25-hydroxyvitamin D3 mediates the link between heavy metal levels and non-melanoma skin cancer

Summary: Abstract Body: The link between combined heavy metal exposure on non-melanoma skin cancer (NMSC) is not well understood. Therefore, we investigated the associations between various metals and NMSC. Data were extracted from the National Health and Nutrition Examination Survey, which included 9,835 participants and measurements of nine urinary metal concentrations: mercury (Hg), cesium (Cs), thallium (Tl), Ionium (Io), cobalt (Co), molybdenum (Mo), lead (Pb), barium (Ba), and arsenic (As). Multivariable logistic regression and weighted quantile sum regression were used to assess the associations of individual and combined metals with NMSC. Additionally, mediation analyses were conducted to explore the mediating role of serum 25(OH)D3 in these associations. Urinary levels of Hg, Io, Co, and combined metals were positively correlated with NMSC. Serum 25(OH)D3 exhibited significant associations with NMSC, as did Hg, Cs, Tl, Io, Co, Mo, Pb, Ba, and the combined metals in relation to 25(OH)D3 levels. Furthermore, the associations between single metals—primarily Hg and Io—and combined metals with NMSC were partially mediated by 25(OH)D3. These findings suggest that metal exposure increases the risk of NMSC, with a portion of this risk being mediated by 25(OH)D3. Kexun Zhang¹, Wei Zhang² 1. Kunshan Center For Disease Control and Prevention, Kunshan, Jiangsu, China. 2. Dermatology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China. Clinical Research: Epidemiology and Observational Research