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Peer-reviewedCC BYBMC Psychiatry

Exposure to multiple metals and adolescent major depressive disorder: a case-control study in China

  • Yuqian He1
  • Xue Li2
  • Dan Zhu3
  • Xueer Liu1
  • Xuemei Li1
  • Teng Teng1
  • Tingting Lei1
  • Jie Li1
  • Yajie Huang1
  • Xieyu Gan4
  • Hang Du5
  • Yijue Wang6
4 more authors
  • Jingye Zhou7
  • Chengzhi Chen8
  • Fen Huang2
  • Xinyu Zhou1
8 affiliations
  1. 1Department of Psychiatry, Key Laboratory of Major Brain Disease and Aging Research (Ministry of Education), The First Affiliated Hospital of Chongqing Medical University
  2. 2Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University
  3. 3Department of Neurology, The First Affiliated Hospital of Chongqing Medical University
  4. 4Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University
  5. 5Chongqing Prevention and Treatment Center for Occupational Diseases, The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College
  6. 6The First Clinical College, Chongqing Medical University
  7. 7International Medical College, Chongqing Medical University
  8. 8Department of Occupational and Environmental Health, School of Public Health, Chongqing Medical University
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Abstract

Background Major depressive disorder (MDD) in adolescents is a common mental health problem with a complicated cause and increasing prevalence. Previous studies reported the impact of metals on adolescents with depressive symptoms, but limited evidence is available on the relationship between metals and adolescent MDD. Methods A total of 203 adolescents with MDD and 203 healthy controls were recruited for this case-control study. Urinary levels of 21 metals were measured using inductively coupled plasma mass spectrometry. The Least Absolute Shrinkage and Selection Operator (LASSO) regression was applied to identify metals for key metals, and conditional logistic regression and Bayesian Kernel Machine Regression (BKMR) were applied to assess individual and joint effects. Results In the multi-metal model, higher urinary copper (Cu) and iron (Fe) levels were associated with increased MDD risk, whereas nickel (Ni) and iodine (I) inversely associated. BKMR analysis confirmed positive associations for Cu and Fe and protective effects for Ni and I. The combined metal exposure showed an overall negative association with MDD risk. These associations were consistent across several subgroups. Conclusions This research was the first case-control study to explore the relationship between urinary metal levels and adolescent MDD. Our study identified urinary Cu and Fe as risk factors for adolescent MDD, whereas urinary Ni and I were potential protective factors. These findings might provide new light on the future prevention of adolescent MDD.

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Cite

BibTeXRIS
BibTeX
@article{he2026exposure,
  title = {{Exposure to multiple metals and adolescent major depressive disorder: a case-control study in China}},
  author = {Yuqian He and Xue Li and Dan Zhu and Xueer Liu and Xuemei Li and Teng Teng and Tingting Lei and Jie Li and Yajie Huang and Xieyu Gan and Hang Du and Yijue Wang and Jingye Zhou and Chengzhi Chen and Fen Huang and Xinyu Zhou},
  journal = {BMC Psychiatry},
  year = {2026},
  month = jul,
  doi = {10.1186/s12888-026-08444-9},
  url = {https://doi.org/10.1186/s12888-026-08444-9},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Exposure to multiple metals and adolescent major depressive disorder: a case-control study in China
AU  - Yuqian He
AU  - Xue Li
AU  - Dan Zhu
AU  - Xueer Liu
AU  - Xuemei Li
AU  - Teng Teng
AU  - Tingting Lei
AU  - Jie Li
AU  - Yajie Huang
AU  - Xieyu Gan
AU  - Hang Du
AU  - Yijue Wang
AU  - Jingye Zhou
AU  - Chengzhi Chen
AU  - Fen Huang
AU  - Xinyu Zhou
PY  - 2026
DA  - 2026/07/01
JO  - BMC Psychiatry
DO  - 10.1186/s12888-026-08444-9
UR  - https://doi.org/10.1186/s12888-026-08444-9
AB  - Background Major depressive disorder (MDD) in adolescents is a common mental health problem with a complicated cause and increasing prevalence. Previous studies reported the impact of metals on adolescents with depressive symptoms, but limited evidence is available on the relationship between metals and adolescent MDD. Methods A total of 203 adolescents with MDD and 203 healthy controls were recruited for this case-control study. Urinary levels of 21 metals were measured using inductively coupled plasma mass spectrometry. The Least Absolute Shrinkage and Selection Operator (LASSO) regression was applied to identify metals for key metals, and conditional logistic regression and Bayesian Kernel Machine Regression (BKMR) were applied to assess individual and joint effects. Results In the multi-metal model, higher urinary copper (Cu) and iron (Fe) levels were associated with increased MDD risk, whereas nickel (Ni) and iodine (I) inversely associated. BKMR analysis confirmed positive associations for Cu and Fe and protective effects for Ni and I. The combined metal exposure showed an overall negative association with MDD risk. These associations were consistent across several subgroups. Conclusions This research was the first case-control study to explore the relationship between urinary metal levels and adolescent MDD. Our study identified urinary Cu and Fe as risk factors for adolescent MDD, whereas urinary Ni and I were potential protective factors. These findings might provide new light on the future prevention of adolescent MDD.
SN  - 1471-244X
ER  -