Introduction: We present data from the Korean National Health and Nutrition Examination Survey 2008-2009 on the association between blood manganese (Mn) levels and menopausal status in women. Methods: The present analysis was restricted to female participants who completed the health examination survey, including blood Mn measurements (n= 1826). Menopausal status was categorized into pre- and post-menopausal. Multivariable linear regression analyses were performed to determine whether menopausal status or serum ferritin were significant predictors of blood Mn level and to investigate whether menopausal status modifies the association between blood Mn and serum ferritin after adjusting for covariates. Results: The geometric means (GMs) of blood Mn in the low and low-normal serum ferritin groups were significantly higher than the GM of blood Mn in the normal group. The GM of blood Mn in premenopausal women was significantly higher than in postmenopausal women Multivariable linear regression analyses showed that both serum ferritin and menopausal status were predictors of blood Mn, after adjusting for various covariates, and menopausal status acted as a modifier of the effect of ferritin on blood Mn levels. Blood Mn levels were 11.0% and 22.7% lower in premenopausal women when serum ferritin increased from 10. μg/dL to 60 and 100. μg/dL, respectively, but the decrease in blood Mn based on the increase in serum ferritin was minimal in postmenopausal women. Discussion: To our knowledge, this is the first report that menopausal status was a predictor of blood Mn level after adjusting for serum ferritin. In conclusion, the present study showed that both serum ferritin and menopausal status were predictors of blood Mn, after adjusting for various covariates, and menopausal status acted as a modifier of the effect of ferritin on blood Mn levels.
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