School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan, China.
School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan, China.
Sci Total Environ. 2024 Nov 20;952:175991. doi: 10.1016/j.scitotenv.2024.175991. Epub 2024 Sep 3.
People are exposed to metals in various ways during their daily lives. However, the association between metal exposure and gallstones remains unclear.
To investigate the relationship between serum elemental concentrations and the risk of gallstones.
Participants (n = 4204) were drawn from the Henan Rural Cohort. Gallstone diagnosis was based on abdominal ultrasound reports during follow-up. Baseline serum elemental concentrations were measured using inductively coupled plasma mass spectrometry. The relationship between serum elemental levels and gallstones was evaluated using robust Poisson regression, restricted cubic spline (RCS), quantile g-computation (Qgcomp), grouped weighted quantile sum (GWQS) and Bayesian kernel machine regression (BKMR).
121 individuals were diagnosed with gallstone (incidence rate of 2.88 %). In robust Poisson regression, after adjusting for confounding factors, the highest quartile of arsenic concentration compared to the lowest quartile had a 1.90 times higher relative risk (RR) [95 % confidence interval (CI): 1.05, 3.44]. Conversely, the highest quartile of zinc concentration compared to the lowest quartile had a 0.50 times lower RR (95 % CI: 0.28, 0.89). RCS showed an approximately "S"-shaped nonlinear relationship between serum arsenic levels and gallstones, with increasing arsenic concentration leading to a higher risk of gallstones; however, the risk plateaued when arsenic concentration exceeded 0.62 μg/L. Both the Qgcomp and GWQS indicated that arsenic plays a significant role in increasing the risk of gallstones, whereas zinc plays a significant role in reducing the risk of gallstones. BKMR showed that raising arsenic exposure from the 25th to the 75th percentile increased the risk of gallstones, while raising serum zinc concentration reduced it.
Higher serum arsenic concentration increases the risk of gallstones, whereas higher zinc concentration may reduce the risk. Effective prevention of gallstones may require further reduction of arsenic exposure and appropriate increases in zinc intake.
人们在日常生活中会通过多种途径接触金属。然而，金属暴露与胆结石之间的关联仍不清楚。
探讨血清元素浓度与胆结石风险的关系。
本研究的数据来自河南农村队列，共纳入 4204 名参与者。在随访过程中，根据腹部超声报告诊断胆结石。采用电感耦合等离子体质谱法测量基线血清元素浓度。采用稳健泊松回归、限制性立方样条（RCS）、分位数 g 计算（Qgcomp）、分组加权求和（GWQS）和贝叶斯核机器回归（BKMR）评估血清元素水平与胆结石之间的关系。
共有 121 人被诊断为胆结石（发病率为 2.88%）。在稳健泊松回归中，调整混杂因素后，与最低四分位相比，最高四分位的砷浓度相对风险（RR）为 1.90（95%置信区间[CI]：1.05，3.44）。相反，与最低四分位相比，最高四分位的锌浓度 RR 为 0.50（95%CI：0.28，0.89）。RCS 显示血清砷水平与胆结石之间呈近似“S”型非线性关系，随着砷浓度的增加，胆结石的风险增加；然而，当砷浓度超过 0.62μg/L 时，风险趋于平稳。Qgcomp 和 GWQS 均表明，砷在增加胆结石风险方面起重要作用，而锌在降低胆结石风险方面起重要作用。BKMR 显示，将砷暴露从第 25 个百分位数提高到第 75 个百分位数会增加胆结石的风险，而提高血清锌浓度会降低其风险。
较高的血清砷浓度会增加胆结石的风险，而较高的锌浓度可能会降低风险。有效预防胆结石可能需要进一步降低砷暴露和适当增加锌摄入。
