Wang Huiying, Wang Jing, Cao Yujie, Chen Jinfa, Deng Qingrong, Chen Yujia, Qiu Yu, Lin Lisong, Shi Bin, Liu Fengqiong, He Baochang, Chen Fa
Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China.
Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China.
Front Nutr. 2022 Jul 7;9:913357. doi: 10.3389/fnut.2022.913357. eCollection 2022.
Trace elements exist widely in the natural environment and mostly enter the human body through drinking water or various types of food, which has raised increasing health concerns. Exposure to a single or a few trace elements has been previously reported to be associated with oral cancer risk, but studies on other elements and combined effects are limited. This study aimed to comprehensively evaluate the independent and joint effects of 33 trace elements on oral cancer risk.
The concentrations of 33 trace elements from the serum samples of 463 cases and 1,343 controls were measured using inductively coupled plasma mass spectrometry (ICP-MS). Propensity score matching was used to minimize the impact of potential confounders. Conditional logistic regression was utilized to evaluate the association of each element individually with oral cancer risk. Quantile g-computation and Bayesian kernel machine regression (BKMR) models were used to assess the joint effect of the overall element mixture and interactions.
In single-element models, essential elements (Cu, Se, Zn, Sr, and Cr) and non-essential elements (As, Li, Th, Ce, Ti, and Sc) showed significant association with oral cancer risk. In multiple-element models, a quartile increase in overall non-essential elements was observed for a significant inverse association with oral cancer risk (β = -3.36, 95% CI: -4.22 to -2.51). The BKMR analysis revealed a potential beneficial joint effect of essential metals on the risk of oral cancer. Among these, higher levels of serum Zn and V exhibited an adverse effect, while serum Sr, Se, and Cu displayed favorable effects when all other essential elements were fixed at 25th or 50th percentiles. Of note, Se performed complex interactions among essential metals. As for non-essential elements, there were greater effect estimates for serum Th, Li, and Y when all other elements were held at the 75th percentile.
This study provides supportive evidence that the overall mixture effect of essential and non-essential elements might be associated with oral cancer risk, especially for serum Zn, V, Cu, Sr, Se, Th, Li, and Y. Extensive prospective studies and other experiments are warranted to confirm our findings.
微量元素广泛存在于自然环境中，主要通过饮用水或各类食物进入人体，这引发了越来越多的健康担忧。此前有报道称，接触单一或少数几种微量元素与口腔癌风险相关，但关于其他元素及其联合效应的研究有限。本研究旨在全面评估33种微量元素对口腔癌风险的独立及联合效应。
采用电感耦合等离子体质谱法（ICP-MS）测定463例病例和1343例对照血清样本中33种微量元素的浓度。使用倾向得分匹配法以尽量减少潜在混杂因素的影响。采用条件逻辑回归评估每种元素与口腔癌风险的单独关联。使用分位数g计算法和贝叶斯核机器回归（BKMR）模型评估整体元素混合物的联合效应及相互作用。
在单元素模型中，必需元素（铜、硒、锌、锶和铬）和非必需元素（砷、锂、钍、铈、钛和钪）与口腔癌风险存在显著关联。在多元素模型中，观察到总体非必需元素增加一个四分位数与口腔癌风险呈显著负相关（β = -3.36，95%可信区间：-4.22至-2.51）。BKMR分析揭示了必需金属对口腔癌风险可能存在有益的联合效应。其中，当所有其他必需元素固定在第25或第50百分位数时，血清锌和钒水平较高呈现出不利影响，而血清锶、硒和铜则显示出有利影响。值得注意的是，硒在必需金属之间表现出复杂的相互作用。对于非必需元素，当所有其他元素保持在第75百分位数时，血清钍、锂和钇的效应估计值更大。
本研究提供了支持性证据，表明必需元素和非必需元素的总体混合效应可能与口腔癌风险相关，尤其是血清锌、钒、铜、锶、硒、钍、锂和钇。需要进行广泛的前瞻性研究和其他实验来证实我们的发现。
