Advances in rapid point-of-care virus testing.

Outbreaks of viral diseases seriously jeopardize people's health and cause huge economic losses. At the same time, virology provides a new perspective for biology, molecular biology and cancer research, and it is important to study the discovered viruses with potential applications. Therefore, the development of immediate and rapid viral detection methods for the prevention and treatment of viral diseases as well as the study of viruses has attracted extensive attention from scientists. With the continuous progress of science and technology, especially in the field of bioanalysis, a series of new detection techniques have been applied to the on-site rapid detection of viruses, which has become a powerful approach for human beings to fight against viruses. In this paper, the latest research progress of rapid point-of-care detection of viral nucleic acids, antigens and antibodies is presented. In addition, the advantages and disadvantages of these technologies are discussed from the perspective of practical application requirements. Finally, the problems and challenges faced by rapid viral detection methods and their development prospects are discussed.

A novel frameshift mutation in RHAG leads to Rhnull phenotype in a Chinese individual.

BACKGROUND: We recently encountered a Rhnull phenotype proband within one family in the Chinese population. Rhnull is a rare autosomal recessive disorder characterized by the absence of the Rh antigens on the erythrocyte membrane, resulting in chronic hemolytic anemia. This study described the serological and molecular analysis of a Chinese Rhnull proband and his immediate family. METHODS: Red blood cells antigen phenotyping and antibody screening/identification were conducted. RHD, RHCE, and RHAG were analyzed using genomic DNA by polymerase chain reaction and sequence analysis. RESULTS: Serologic tests showed a D-C-E-c-e- phenotype in the proband associated with the suspicion of anti-Rh29 (titer 16). Molecular analyses showed a new mutation (c.406dupA) in exon 3 of RHAG. This duplication introduced a reading frameshift (p.Thr136AsnfsTer21). The RHAG mutation was found in the homozygous state for the proband and heterozygous state for his parents. CONCLUSION: We identified a novel RHAG mutation resulting in the Rhnull phenotype of the regulator type. Inheritance of the novel allele was shown by family study.

Exploration of the biomarkers of comorbidity of psoriasis with inflammatory bowel disease and their association with immune infiltration.

BACKGROUND: There was evidence that significant bidirectional associations between psoriasis and inflammatory bowel diseases (IBDs), which influences management strategy of the patients, so the investigation on the mechanisms by which these two diseases co-occur is important. METHODS: The Gene Expression Omnibus (GEO) database was used to download gene expression profiles of psoriasis and IBD. The differentially expressed genes (DEGs) between disease and health control groups for each data set were calculated, and Venn diagram was used to obtain for intersection. We performed Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis on the intersection, followed by developing a protein-protein interaction network and module construction, and identified hub genes by cytoHubba. Thereafter, least absolute shrinkage and selection operator algorithms was used to identify the co-biomarkers of psoriasis and IBD from the top 50 hub genes. The biomarkers were used to construct a screening model, the discriminatory capacity of which was verified by receiver operating characteristic (ROC) curves. CIBERSORT algorithm was utilized to estimate the compositional patterns of immune cell infiltration in biomarkers of psoriasis and IBD. Spearman rank correlation analysis was used to further evaluate the correlation between the identified biomarkers and immune cells. RESULTS: A total of 271 shared DEGs were screened. The GO and KEGG enrichment analysis indicated that the shared DEGs were mainly enriched in response to lipopolysaccharide, secretory granule lumen, cytokine activity, and interleukin (IL)-17 signaling pathway. Fifty genes such as IL1B, IL6, were identified as hub genes, based on which, FOS, IFI44, MMP9, MNDA, PTGS2, S100A9, and STAT1 were identified as biomarkers of psoriasis. CCL20, CD274, CTGF, CXCL1, CXCL10, CXCL2, CXCL9, FCGR3B, FOS, GBP1, GZMB, IFI27, IFI6, IL1RN, ISG15, ISG20, LCN2, LILRB2, MMP12, MMP7, S100A8, TLR8, and TNFSF13B were identified as biomarkers of IBD. FOS was the common biomarker of psoriasis and IBD. Screening models were validated in the validation data set (Psoriasis: area under the curve (AUC) = 1.000, IBD: AUC = 0.870). Immunocyte infiltration analysis showed the macrophages cells, mast cells resting, and T cells CD4 memory activated have the common characteristics in psoriasis and IBD. CONCLUSIONS: FOS may play a key role in the occurrence and development of psoriasis complicated with IBD and macrophages cells may be an entrance for treating this comorbidity.

EMNPD: a comprehensive endophytic microorganism natural products database for prompt the discovery of new bioactive substances.

The discovery and utilization of natural products derived from endophytic microorganisms have garnered significant attention in pharmaceutical research. While remarkable progress has been made in this field each year, the absence of dedicated open-access databases for endophytic microorganism natural products research is evident. To address the increasing demand for mining and sharing of data resources related to endophytic microorganism natural products, this study introduces EMNPD, a comprehensive endophytic microorganism natural products database comprising manually curated data. Currently, EMNPD offers 6632 natural products from 1017 endophytic microorganisms, targeting 1286 entities (including 94 proteins, 282 cell lines, and 910 species) with 91 diverse bioactivities. It encompasses the physico-chemical properties of natural products, ADMET information, quantitative activity data with their potency, natural products contents with diverse fermentation conditions, systematic taxonomy, and links to various well-established databases. EMNPD aims to function as an open-access knowledge repository for the study of endophytic microorganisms and their natural products, thereby facilitating drug discovery research and exploration of bioactive substances. The database can be accessed at http://emnpd.idrblab.cn/ without the need for registration, enabling researchers to freely download the data. EMNPD is expected to become a valuable resource in the field of endophytic microorganism natural products and contribute to future drug development endeavors.

Physiological and Psychological Effects of Isotretinoin in the Treatment of Patients with Acne: A Narrative Review.

Isotretinoin (ISO) is a powerful vitamin A derivative that offers the potential for treatment of permanent remission of acne; however, its potential side effects on both physiological and psychological aspects limit its application. This article reviews the side effects of ISO from physiological and psychological aspects in detail, to better screen the suitable population of ISO and improve the efficiency of clinical treatment. Our findings indicate that ISO may cause teratogenicity, skin reactions, ocular reactions, changes in blood indicators, and occasional acne fulminans. To optimize clinical treatment, more attention should be paid to identifying the specific conditions under which these reactions occur, how severe they are, and how they subside to alleviate patient concerns. Regarding the controversial issue of psychological side effects caused by ISO, researchers should shift their focus to the psychological problems that acne itself may cause.

Collaboration between meteorology and public health: Predicting the dengue epidemic in Guangzhou, China, by meteorological parameters.

Background: Dengue has become an increasing public health threat around the world, and climate conditions have been identified as important factors affecting the transmission of dengue, so this study was aimed to establish a prediction model of dengue epidemic by meteorological methods. Methods: The dengue case information and meteorological data were collected from Guangdong Provincial Center for Disease Prevention and Control and Guangdong Meteorological Bureau, respectively. We used spatio-temporal analysis to characterize dengue epidemics. Spearman correlation analysis was used to analyze the correlation between lagged meteorological factors and dengue fever cases and determine the maximum lagged correlation coefficient of different meteorological factors. Then, Generalized Additive Models were used to analyze the non-linear influence of lagged meteorological factors on local dengue cases and to predict the number of local dengue cases under different weather conditions. Results: We described the temporal and spatial distribution characteristics of dengue fever cases and found that sporadic single or a small number of imported cases had a very slight influence on the dengue epidemic around. We further created a forecast model based on the comprehensive consideration of influence of lagged 42-day meteorological factors on local dengue cases, and the results showed that the forecast model has a forecast effect of 98.8%, which was verified by the actual incidence of dengue from 2005 to 2016 in Guangzhou. Conclusion: A forecast model for dengue epidemic was established with good forecast effects and may have a potential application in global dengue endemic areas after modification according to local meteorological conditions. High attention should be paid on sites with concentrated patients for the control of a dengue epidemic.

Epidemiology of Psoriasis and Comorbid Diseases: A Narrative Review.

Psoriasis is a chronic autoimmune inflammatory disease that remains active for a long period, even for life in most patients. The impact of psoriasis on health is not only limited to the skin, but also influences multiple systems of the body, even mental health. With the increasing of literature on the association between psoriasis and extracutaneous systems, a better understanding of psoriasis as an autoimmune disease with systemic inflammation is created. Except for cardiometabolic diseases, gastrointestinal diseases, chronic kidney diseases, malignancy, and infections that have received much attention, the association between psoriasis and more systemic diseases, including the skin system, reproductive system, and oral and ocular systems has also been revealed, and mental health diseases draw more attention not just because of the negative mental and mood influence caused by skin lesions, but a common immune-inflammatory mechanism identified of the two systemic diseases. This review summarizes the epidemiological evidence supporting the association between psoriasis and important and/or newly reported systemic diseases in the past 5 years, and may help to comprehensively recognize the comorbidity burden related to psoriasis, further to improve the management of people with psoriasis.

Epidemiological characteristics of gonorrhea and its influential meteorological factors: a 14-year retrospective assessment in China.

This study aimed to investigate the seasonal variation of gonorrhea in China, and to analyze the relationship between the incidence of gonorrhea and meteorological factors. Data from gonorrhea cases were obtained from the Disease Prevention and Control Bureau and the Data-Center for China Public Health Science, Chinese Center for Disease Control and Prevention, and the incidence of gonorrhea in China from 1 January 2006 to 31 December 2019 was analyzed. Meteorological data from the same period were obtained from the South China Meteorological Data Sharing Center, including the average monthly temperature, relative humidity, atmospheric pressure, sunshine hours, number of rainy days, and precipitation. The ratio-to-moving average method and seasonal subseries plots were used to analyze the seasonality of gonorrhea cases. The distributed lag non-linear model and attribution risks were used to investigate the effects of meteorological indexes on gonorrhea cases. The number of gonorrhea cases showed seasonal variation, with a peak in the third quarter and a decline in the first quarter. The Spearman assay showed that the reported number of patients with gonorrhea was positively correlated with the monthly temperature, relative humidity, precipitation, and number of rainy days. The risk of gonorrhea onset was highest at 6-11 °C, and the highest risk occurred when the average monthly temperature was 7 °C (resulting in an increase of 14.5% compared with 13 °C); a similar result was found regarding the cumulative risk of gonorrhea onset in relation to temperature. The attribution score of temperature to the onset of gonorrhea was 5.02% (95% confidence interval: - 3.84%, 13.88%). The study findings suggest that increased emphasis should be placed on screening for gonorrhea during summer and autumn, and that education on safe sexual behavior should be promoted during these times.

Corrigendum: The GABAA Receptor Influences Pressure Overload-Induced Heart Failure by Modulating Macrophages in Mice.

[This corrects the article DOI: 10.3389/fimmu.2021.670153.].

Prediction of skin disease using a new cytological taxonomy based on cytology and pathology with deep residual learning method.

With the development of artificial intelligence, technique improvement of the classification of skin disease is addressed. However, few study concerned on the current classification system of International Classification of Diseases, Tenth Revision (ICD)-10 on Diseases of the skin and subcutaneous tissue, which is now globally used for classification of skin disease. This study was aimed to develop a new taxonomy of skin disease based on cytology and pathology, and test its predictive effect on skin disease compared to ICD-10. A new taxonomy (Taxonomy 2) containing 6 levels (Project 2-4) was developed based on skin cytology and pathology, and represents individual diseases arranged in a tree structure with three root nodes representing: (1) Keratinogenic diseases, (2) Melanogenic diseases, and (3) Diseases related to non-keratinocytes and non-melanocytes. The predictive effects of the new taxonomy including accuracy, precision, recall, F1, and Kappa were compared with those of ICD-10 on Diseases of the skin and subcutaneous tissue (Taxonomy 1, Project 1) by Deep Residual Learning method. For each project, 2/3 of the images were included as training group, and the rest 1/3 of the images acted as test group according to the category (class) as the stratification variable. Both train and test groups in the Projects (2 and 3) from Taxonomy 2 had higher F1 and Kappa scores without statistical significance on the prediction of skin disease than the corresponding groups in the Project 1 from Taxonomy 1, however both train and test groups in Project 4 had a statistically significantly higher F1-score than the corresponding groups in Project 1 (P = 0.025 and 0.005, respectively). The results showed that the new taxonomy developed based on cytology and pathology has an overall better performance on predictive effect of skin disease than the ICD-10 on Diseases of the skin and subcutaneous tissue. The level 5 (Project 4) of Taxonomy 2 is better on extension to unknown data of diagnosis system assisted by AI compared to current used classification system from ICD-10, and may have the potential application value in clinic of dermatology.

Diversity and function of culturable actinobacteria in the root-associated of Salvia miltiorrhiza Bunge.

The root-associated actinobacteria play important roles in plant growth, nutrient use, and disease resistance due to their functional diversity. Salvia miltiorrhiza is a critical medicinal plant in China. The root actinobacterial community structure has been studied; however, the functions of root-associated actinobacteria of S. miltiorrhiza have not been elucidated. This study aimed to decipher the diversity and function of the culturable root-associated actinobacteria in plant growth using culture-dependent technology and culturable microbe metagenomes. We isolated 369 strains from the root-associated actinobacteria, belonging to four genera, among which Streptomyces was dominant. Besides, the functional prediction revealed some pathways related to plant growth, nitrogen and phosphorus metabolism, and antagonistic pathogens. We systematically described the diversity and functions of the culturable root-associated actinobacteria community. Our results demonstrated that the culturable root-associated actinobacteria of S. miltiorrhiza have rich functionalities, explaining the possible contribution of culturable root-associated actinobacteria to S. miltiorrhiza's growth and development. This study provides new insights into understanding the function of the culturable root-associated actinobacteria and can be used as a knowledge base for plant growth promoters and biological control agent development in agriculture.

The GABAA Receptor Influences Pressure Overload-Induced Heart Failure by Modulating Macrophages in Mice.

Background: Myocardial macrophages have key roles in cardiac remodeling and dysfunction. The gamma-aminobutyric acid subtype A (GABAA) receptor was recently found to be distributed in macrophages, allowing regulation of inflammatory responses to various diseases. This study aimed to clarify the role of GABAA receptor-mediated macrophage responses in pressure overload-induced heart failure. Methods and Results: C57BL/6J mice underwent transverse aortic constriction for pressure-overload hypertrophy (POH) and were intraperitoneally treated with a specific GABAA receptor agonist (topiramate) or antagonist (bicuculline). Echocardiography, histology, and flow cytometry were performed to evaluate the causes and effects of myocardial hypertrophy and fibrosis. Activation of the GABAA receptor by topiramate reduced ejection fraction and fractional shortening, enlarged the end-diastolic and end-systolic left ventricular internal diameter, aggravated myocardial hypertrophy and fibrosis, and accelerated heart failure in response to pressure overload. Mechanistically, topiramate increased the number of Ly6Clow macrophages in the heart during POH and circulating Ly6Chigh classic monocyte infiltration in late-phase POH. Further, topiramate drove Ly6Clow macrophages toward MHCIIhigh macrophage polarization. As a result, Ly6Clow macrophages activated the amphiregulin-induced AKT/mTOR signaling pathway, and Ly6ClowMHCIIhigh macrophage polarization increased expression levels of osteopontin and TGF-ß, which led to myocardial hypertrophy and fibrosis. Conversely, GABAA receptor blockage with bicuculline reversed these effects. Conclusions: Control of the GABAA receptor activity in monocytes/macrophages plays an important role in myocardial hypertrophy and fibrosis after POH. Blockade of the GABAA receptor has the potential to improve pressure overload-induced heart failure.

Colorimetric determination of the activity of methyltransferase based on nicking enzyme amplification and the use of gold nanoparticles conjugated to graphene oxide.

A method is described for the colorimetric determination of the activity of CpG methyltransferase (M.SssI). It is based on (a) the crosslinking effect between dsDNA-modified gold nanoparticles (AuNPs) and graphene oxide (GO), and (b) an amplification reaction with the aid of a nicking enzyme. To avoid the aggregation of AuNPs (which would produce false signals), a hairpin DNA was connected to the AuNPs. Thus, the red color of the solution (measured at 530 nm) increases linearly with the activity of M.SssI from 0.2 to 60 U·mL-1, and the limit of detection is 67 U·mL-1. This is superior to some reported strategies. The method was successfully applied to analyze spiked serum samples. Conceivably, it represents a powerful tool for use in drug development and diagnosis. Graphical abstracts A method based on the conjugated cross-linking effect between dsDNA modified Au NPs and GO coupled with an amplification reaction of nicking enzyme has been developed for colorimetric detection of the activity of CpG methyltransferase (M.SssI).

Colonic electrical stimulation improves colonic transit in rotenone-induced Parkinson's disease model through affecting enteric neurons.

AIMS: The aims of this study were to investigate the effect of colonic electrical stimulation (CES) on delayed colonic transit in Parkinson's disease (PD) model induced by rotenone and its possible mechanisms. MAIN METHODS: Sprague-Dawley male rats were implanted with a pair of electrodes on the serosa at the proximal colon and rotenone was subcutaneously injected for 6 weeks to induce the PD model. Behavior activity, stool volume and open-field test were recorded during the injection. Colonic propulsion rate was measured 6 weeks after rotenone injection. Colon samples of all rats were collected for the measurement of phosphorylated alpha-synuclein, choline acetyltransferase (CHAT), neuronal nitric oxide synthase (nNOS), and tyrosine hydroxylase (TH). The protocols of control rats were the same as the PD rats except that no electrodes were implanted and no rotenone was injected. KEY FINDINGS: (1) Rotenone-induced PD rats demonstrated weight loss, significant decrease of the dopaminergic neurons in substantia nigra, and impairment of colon movement. (2) CES significantly accelerated the delayed colonic transmit (91.67 ±â€¯5.58% vs 51.33 ±â€¯4.18%), superior to Macrogol-4000. (3) CES significantly upregulated the expression of CHAT, nNOS and TH protein in colon of PD rats. (4) In colon of PD rats, the phosphorylated alpha-synuclein was significantly upregulated, but CES had no significant effect on phosphorylated alpha-synuclein. SIGNIFICANCE: Our data show that CES can normalize the delayed colonic transit and this normalization may attribute to affecting enteric excitatory and inhibitory neurons.

Diagnostic utility of gut α-synuclein in Parkinson's disease: A systematic review and meta-analysis.

BACKGROUND: The accumulation of misfolded α-synuclein in the brain is associated with Parkinson's disease. However, the association between gut α-synuclein and PD and diagnostic value of α-synuclein in the gut still remain controversial. METHODS: A literature search from inception to June 2018 was conducted, yielding 21 studies eligible for a systematic review and meta-analysis. We included studies that reported data on gut α-synuclein or phosphorylated α-synuclein in patients with PD and controls. The odds ratio(OR) was pooled using random-effect models, and heterogeneity was reported as I2. Studies were assessed for quality using the Newcastle-Ottawa Scale. Sensitivity and specificity analyses were performed using the summary receiver operating characteristics curve approach. RESULTS: The database search yielded 395 results, of which 21 studies were deemed relevant. The PD group had a pooled OR of 10.01 (95% CI: 3.15-31.82, I2 = 72%) for gut α-synuclein compared with the control group. Sensitivity and specificity for distinguishing PD from controls were 0.568 and 0.819, respectively, for the colon, and 0.579 and 0.822, respectively, for phosphorylated α-synuclein. CONCLUSION: Heterogeneity was high in most of the studies. This systematic review and meta-analysis confirmed a high degree of association between gut α-synuclein and PD, which suggested that gut α-synuclein is a potential therapeutic intervention. The measurement of gut α-synuclein alone could lead to the underdiagnosis of PD. Future research combining gut α-synuclein with other biochemical markers could improve the standardization of current assays.

Cross-Talk between Gut Microbiota and Heart via the Routes of Metabolite and Immunity.

Considering the prevalence of cardiovascular disease (CVD), significant interest has been focused on the gut microbiota-heart interaction because the gut microbiota has been recognized as a barometer of human health. Dysbiosis, characterized by changes in the gut microbiota in CVD, has been reported in cardiovascular pathologies, such as atherosclerosis, hypertension, and heart failure. Conversely, gut microbiota-derived metabolites, such as trimethylamine/trimethylamine N-oxide (TMA/TMAO), can impact host physiology. Further, bacterial dysbiosis can disturb gut immunity, which increases the risk of acute arterial events. Moreover, studies of germ-free mice have provided evidence that microbiota diversity and the presence of a specific microbe in the gut can affect immune cells in hosts. Therefore, the changes in the composition of the gut microbiota can affect host metabolism and immunity. Importantly, these effects are not only confined to the gut but also spreaded to distal organs. The purpose of the current review is to highlight the complex interplay between the microbiota and CVD via TMAO and different immune cells and discuss the roles of probiotics and nutrition interventions in modulating the intestinal microbiota as novel therapeutic targets of CVD.

CD8+T cells expressing both PD-1 and TIGIT but not CD226 are dysfunctional in acute myeloid leukemia (AML) patients.

Acute myeloid leukemia (AML) is one of the most common types of leukemia among adults with an overall poor prognosis and very limited treatment management. Immune checkpoint blockade of PD-1 alone or combined with other immune checkpoint blockade has gained impressive results in murine AML models by improving anti-leukemia CD8+T cell function, which has greatly promoted the strategy to utilize combined immune checkpoint inhibitors to treat AML patients. However, the expression profiles of these immune checkpoint receptors, such as co-inhibitory receptors PD-1 and TIGIT and co-stimulatory receptor CD226, in T cells from AML patients have not been clearly defined. Here we have defined subsets of CD8+ and CD4+ T cells in the peripheral blood (PB) from newly diagnosed AML patients and healthy controls (HCs). We have observed increased frequencies of PD-1- and TIGIT- expressing CD8+ T cells but decreased occurrence of CD226-expressing CD8+T cells in AML patients. Further analysis of these CD8+ T cells revealed a unique CD8+ T cell subset that expressed PD-1 and TIGIT but displayed lower levels of CD226 was associated with failure to achieve remission after induction chemotherapy and FLT3-ITD mutations which predict poor clinical prognosis in AML patients. Importantly, these PD-1+TIGIT+CD226-CD8+T cells are dysfunctional with lower expression of intracellular IFN-γ and TNF-α than their counterparts in HCs. Therefore, our studies revealed that an increased frequency of a unique CD8+ T cell subset, PD-1+TIGIT+CD226-CD8+T cells, is associated with CD8+T cell dysfunction and poor clinical prognosis of AML patients, which may reveal critical diagnostic or prognostic biomarkers and direct more efficient therapeutic strategies.

Surveillance of Antibiotic Susceptibility Patterns of Neisseria gonorrhoeae from 2013 to 2015 in Guangxi Province, China.

Neisseria gonorrhoeae is a sexually transmitted pathogen highly prevalent worldwide with an increasing trend of resistance to antimicrobial treatment. We conducted this study to trace the susceptibility of N. gonorrhoeae to penicillin (PC), spectinomycin (SPCM), ciprofloxacin (CPFX), azithromycin (AZM), cefixime (CFIX), and ceftriaxone (CTRX) in Guangxi province. In total, 303 N. gonorrhoeae isolates were obtained from patients infected with N. gonorrhoeae in 6 cities in Guangxi during 2013-2015, and the antibiotic susceptibility patterns were analyzed by an agar dilution assay. The results showed that N. gonorrhoeae was susceptible to treatment with cephalosporins, including CTRX (99.7% of isolates), CFIX (99%), SPCM (100%), and AZM (96.4%), and this is the first report of antibiotic susceptibility for AZM surveillance of N. gonorrhoeae in Guangxi. Penicillinase-producing N. gonorrhoeae (PPNG) isolates increased in prevalence from 37% in 2013 to 64% in 2015 (P = 0.068), and tetracycline-resistant N. gonorrhoeae (TRNG) prevalence increased from 23% in 2013 to 44% in 2015 (P = 0.071). High resistance of N. gonorrhoeae to PC was associated with infection in patients at ages 25 to 30 years (P ＜ 0.05), whereas PPNG positivity (P ＜ 0.01), and TRNG positivity were risk factors for CPFX resistance (P = 0.0407). Our study provides plausible evidence for therapeutic strategies and N. gonorrhoeae infection control and prevention in Guangxi, China.

Relationship between Selected Serum Metallic Elements and Obesity in Children and Adolescent in the U.S.

The prevalence of obesity has increased at an alarming rate worldwide. Metallic elements are involved in the pathogenesis of obesity and related diseases. To date, whether environmental exposure to metallic elements has effects on obesity in children and adolescents is still unclear. The aim of the current study was to investigate the association of blood metallic elements with obesity in U.S. children and adolescents. This cross-sectional study was performed with 5404 children and adolescents (6-19 years, 2745 males and 2659 females) who participated in the US National Health and Nutrition Examination Survey 2011-2014. Blood lead, mercury, selenium, manganese, copper, and zinc, as well as biochemical parameters including triglyceride (TG), cholesterol, low-density lipoprotein (LDL), and homeostasis model assessment of insulin resistance (HOMA-IR) were assessed for all subjects. Multivariate logistic regression and linear regression were applied to assess associations of metallic elements and overweight, obesity status, and serum metabolites as distinct outcomes adjusted for age, gender, ethnicity, and the poverty income ratio. When stratified by age and sex, significant associations were found between the highest quartile of copper concentrations in blood with obesity status (OR = 9.27, 95% CI: 5.43, 15.82, pfor trend < 0.001) and cholesterol (OR = 3.08, 95% CI: 1.43, 6.63, pfor trend < 0.001). The highest concentrations of manganese in the blood was associated with obesity in those aged 6-19 years (OR = 2.29, 95% CI: 1.74, 3.02, pfor trend < 0.001). Moreover, blood mercury and selenium showed positive relationships with cholesterol. Further, a negative association existed between blood zinc and obesity. The National Health and Nutrition Examination Survey data provide epidemiological evidence that blood metallic elements are positively associated with obesity in children and adolescents. However, the underlying mechanisms still need further exploration.