Cao Hai-Ming, Yang Ya-Zhu, Huang Bao-Yi, Zhang Yunzhe, Wu Yu, Wan Zi, Ma Lin
The Reproductive Andrology, The Reproductive Medicine Center, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, 518000, People's Republic of China.
The Reproductive Medicine Center, The Seventh Affiliated Hospital of Sun Yat-Sen University, No. 628 Zhenyuan Road, Shenzhen, 518000, People's Republic of China.
Environ Sci Pollut Res Int. 2023 May;30(21):61005-61017. doi: 10.1007/s11356-023-26828-2. Epub 2023 Apr 12.
Given the complexity of tumorigenesis, numerous studies have also shown that excessive exposure to heavy metals increases the risk of cancers and disrupts the secretion of sex hormones. However, the specific effects of heavy metals on cancers remain to be proven. To confirm the association between heavy metals and pan-cancer sex hormone levels among adults, 94,337 individuals from the National Health and Nutrition Examination Survey were assessed. We examined the associations between pan-cancers associated with sex hormones (ovarian, testicular, breast, and prostate cancers) and heavy metals in blood/urine. The methods (the WQS (weighted quantile sums) and SVYGLM (survey generalized linear model) regressions) were used to evaluate the association between sex hormone-related cancers and each metal category by incorporating covariates. To evaluate the overall effect of heavy metals and detect the dose-response relationship between the prevalence of pan-cancers associated with sex hormones and heavy metals, RCS (restricted cubic splines) were applied. Environmental exposure to heavy metals may be associated with pan-cancers associated with sex hormones in adults in the USA. Prostate cancer was inversely associated with blood cadmium while positively associated with blood lead, urinary tin, and thallium. Breast cancer was inversely associated with blood lead. Ovarian cancer was positively associated with blood cadmium. We also found a non-linear dose-response relationship between pan-cancers associated with sex hormones and heavy metals, which was non-parametric, using RCS models. The OR for breast cancer decreased along with the increase in lead concentration under approximately 20 µg/dl, while the OR for prostate cancer increased between urine thallium levels of approximately 0.17-1.1 ng/ml. Pan-cancers associated with sex hormones are associated with exposure to heavy metals. Considering the design of the NHANES study, further studies need to be conducted on other nationally representative surveys.
鉴于肿瘤发生的复杂性，众多研究还表明，过度接触重金属会增加患癌风险并扰乱性激素分泌。然而，重金属对癌症的具体影响仍有待证实。为了确认成年人中重金属与泛癌性激素水平之间的关联，对来自美国国家健康与营养检查调查的94337人进行了评估。我们研究了与性激素相关的泛癌（卵巢癌、睾丸癌、乳腺癌和前列腺癌）与血液/尿液中重金属之间的关联。采用加权分位数和回归（WQS）及调查广义线性模型回归（SVYGLM）方法，通过纳入协变量来评估性激素相关癌症与每种金属类别的关联。为了评估重金属的总体影响并检测与性激素相关的泛癌患病率与重金属之间的剂量反应关系，应用了受限立方样条（RCS）。在美国，环境中重金属暴露可能与成年人中与性激素相关的泛癌有关。前列腺癌与血液镉呈负相关，而与血液铅、尿锡和铊呈正相关。乳腺癌与血液铅呈负相关。卵巢癌与血液镉呈正相关。我们还使用RCS模型发现了与性激素相关的泛癌和重金属之间的非线性剂量反应关系，该关系是非参数性的。在铅浓度约20μg/dl以下时，乳腺癌的比值比随铅浓度增加而降低，而在尿铊水平约0.17 - 1.1ng/ml之间时，前列腺癌的比值比增加。与性激素相关的泛癌与重金属暴露有关。考虑到美国国家健康与营养检查调查（NHANES）研究的设计，需要对其他具有全国代表性的调查进行进一步研究。
