有限的流行病学证据表明，接触微量元素会对胃癌前期病变（GPL）和胃癌（GC）的发展产生不利影响。本研究旨在评估个体尿液中多种元素暴露与GPL和GC的关系。2021年3月至2022年12月在安徽省进行了病例对照调查。共528名受试者（从1,020名GPL患者中随机抽样，我们的研究包括 200 名 GC 患者和 762 名正常对照。使用电感耦合等离子体质谱 (ICP-MS) 测量尿液中铁 (Fe)、铜 (Cu)、锌 (Zn)、镍 (Ni)、锶 (Sr) 和铯 (Cs) 的含量。采用四种不同的统计方法来探讨混合暴露下 GPL 和 GC 的风险，包括多元逻辑回归、加权分位数回归 (WQS)、分位数 g 计算 (Qgcomp) 和贝叶斯核机器回归 (BKMR) 模型。 WQS 模型表明，尿液中元素混合物的暴露与 GPL 和 GC 均呈正相关，GPL 和混合物暴露的 OR 分别为 1.34（95% CI：1.34-1.61）和 1.38（95% CI：1.27-1.50）用于气相色谱。 Qgcomp和BKMR模型还证明混合物与GPL和GC之间存在统计学上显着的正相关性。考虑到病例对照研究的局限性，未来的前瞻性研究有必要阐明微量元素暴露对人类健康的综合影响和机制。版权所有 © 2024 钱、徐、王、张、丁、金、张、程、王、朱、王、Ofosuhemaa、王、林、朱、吕、胡、杨、何和赵。

Limited epidemiological evidence suggests that exposure to trace elements adversely impacts the development of gastric precancerous lesions (GPL) and gastric cancer (GC). This study aimed to estimate the association of individual urinary exposure to multiple elements with GPL and GC.A case-control investigation was conducted in Anhui Province from March 2021 to December 2022. A total of 528 subjects (randomly sampled from 1,020 patients with GPL, 200 patients with GC, and 762 normal controls) were included in our study. Urinary levels of iron (Fe), copper (Cu), zinc (Zn), nickel (Ni), strontium (Sr), and Cesium (Cs) were measured using inductively coupled plasma mass spectrometry (ICP-MS). Four different statistical approaches were employed to explore the risk of GPL and GC with mixed exposure, including multivariate logistic regression, weighted quantile regression (WQS), quantile g-computation (Qgcomp), and the Bayesian kernel machine regression (BKMR) model.The WQS model indicated that urinary exposure to a mixture of elements is positively correlated with both GPL and GC, with ORs for the mixture exposure of 1.34 (95% CI: 1.34-1.61) for GPL and 1.38 (95% CI: 1.27-1.50) for GC. The Qgcomp and BKMR models also demonstrated a statistically significant positive correlation between the mixture and both GPL and GC.Considering the limitations of case-control studies, future prospective studies are warranted to elucidate the combined effects and mechanisms of trace elements exposure on human health.Copyright © 2024 Qian, Xu, Wang, Zhang, Ding, Jin, Zhang, Cheng, Wang, Zhu, Wang, Ofosuhemaa, Wang, Lin, Zhu, Lv, Hu, Yang, He and Zhao.