安微省东部中国，尿液多微量元素浓度与胃前癌病变及胃癌的相关性分析

Association analyses between urinary concentrations of multiple trace elements and gastric precancerous lesions and gastric cancer in Anhui province, eastern China

FRONTIERS IN PUBLIC HEALTH

影响因子:3.4

分区:医学3区 / 公共卫生3区

发表日期:2024

作者: Shiqing Qian, Fang Xu, Min Wang, Meng Zhang, Shaopeng Ding, Guoqing Jin, Xiaohui Zhang, Wenli Cheng, Li Wang, Yuting Zhu, Wuqi Wang, Princess Ofosuhemaa, Tingting Wang, Xiao Lin, Yu Zhu, Yaning Lv, Anla Hu, Wanshui Yang, Gengsheng He, Qihong Zhao

DOI: 10.3389/fpubh.2024.1423286

摘要

有限的流行病学证据表明，微量元素暴露对胃前癌病变（GPL）和胃癌（GC）的发生具有不良影响。本研究旨在估计单个尿液中多元素暴露与GPL和GC的关联性。2021年3月至2022年12月在安徽省进行了一项病例对照研究。共纳入528名受试者（随机抽样自1020例GPL患者、200例GC患者和762名正常对照）。通过电感耦合等离子体质谱（ICP-MS）测定铁（Fe）、铜（Cu）、锌（Zn）、镍（Ni）、锶（Sr）和铯（Cs）的尿液水平。采用四种不同的统计方法探索混合暴露与GPL和GC的风险，包括多变量逻辑回归、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模型显示元素混合物的尿液暴露与GPL和GC均呈正相关，GPL的比值比（OR）为1.34（95% CI：1.34-1.61），GC的OR为1.38（95% CI：1.27-1.50）。Qgcomp和BKMR模型也表明混合物与GPL及GC之间存在统计学显著的正相关。考虑到病例对照研究的局限性，未来还需进行前瞻性研究以阐明微量元素暴露对人类健康的联合效应及机制。

Abstract

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.