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. 2023 Jul 3:10:1142861.
doi: 10.3389/fnut.2023.1142861. eCollection 2023.

Associations between serum trace elements and the risk of nasopharyngeal carcinoma: a multi-center case-control study in Guangdong Province, southern China

Xin-Yu Ge  1   2 , Shang-Hang Xie  1 , Hao Wang  3 , Xin Ye  2 , Wenjie Chen  1 , Hang-Ning Zhou  1 , Xueqi Li  1   2 , Ai-Hua Lin  2 , Su-Mei Cao  1   4
Affiliations

Associations between serum trace elements and the risk of nasopharyngeal carcinoma: a multi-center case-control study in Guangdong Province, southern China

Xin-Yu Ge et al. Front Nutr. .

Abstract

Background: Associations between trace elements and nasopharyngeal carcinoma (NPC) have been speculated but not thoroughly examined.

Methods: This study registered a total of 225 newly diagnosed patients with NPC and 225 healthy controls matched by sex and age from three municipal hospitals in Guangdong Province, southern China between 2011 and 2015. Information was collected by questionnaire on the demographic characteristics and other possibly confounding lifestyle factors. Eight trace elements and the level of Epstein-Barr virus (EBV) antibody were measured in casual (spot) serum specimens by inductively coupled plasma-mass spectrometry (ICP-MS) and enzyme-linked immunosorbent assay (ELISA), respectively. Restricted cubic splines and conditional logistic regression were applied to assess the relationship between trace elements and NPC risk through single-and multiple-elements models.

Results: Serum levels of chromium (Cr), cobalt (Co), nickel (Ni), arsenic (As), strontium (Sr) and molybdenum (Mo) were not associated with NPC risk. Manganese (Mn) and cadmium (Cd) were positively associated with NPC risk in both single-and multiple-element models, with ORs of the highest tertile compared with the reference categories 3.90 (95% CI, 1.27 to 7.34) for Mn and 2.30 (95% CI, 1.26 to 3.38) for Cd. Restricted cubic splines showed that there was a linear increasing trend between Mn and NPC risk, while for Cd there was a J-type correlation.

Conclusion: Serum levels of Cd and Mn was positively related with NPC risk. Prospective researches on the associations of the two trace elements with NPC ought to be taken into account within the future.

Keywords: cadmium (Cd); head and neck cancer; logistic regression; manganese (Mn); nasopharyngeal carcinoma (NPC); odds ratio; restricted cubic splines; trace element (TE).

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Conflict of interest statement

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.

Figures

Figure 1
Figure 1
Nonlinear associations between trace elements in serum (log-transformed) and the risk of NPC (Odds Ratio) in the single-element models. Nonlinear associations were presented by the restricted cubic splines, and adjusted by age (years), gender (male, female), chronic rhinitis status (yes, no), first-degree family history of NPC (yes, no), drinking (ever, never), smoking status (ever, never) and the levels of VCA-lgA (higher, lower). Shading in the plots indicated the confidence interval (95%CI). The knots in the plots were set at 5th, 35th, 65th, and 95th percentile, respectively. Dashed red lines indicate the concentration of serum trace elements with the lowest risk of NPC for nonlinear trace element. Figure A-H represented the risk of NPC with the concentration of serum chromium, manganese, cobalt, nickel, arsenic, strontium, molybdenum and cadmium, respectively.
Figure 2
Figure 2
Associations between trace elements in serum (log-transformed) and the risk of NPC (Odds Ratio) in the multiple-element models. Adjusted by age, gender, chronic rhinitis status, smoking, drinking, first-degree family history of NPC and VCA-lgA. OR: odds ratio. CI: confidence interval. Trace elements were added 10 and log transformed.
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