effects of metal mixtures on CKM syndrome and identify key toxic drivers.
Analyzed NHANES data (2011–2016) from 1,816 participants.
Employed Weighted Quantile Sum regression, generalized linear models, and ridge regression.
Used Adverse Outcome Pathway framework to explore mechanisms of metal-mediated CKM.
WQS regression indicated a significant association between mixed metal exposure and CKM (β = 0.502, p = 0.013).
GLMs and ridge regression identified cobalt as the key driver in CKM progression.
The AOP framework revealed distinct metabolic and immune dysregulation related to cobalt exposure.

Zhang et al. (2025) studied this question.

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