Year of Publication



Public Health

Date Available


Degree Name

Dr. of Public Health (Dr.P.H.)

Committee Chair

Erin N. Haynes, DrPH, MS


Introduction: Manganese is an essential trace element that can cause adverse health effects with deficiency and in excess amounts. The purpose of this study is to determine the asscociation of blood manganese levels and the prevalence of myocardial infarction, stroke, and renal dysfunction in a general US population.

Methods: Data were used from the National Health and Nutritional Examination Survey (NHANES) of non-institutionalized US adults 20 years and older using the 2011-2012, 2013-2014, and 2015-2016 survey cycles (n=16629). Weighted multivariable logistic regression models adjusted for age, race/ethnicity, sex, and poverty income ratio (PIR), were used to determine the association of blood manganese levels and myocardial infarction, stroke, and renal dysfunction accounting for the complex sample survey design.

Results: The mean and standard errors (SEs) of blood manganese levels for myocardial infarction were [10.2 (0.4) µg/L], stroke [9.6 (0.2) µg/L], and renal dysfunction [9.4 (0.1) µg/L] for the combined six years. In the adjusted models, the odds of myocardial infarction [odds ratio (OR) 1.20 (95% CI: 0.76-1.90)] were highest in the highest quartile (Q4: ≥11.3 µg/L) compared to the lower quartile (Q1: ≤7.36 µg/L). There was a non-signicant 17% increased odds of stroke 1.17 (95% CI: 0.72-1.92) comparing the highest quartile (Q4) to the lowest quartile (Q1). There was a non-significant decreased odds of renal dysfunction 0.80 (95% CI: 0.62-1.05) in the highest quartile (Q4) compared to the lowest quartile (Q1).

Conclusion: The increasing odds for stroke and myocardial infarction based on the manganese quartiles, suggests that increased blood manganese levels may play an important role in the disease process.

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