PMID- 37831242
OWN - NLM
STAT- MEDLINE
DCOM- 20231115
LR  - 20231208
IS  - 1614-7499 (Electronic)
IS  - 0944-1344 (Linking)
VI  - 30
IP  - 52
DP  - 2023 Nov
TI  - The impact of multiple metals exposure on the risk of developing proliferative 
      diabetic retinopathy in Anhui, China: a case-control study.
PG  - 112132-112143
LID - 10.1007/s11356-023-30294-1 [doi]
AB  - Through multiple different pathways, the environmental multiple metals make their 
      ways to the human bodies, where they induce different levels of the oxidative 
      stress response. This study further investigated the impact of multiple-metal 
      exposure on the risk of developing proliferative diabetic retinopathy (PDR). We 
      designed a case-control study with type 2 diabetic patients (T2D), in which the 
      case group was the proliferative diabetic retinopathy group (PDR group), while 
      the control group was the non-diabetic retinopathy group (NDR group). Graphite 
      furnace atomic absorption spectrometry (GFAAS) and inductively coupled plasma 
      optical emission spectrometry (ICP-OES) were used to detect the metal levels in 
      our participants' urine samples. The least absolute shrinkage and selection 
      operator (LASSO) regression approach was used to include these representative 
      trace elements in a multiple exposure model. Following that, logistic regression 
      models and Bayesian kernel machine regression (BKMR) models were used to describe 
      the effect of different elements and also analyze their combined effect. In the 
      single-element model, we discovered that lithium (Li), cadmium (Cd), and 
      strontium (Sr) were all positively related to PDR. The multiple-exposure model 
      revealed a positive relationship between Li and PDR risk, with a maximum quartile 
      OR of 2.80 (95% CI: 1.10-7.16). The BKMR model also revealed that selenium (Se) 
      might act as a protective agent, whereas magnesium (Mg), Li, and Cd may raise the 
      risk of PDR. In conclusion, our study not only revealed an association between 
      exposure to multiple metals and PDR risk but it also implied that urine samples 
      might be a useful tool to assess PDR risk.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, 
      part of Springer Nature.
FAU - Li, Yan-Qing
AU  - Li YQ
AD  - Department of Ophthalmology, First Affiliated Hospital of Anhui Medical 
      University, No.218, Jixi Road, Shushan District, Hefei, Anhui, China.
FAU - Zhang, Si-Tian
AU  - Zhang ST
AD  - Department of Ophthalmology, First Affiliated Hospital of Anhui Medical 
      University, No.218, Jixi Road, Shushan District, Hefei, Anhui, China.
FAU - Ke, Nai-Yu
AU  - Ke NY
AD  - Department of First Clinical Medical College, Anhui Medical University, 81 
      Meishan Road, Hefei, Anhui, China.
FAU - Fang, Yan-Cheng
AU  - Fang YC
AD  - Department of Ophthalmology, First Affiliated Hospital of Anhui Medical 
      University, No.218, Jixi Road, Shushan District, Hefei, Anhui, China.
FAU - Hu, Wen-Lei
AU  - Hu WL
AD  - Department of Epidemiology and Biostatistics, School of Public Health, Anhui 
      Medical University, 81 Meishan Road, Hefei, Anhui, China.
FAU - Li, Guo-Ao
AU  - Li GA
AD  - Department of Epidemiology and Biostatistics, School of Public Health, Anhui 
      Medical University, 81 Meishan Road, Hefei, Anhui, China.
FAU - Huang, Fen
AU  - Huang F
AD  - Department of Epidemiology and Biostatistics, School of Public Health, Anhui 
      Medical University, 81 Meishan Road, Hefei, Anhui, China.
FAU - Zhou, Yan-Feng
AU  - Zhou YF
AD  - Department of Ophthalmology, First Affiliated Hospital of Anhui Medical 
      University, No.218, Jixi Road, Shushan District, Hefei, Anhui, China. 
      lizzhou@163.com.
LA  - eng
GR  - gxbjZD09/The Project for Top Disciplinary Talents of Majors in Universities of 
      Anhui Province/
PT  - Journal Article
DEP - 20231013
PL  - Germany
TA  - Environ Sci Pollut Res Int
JT  - Environmental science and pollution research international
JID - 9441769
RN  - 00BH33GNGH (Cadmium)
RN  - 0 (Trace Elements)
RN  - 9FN79X2M3F (Lithium)
SB  - IM
MH  - Humans
MH  - *Diabetic Retinopathy/epidemiology/diagnosis
MH  - Case-Control Studies
MH  - Cadmium
MH  - Bayes Theorem
MH  - *Trace Elements
MH  - Lithium
MH  - *Diabetes Mellitus
OTO - NOTNLM
OT  - BKMR analysis
OT  - Case-control study
OT  - Multiple metals
OT  - Proliferative diabetic retinopathy
OT  - Risk factors
EDAT- 2023/10/13 12:42
MHDA- 2023/11/15 06:43
CRDT- 2023/10/13 11:11
PHST- 2023/06/07 00:00 [received]
PHST- 2023/10/02 00:00 [accepted]
PHST- 2023/11/15 06:43 [medline]
PHST- 2023/10/13 12:42 [pubmed]
PHST- 2023/10/13 11:11 [entrez]
AID - 10.1007/s11356-023-30294-1 [pii]
AID - 10.1007/s11356-023-30294-1 [doi]
PST - ppublish
SO  - Environ Sci Pollut Res Int. 2023 Nov;30(52):112132-112143. doi: 
      10.1007/s11356-023-30294-1. Epub 2023 Oct 13.