Elevated Urinary Iron, Zinc and Nickel Associate with Increased Oxidative Stress in Bladder Cancer Patients
Keywords:
iron, zinc, nickel, oxidative stress, bladder cancerAbstract
Objective: To determine urinary calcium, magnesium and heavy metals in patients with bladder cancer. Whether levels of urinary elements were associated with oxidative stress markers and patientsû occupation were investigated.
Design: Analytical observational study
Methods: Forty-one patients with bladder cancer (aged 62.5+12.4 years) and 29 healthy controls (aged of 68.2+13.1 years) were recruited for the study. Urinary levels of 18 elements, i.e., arsenic, calcium, cadmium, cobalt, chromium, copper, iron, lithium, magnesium, manganese, molybdenum, nickel, lead, stibium, selenium, strontium, vanadium and zinc were analyzed. Urinary total antioxidant status (TAS) and plasma protein carbonyl concentration, as oxidative stress biomarkers were measured.
Results: Plasma protein carbonyl content in patients was significantly greater than that in controls. Inversely, urinary TAS was significantly decreased in patients group compared to the controls. The urinary levels of iron, zinc and nickel in bladder cancer group was significantly higher, while calcium, magnesium, lithium, arsenic, strontium and lead were lower, than the control group. Urinary nickel (Spearmanûs rho=0.463, p<0.001) and zinc (Spearmanûs rho=0.295, p=0.014) were positively correlated with protein carbonyl content. Urinary iron (Spearmanûs rho=-0.254, p=0.034), nickel (Spearmanûs rho=-0.453, p<0.001) and zinc (Spearmanûs rho=-0.269, p=0.025) were inversely correlated with urinary TAS. A trend of higher urinary iron in patients with high grade tumor (n=23) compared to those with low grade (n=18) was observed, although it was not statistically significant. Urinary nickel and zinc in patients who were mining and metal workers were higher than in patients worked in farms and those worked in offices, respectively.
Conclusion: Urinary levels of iron, nickel and zinc were elevated in patients with bladder cancer. The elevation of these elements was associated with an increased oxidative stress. We hypothesized that iron, zinc and nickel may play an important role in tumorigenesis of the bladder in Thai patients.
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