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New research · Rheumatology
Ecotoxicology and environmental safety · 23h
Case-controlEcotoxicology and environmental safety · 2026

Associations of heavy metals and essential trace elements exposures with rheumatoid arthritis: The potential mediating role of telomere length.

Chan-Na Zhao, Xunliang Li, Xiao-Xiao Li … Guo-Cui Wu
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RheumatologyCase-control

Telomere length was associated with 4.82% of lead's association with rheumatoid arthritis.

Associations of heavy metals and essential trace elements exposures with rheumatoid arthritis: The potential mediating role of telomere length.

Chan-Na Zhao et al. · Ecotoxicology and environmental safety · 2026
Background

The relationships linking heavy metals and essential trace elements to rheumatoid arthritis (RA) risk have not been fully elucidated.

Purpose

The aim of this study was to explore the relationship between multi-metal exposure and the risk of RA, and to assess the mediating role of telomere length (TL) in these associations.

Methods

This case-control study recruited 548 RA patients and 548 controls, quantifying peripheral blood concentrations of 15 metals (Cr, Mn, Co, Zn, Se, Sr, Mo, Sn, Sb, Cu, Ni, Cd, Ba, Tl, Pb) via inductively coupled plasma mass spectrometry (ICP-MS).

n = 548 controls
Results

DNA protective caps' length explained this percentage of lead's link to rheumatoid arthritis

OR 0.82 (95% CI 0.69 to 0.98)
null = 10.690.98
CI excludes the null - significant
More results

Overall concentrations of five heavy metals (Cu, Pb, Ni, Cd, and Ba) were positively associated with RA risk, primarily driven by exposures to Cu, Ni, and Cd.

More results

Conversely, overall concentrations of seven essential metals (Sn, Se, Mn, Cr, Zn, Sr, and Mo) were inversely associated with RA risk, with Se, Sn, Mn, Sr, and Cr emerging as the main protective factors.

A U-shaped relationship emerged between the overall concentrations of these 12 metals and RA risk.

“
Conclusion

Our study reveals that excessive heavy metals and insufficient trace essential elements increase the risk of RA, and emphasizes the potential mediating role of TL in this process.

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