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血镉水平与非黑素瘤皮肤癌之间是否存在关联:一项横断面研究的结果

Is there an association of blood cadmium level with nonmelanoma skin cancer: results from a cross-sectional study.

作者信息

Li Dan, Chen Jigang, Feng Rui, Wang Yanni

机构信息

Department of Burn and Plastic Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.

出版信息

Front Public Health. 2025 Jan 10;12:1507492. doi: 10.3389/fpubh.2024.1507492. eCollection 2024.

Abstract

OBJECTIVE

Nonmelanoma skin cancer (NMSC) is a common malignancy that starts in the top layer of the skin. Exposure to heavy metals has been suggested to increase the risk of skin cancer. Cadmium, prevalent in various industries and present in cigarette smoke, has been implicated in potential skin effects in animal studies. However, the impact of chronic cadmium exposure on NMSC development remains largely unexplored. This study aimed to investigate the relationship between blood cadmium levels and the odds of NMSC.

METHODS

We analyzed cross-sectional data from the National Health and Nutrition Examination Survey, covering the years 1999-2000 to 2017-2018. NMSC cases were identified through self-reported physician diagnoses. We assessed the association between blood cadmium levels-considered as both a continuous variable and in quartiles-and the odds of NMSC using multivariable logistic regression models. Restricted cubic splines (RCS) were incorporated to estimate the non-linear relationship between cadmium levels and NMSC.

RESULTS

The study included 41,577 participants, with 952 reporting NMSC and 40,625 without any cancers. No association was found between cadmium levels and NMSC when analyzed as either a continuous or quartile variable. However, RCS revealed an inverted U-shaped curve indicating a relationship between blood cadmium levels and NMSC odds. This pattern persisted when focusing exclusively on non-Hispanic White participants.

CONCLUSION

A statistically significant relationship was observed between blood cadmium levels and the odds of NMSC, though the increased odds were only evident at low cadmium levels. Further research is necessary to investigate the causality and underlying mechanisms involved.

摘要

目的

非黑色素瘤皮肤癌(NMSC)是一种起源于皮肤最上层的常见恶性肿瘤。有研究表明,接触重金属会增加患皮肤癌的风险。镉在各个行业中普遍存在,且存在于香烟烟雾中,动物研究表明其可能对皮肤产生影响。然而,慢性镉暴露对非黑色素瘤皮肤癌发生发展的影响在很大程度上仍未得到充分研究。本研究旨在探讨血镉水平与非黑色素瘤皮肤癌发病几率之间的关系。

方法

我们分析了1999 - 2000年至2017 - 2018年期间美国国家健康与营养检查调查(National Health and Nutrition Examination Survey)的横断面数据。非黑色素瘤皮肤癌病例通过自我报告的医生诊断来确定。我们使用多变量逻辑回归模型评估血镉水平(作为连续变量和四分位数)与非黑色素瘤皮肤癌发病几率之间的关联。纳入限制立方样条(RCS)以估计镉水平与非黑色素瘤皮肤癌之间的非线性关系。

结果

该研究纳入了41,577名参与者,其中952人报告患有非黑色素瘤皮肤癌,40,625人未患任何癌症。当将镉水平作为连续变量或四分位数变量进行分析时,未发现镉水平与非黑色素瘤皮肤癌之间存在关联。然而,限制立方样条显示出倒U形曲线,表明血镉水平与非黑色素瘤皮肤癌发病几率之间存在关系。这种模式在仅关注非西班牙裔白人参与者时仍然存在。

结论

观察到血镉水平与非黑色素瘤皮肤癌发病几率之间存在统计学上的显著关系,尽管发病几率增加仅在低镉水平时明显。有必要进一步研究其中的因果关系及潜在机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ec0/11757235/e1aba2c0f89f/fpubh-12-1507492-g001.jpg

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