PMID- 35873417 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220726 IS - 2296-861X (Print) IS - 2296-861X (Electronic) IS - 2296-861X (Linking) VI - 9 DP - 2022 TI - Combined Exposure to 33 Trace Elements and Associations With the Risk of Oral Cancer: A Large-Scale Case-Control Study. PG - 913357 LID - 10.3389/fnut.2022.913357 [doi] LID - 913357 AB - BACKGROUND: 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. METHODS: 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. RESULTS: 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 (beta = -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. CONCLUSION: 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. CI - Copyright (c) 2022 Wang, Wang, Cao, Chen, Deng, Chen, Qiu, Lin, Shi, Liu, He and Chen. FAU - Wang, Huiying AU - Wang H AD - Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China. AD - Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China. FAU - Wang, Jing AU - Wang J AD - Laboratory Center, School of Public Health, The Major Subject of Environment and Health of Fujian Key Universities, Fujian Medical University, Fuzhou, China. FAU - Cao, Yujie AU - Cao Y AD - Department of Stomatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China. FAU - Chen, Jinfa AU - Chen J AD - Laboratory Center, School of Public Health, The Major Subject of Environment and Health of Fujian Key Universities, Fujian Medical University, Fuzhou, China. FAU - Deng, Qingrong AU - Deng Q AD - Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China. AD - Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China. FAU - Chen, Yujia AU - Chen Y AD - Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China. AD - Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China. FAU - Qiu, Yu AU - Qiu Y AD - Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China. FAU - Lin, Lisong AU - Lin L AD - Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China. FAU - Shi, Bin AU - Shi B AD - Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China. FAU - Liu, Fengqiong AU - Liu F AD - Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China. AD - Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China. FAU - He, Baochang AU - He B AD - Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China. AD - Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China. AD - Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China. FAU - Chen, Fa AU - Chen F AD - Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China. AD - Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China. LA - eng PT - Journal Article DEP - 20220707 PL - Switzerland TA - Front Nutr JT - Frontiers in nutrition JID - 101642264 PMC - PMC9301066 OTO - NOTNLM OT - combined exposure OT - mixtures OT - oral cancer OT - propensity score matching OT - trace elements COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2022/07/26 06:00 MHDA- 2022/07/26 06:01 PMCR- 2022/01/01 CRDT- 2022/07/25 03:35 PHST- 2022/04/05 00:00 [received] PHST- 2022/06/16 00:00 [accepted] PHST- 2022/07/25 03:35 [entrez] PHST- 2022/07/26 06:00 [pubmed] PHST- 2022/07/26 06:01 [medline] PHST- 2022/01/01 00:00 [pmc-release] AID - 10.3389/fnut.2022.913357 [doi] PST - epublish SO - Front Nutr. 2022 Jul 7;9:913357. doi: 10.3389/fnut.2022.913357. eCollection 2022.