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Association of copper exposure with metabolic syndrome: a dose-response meta-analysis

Chou‐Yi HsuDepartment of Pharmacy, Chia Nan University of Pharmacy and Science, Tainan, 71710, TaiwanMohammed Hashim MohammedMedical Laboratory Techniques Department, College of Health and Medical Technology, Al-maarif University, Anbar, IraqSarah F. Al-TaieCollege of Science, Department of Biotechnology, University of Baghdad, Baghdad, IraqJasur RizaevDepartment of Public Health and Healthcare Management, Rector, Samarkand State Medical University, Samarkand, UzbekistanMeka Sreedhar RaoFaculty of Ayurveda, Gokul Global University, Sidhpur, Gujarat, IndiaIrwanjot KaurDepartment of Chemistry & Biochemistry, Sharda School of Engineering & Sciences, Sharda University, Greater, Noida, IndiaNeeraj BainsalUniversity Institute of Pharma Sciences, Chandigarh University, Mohali, Punjab, IndiaSamir SahooDepartment of General Medicine, IMS and SUM Hospital, Siksha ’O’ Anusandhan (Deemed to be University), Bhubaneswar, Odisha, 751003, IndiaAseel smeratAseel Smerat Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, 19328, JordanHamzeh AlizadehGenetics Research Center, Department of Genetics and Breeding, The University of Guilan, Rasht, Iran

2026en

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Аннотация

Metabolic syndrome (MetS) represents a cluster of interconnected metabolic derangements with a growing global prevalence. The association of copper (Cu) exposure with the odds of MetS remains unclear. This dose-response meta-analysis aimed to examine the relationship between urinary and serum Cu concentrations and MetS. We searched Cochrane library, Web of Science, PubMed, and Scopus from inception to 4 February 2026. Studies providing association estimates for the relationship between serum or urinary Cu and MetS were included. Pooled effect sizes were presented as odds ratios (ORs) with 95% confidence intervals (CIs), calculated with the use of random-effects models. Twenty-three studies with 69,121 participants and 9,964 MetS cases were included. Higher serum Cu concentrations were significantly linked to elevated odds of MetS (OR = 1.17, 95% CI = 1.02–1.35), with considerable heterogeneity (I² = 79.6%, P < 0.001). Dose-response analysis revealed no significant linear association; however, a significant non-linear relationship was identified, with the odds of MetS increasing more markedly at serum Cu concentrations above approximately 1,100 µg/L ( P = 0.047). Higher urinary Cu concentrations were also significantly associated with greater odds of MetS (OR = 1.41, 95% CI: 1.03–1.95; I² = 83.1%). The associations for both serum and urinary Cu were attenuated after adjustment for lifestyle-related factors and BMI. Elevated serum and urinary Cu concentrations were significantly linked to an elevated odds of MetS, with evidence of a non-linear dose-response association. Lifestyle factors may confound this association. Not applicable.

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DOI: 10.1186/s12902-026-02434-4

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