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Trace elements in hair or fingernail and gastroesophageal cancers: results from a population-based case-control study

Journal of Exposure Science & Environmental Epidemiology volume 33, pages 933–944 (2023)Cite this article

Abstract

Background

Growing evidence suggests that environmental factors probably play important roles in the development of gastroesophageal cancers (GOC), however, the effects of trace elements on GOC remain unclear.

Objective

To assess the effect of trace elements on GOC and the effect modification by other factors.

Methods

Hair and fingernail samples were collected from GOC cases and controls in a population-based case-control study in Taixing, China, and were used to detect the concentrations of 12 trace elements using inductively coupled plasma mass spectrometry. Unconditional logistic regression models were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for concentrations of 12 trace elements in association with GOC after adjusting the other factors.

Results

A total of 830 hair samples (581 controls and 249 cases) and 895 fingernail samples (559 controls and 336 cases) were included. Compared to the lowest-tertile concentration, the higher tertiles of Ca, Zn, Fe, Al, Cr, Pb, Se, and V were positively associated with GOC, while the higher tertiles of Mg, Mn, Sr, and As were inversely associated with GOC. Significant interactions between the hair level of Cr and two other risk factors, including smoking (P for interaction = 0.044) and alcohol drinking (P for interaction = 0.028), were observed in association with GOC.

Significance

The current study reveals that these 12 trace elements in hair and fingernails are associated with GOC to varying degrees. Further studies and animal experiments are needed to clarify the associations and explore potential mechanisms.

Impact statement

The role of trace elements in the development or inhibition of gastroesophageal cancers (GOC) remains unclear. In this study, we further explored the associations between 12 trace elements and GOC based on a population-based case-control study conducted in Taixing, China. Higher levels of Ca, Zn, Fe, Al, Cr, Pb, Se, and V were positively associated with increased GOC, while inverse associations between higher levels of Mg, Mn, Sr, As, and GOC were observed. Observed associations were consistent in hair and fingernail samples. Moreover, interaction effects between hair level of Cr and smoking or alcohol drinking were identified.

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Fig. 1: The distributions of hair and fingernail levels of trace elements between gastroesophageal cancer (GOC) cases and controls in Taixing, China.
Fig. 2: Interaction effects of hair level of Cr with smoking or alcohol drinking on gastroesophageal cancers (GOC).

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Data availability

The datasets and code used and analyzed during the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

We would like to thank the interviewers and technicians of Fudan University Taizhou Institute of Health Sciences for their work in data and sample collection. We also thank the staff of the Taixing Center for Disease Control and Prevention for the help they provided in the study field and the staff of Taixing People’s Hospital for their help in the sample collection.

Funding

This study was supported by the National Natural Science Foundation of China (82173591, 81973116, 82073637, 82204129, 82103912, and 91846302), the National Key Research and Development Program of China (2021YFF1201101, 2017YFC0907003, and 2017YFC0907002), and Shandong Provincial Natural Science Foundation (ZR2022QH162). The funders were not involved in the collection, analysis, or interpretation of data, or the writing or submitting of this report.

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Author notes

  1. These authors contributed equally: Tongchao Zhang, Xiaolin Yin.

Authors and Affiliations

  1. Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China

    Tongchao Zhang, Xiaolin Yin, Xiaorong Yang & Ming Lu

  2. Clinical Research Center of Shandong University, Jinan, China

    Tongchao Zhang, Xiaolin Yin, Xiaorong Yang & Ming Lu

  3. Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China

    Xiaolin Yin & Ming Lu

  4. Fudan University Taizhou Institute of Health Sciences, Taizhou, China

    Ziyu Yuan, Qiyun Wu, Li Jin, Xingdong Chen, Ming Lu & Weimin Ye

  5. State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China

    Ziyu Yuan, Li Jin & Xingdong Chen

  6. Department of Occupational Medicine and Environmental Toxicology, School of Public Health, Nantong University, Nantong, China

    Qiyun Wu

  7. Human Phenome Institute, Fudan University, Shanghai, China

    Li Jin & Xingdong Chen

  8. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

    Weimin Ye

  9. Department of Epidemiology and Health Statistics & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Weimin Ye

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Contributions

Conceptualization: TZ, QW, LJ, XC, ML, and WY. Data curation, formal analysis, and methodology: TZ, XY, XY, ZY, QW, LJ, XC, ML, and WY. Validation and visualization: TZ, XY, XY. Interpretation: TZ, XY, QW, ML, and WY. Writing original draft: TZ and XY. Review, and/or revision of the draft: QW, LJ, XC, ML, and WY. All authors contributed to and have approved the final manuscript.

Corresponding author

Correspondence to Ming Lu.

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The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Ethics approval

This study was approved by the institutional review board of the School of Life Sciences, Fudan University, and the Institutional Review Board of Qilu Hospital, Shandong University. All participants voluntarily joined this study and provided written informed consent.

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Zhang, T., Yin, X., Yang, X. et al. Trace elements in hair or fingernail and gastroesophageal cancers: results from a population-based case-control study. J Expo Sci Environ Epidemiol 33, 933–944 (2023). https://doi.org/10.1038/s41370-023-00528-y

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