Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Geriatric Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Sci Total Environ. 2021 Jan 1;750:141547. doi: 10.1016/j.scitotenv.2020.141547. Epub 2020 Aug 6.
High total urinary arsenic concentrations and low estimated glomerular filtration rate (eGFR) increase the risk of renal cell carcinoma (RCC). This study aimed to determine whether other metals or metalloids can affect RCC. A total of 401 patients with RCC and 774 age- and sex-matched controls were recruited between November 2006 and December 2012 in Taiwan. Surgical resection or image-guided biopsy of renal tumors was performed to pathologically verify RCC. High-performance liquid chromatography linked to a hydride generator and atomic absorption spectrometer were used to measure the urinary arsenic species concentrations. Inductively coupled plasma mass spectrometry was used to determine plasma selenium and red blood cell cadmium and lead concentration. Plasma selenium levels were inversely related to RCC, whereas red blood cell cadmium levels were directly related to RCC. The odds ratio (OR) and 95% confidence interval (CI) were 0.14 (95% CI, 0.10-0.20) and 1.33 (95% CI, 1.03-1.72), respectively. A low plasma selenium level tended to interact with high total urinary arsenic levels or with high red blood cell cadmium concentration to increase the OR of RCC. In particular, low eGFR multiplicatively interacted with high red blood cell cadmium concentration to increase the OR of RCC (P=0.003). This study was the first to find a significant multiplicative interaction between eGFR and the red blood cell cadmium levels on the increased OR of RCC.
高总尿砷浓度和低估计肾小球滤过率（eGFR）增加了肾细胞癌（RCC）的风险。本研究旨在确定其他金属或类金属是否会影响 RCC。2006 年 11 月至 2012 年 12 月，在台湾共招募了 401 例 RCC 患者和 774 例年龄和性别匹配的对照者。对肾肿瘤进行手术切除或图像引导活检，以对 RCC 进行病理证实。采用高效液相色谱法与氢化物发生器和原子吸收光谱仪测定尿砷形态浓度。电感耦合等离子体质谱法测定血浆硒和红细胞镉、铅浓度。血浆硒水平与 RCC 呈负相关，而红细胞镉水平与 RCC 呈正相关。比值比（OR）和 95%置信区间（CI）分别为 0.14（95%CI，0.10-0.20）和 1.33（95%CI，1.03-1.72）。血浆硒水平较低时，往往与高总尿砷水平或高红细胞镉浓度相互作用，增加 RCC 的 OR。特别是，低 eGFR 与高红细胞镉浓度相乘会增加 RCC 的 OR（P=0.003）。本研究首次发现 eGFR 与红细胞镉水平之间存在显著的相乘交互作用，增加了 RCC 的 OR。
