4.7 Article

Plasma metals and cancer incidence in patients with type 2 diabetes

Journal

SCIENCE OF THE TOTAL ENVIRONMENT
Volume 758, Issue -, Pages -

Publisher

ELSEVIER
DOI: 10.1016/j.scitotenv.2020.143616

Keywords

Metal exposure; Type 2 diabetes mellitus; Cancer; Cohort study

Funding

  1. National Key Research and Development Program of China [2017YFC0907501]
  2. National Natural Science Foundation [NSFC-81473051, 81522040]
  3. Program for HUST Academic Frontier Youth Team [2017QYTD18]

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Limited evidence suggests a link between plasma levels of multiple metals and incident cancer risk in patients with type 2 diabetes mellitus. Copper and lead were significantly associated with increased cancer risk, while zinc and chromium were associated with decreased cancer risk. Monitoring metal levels in diabetic patients is crucial for cancer prevention.
There is limited evidence on the relationships between plasma levels of multiple metals and risk of incident cancer in patientswith type 2 diabetes mellitus (T2DM). We examined the associations between plasma levels of 12 metals (iron, copper, zinc, selenium, chromium, manganese, molybdenum, cobalt, nickel, arsenic, cadmium, and lead) and cancer risk in 4573 T2DM patients using Cox proportional hazardsmodels. With amedian follow-up of 10.2 years, 541 incident cancers were identified. The multiple-metals model revealed that each 1-SD increase in ln-transformed plasma copper (HR: 1.14; 95%CI: 1.02, 1.27) and lead (HR:1.20; 95%CI:1.03, 1.39) were significantly associated with increased cancer incidence while each 1-SD increase in ln-transformed plasma zinc (HR: 0.82; 95%CI: 0.71, 0.96) and chromium (HR: 0.88; 95%CI: 0.82, 0.94) were significantly associated with decreased cancer incidence. When all participants were further stratified into four subgroups by the quartile levels (Q1-4) of plasma metals, manganese showed significant positive associationswith cancer incidence in the upper two quartiles (P trend = 0.003) while nickel showed significant negative associations with cancer incidence in Q2 and 4 groups (P trend = 0.033) compared with participants in Q1 group. Collectively, monitoring of metal levels in diabetic patients needs to be strengthened, which is of great significance for the prevention of incident cancer. (C) 2020 Elsevier B.V. All rights reserved.

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