必需金属元素及其混合物与我国老年人胆结石病的关系：超氧化物歧化酶的中介作用

The associations of essential metal elements and their mixture with gallstone disease in Chinese older adults: The mediation role of superoxide dismutase

必需金属元素及其混合物与我国老年人胆结石病的关系：超氧化物歧化酶的中介作用

Authors:Ziwei Tian, Xianglong Liu, Wenyuan Liu, Xuqiu Cheng, Yuantao Zhang, Yan Zhang, Xianwei Guo, Guimei Chen, Bing Hu, Changliu Liang, Chunmei Liang, Fangbiao Tao, Linsheng Yang

Source:Environmental Pollution

DOI:10.1016/j.envpol.2025.126678 

Abstract

Prior research has yielded inconsistent results regarding the relationships between individual essential metal elements (EMEs) and gallstone disease (GSD). Furthermore, the association between the EME mixture and GSD, as well as the underlying mechanisms, remains poorly understood. We aimed to assess the associations between individual EMEs and their mixture with GSD, and to investigate the mediation roles of superoxide dismutase (SOD). A total of 3437 Chinese adults aged ≥60 years were included in this study. Urine levels of vanadium (V), strontium (Sr), selenium (Se), cobalt (Co), magnesium (Mg), calcium (Ca) and molybdenum (Mo) were detected by ICP-MS. GSD was determined using a combination of self-report and abdominal ultrasound. SOD was assessed using an automated chemiluminescence immunoassay device. Logistic regression, restricted cubic spline (RCS), quantile-based computation (QGC), and Bayesian kernel machine regression (BKMR) models were employed to assess individual and combined correlations of the EMEs with GSD. Further mediation analyses were conducted to investigate the mediating roles of SOD in aforementioned associations. Adjusted logistic regression revealed significant negative associations of Ca (OR = 0.84, 95 % CI: 0.72-0.99), Mg (OR = 0.86, 95 % CI: 0.76-0.99) with the odds of GSD. The RCS model demonstrated a negative linear association of Ca and Mg with the odds of GSD. Both the QGC and BKMR models showed a significant negative association between the EME mixture and the odds of GSD, with Ca and Mg contributing the most. Mediation analyses suggested that SOD mediated the correlation of the EME mixture with the decreased risk of GSD. In conclusion, the EME mixture is associated with a reduced risk of GSD in older adults, primarily driven by Ca and Mg. Additionally, the negative effect of EMEs on GSD risk may be partly mediated by SOD. Further prospective studies are needed to validate these findings.

Keywords:Essential metal elements; Gallstone disease; Older adults; Superoxide dismutase

摘要

先前研究对个体必需金属元素（EMEs）与胆结石病（GSD）之间的关系得出了不一致的结果。此外，EMEs混合物与GSD之间的关联以及其潜在机制仍不明确。本研究旨在评估个体EMEs及其混合物与GSD之间的关联，并探讨超氧化物歧化酶（SOD）的介导作用。本研究纳入了3437名60岁及以上的中国成年人。通过电感耦合等离子体质谱法（ICP-MS）检测了尿液中钒（V）、锶（Sr）、硒（Se）、钴（Co）、镁（Mg）、钙（Ca）和钼（Mo）的水平。胆石病通过自我报告和腹部超声的结合进行诊断。SOD水平采用自动化学发光免疫分析仪进行测定。通过逻辑回归、限制性立方样条（RCS）、分位数基计算（QGC）及贝叶斯核机器回归（BKMR）模型，评估EMEs与GSD的个体及联合相关性。进一步开展中介分析以探究SOD在上述关联中的中介作用。调整后逻辑回归显示，钙（OR = 0.84，95% CI：0.72-0.99）和镁（OR = 0.86，95% CI：0.76-0.99）与GSD的发生风险呈显著负相关。RCS模型显示，Ca和Mg与GSD风险呈负线性关联。QGC和BKMR模型均显示EME混合物与GSD风险呈显著负相关，其中Ca和Mg贡献最大。中介分析表明，SOD介导了EME混合物与GSD风险降低之间的关联。综上所述，EME混合物与老年人GSD风险降低相关，主要由钙和镁驱动。此外，EME对GSD风险的负面影响可能部分通过SOD介导。需要进一步的前瞻性研究来验证这些发现。

关键词：必需金属元素；胆石病；老年人；超氧化物歧化酶