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ORIGINAL RESEARCH article

Front. Public Health
Sec. Environmental Health and Exposome
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1423286

Association of urinary concentrations of multiple trace elements with gastric precancerous lesions and gastric cancer in Anhui province, eastern China

Provisionally accepted
Shiqing Qian Shiqing Qian 1Fang Xu Fang Xu 2Xiaohui Zhang Xiaohui Zhang 2Wenli Cheng Wenli Cheng 2Li Wang Li Wang 2Min Wang Min Wang 2Yuting Zhu Yuting Zhu 2Guoqing Jin Guoqing Jin 2Shaopeng Ding Shaopeng Ding 2Wuqi Wang Wuqi Wang 2Meng Zhang Meng Zhang 2Tingting Wang Tingting Wang 2Xiao Lin Xiao Lin 2Yu Zhu Yu Zhu 3Yaning Lv Yaning Lv 4Anla Hu Anla Hu 2Wanshui Yang Wanshui Yang 5Gengsheng He Gengsheng He 6Qihong Zhao Qihong Zhao 2*
  • 1 Lujiang County People's Hospital Hefei, Hefei, China
  • 2 Anhui Medical University, Hefei, Anhui Province, China
  • 3 Wannan Medical College, Wuhu, Anhui Province, China
  • 4 Hefei Customs Technology Center, Hefei, China
  • 5 Department of Nutrition and Food Hygiene, Anhui Medical University, Hefei, China
  • 6 Fudan University, Shanghai, Shanghai Municipality, China

The final, formatted version of the article will be published soon.

    Limited epidemiological evidence suggests that the exposure to trace elements adversely impacts the development of gastric precancerous lesions (GPL) and gastric cancer (GC). The study aimed to estimate the association of individual urinary exposure to multiple elements with GPL and GC. A case-control investigation was conducted in Anhui Province from March 2021 to December 2022. A total of 528 subjects (randomly sampled from 1020 patients with GPL, 200 patients with GC, and 762 normal controls) were included in our study. Urinary levels of iron (Fe), copper (Cu), zinc (Zn), nickel (Ni), strontium (Sr) and cesium (Cs) were measured using inductively coupled plasma mass spectrometry (ICP-MS). Four different statistical approaches were employed to explore the risk of GPL and GC with mixed exposure, including multivariate logistic regression, weighted quantile regression (WQS), quantile g-computation (Qgcomp) and the Bayesian kernel machine regression (BKMR) model. The WQS model indicated that urinary exposure to a mixture of elements is positively correlated with both GPL and GC, with ORs for the mixture exposure of 1.34([95% CI]: [1.34-1.61]) for GPL and 1.38([95% CI]: [1.27-1.50]) for GC. The Qgcomp and BKMR Models also demonstrated a statistically significant positive correlation between the mixture and both GPL and GC. Considering the limitations of case-control studies, future prospective studies are warranted to elucidate the combined effects and mechanisms of trace elements exposure on human health. Keywords： Trace elements; Gastric precancerous lesions; Gastric cancer; Weighted quantile regression model (WQS); BKMR

    Keywords: BKMR, WQS, GC, Combined effect, case-control study

    Received: 25 Apr 2024; Accepted: 24 Jul 2024.

    Copyright: © 2024 Qian, Xu, Zhang, Cheng, Wang, Wang, Zhu, Jin, Ding, Wang, Zhang, Wang, Lin, Zhu, Lv, Hu, Yang, He and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Qihong Zhao, Anhui Medical University, Hefei, 230032, Anhui Province, China

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