The association of tryptophan and phenylalanine are associated with arsenic-induced skin lesions in a Chinese population chronically exposed to arsenic via drinking water: a case–control study

Objectives We investigated the association of specific serum amino acids (AAs) with the odds of arsenic-induced skin lesions (AISL) and their ability to distinguish patients with AISL from people chronically exposed to arsenic.Design Case–control study.Setting Three arsenic-exposed villages in Wuyua...

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Main Authors: Yaping Wei, Chaonan Jia, Yuan Lan, Xiangqing Hou, Jingjing Zuo, Jushuang Li, Guangyun Mao
Format: Article
Language:English
Published: BMJ Publishing Group 2019-10-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/10/e025336.full
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author Yaping Wei
Chaonan Jia
Yuan Lan
Xiangqing Hou
Jingjing Zuo
Jushuang Li
Guangyun Mao
author_facet Yaping Wei
Chaonan Jia
Yuan Lan
Xiangqing Hou
Jingjing Zuo
Jushuang Li
Guangyun Mao
author_sort Yaping Wei
collection DOAJ
description Objectives We investigated the association of specific serum amino acids (AAs) with the odds of arsenic-induced skin lesions (AISL) and their ability to distinguish patients with AISL from people chronically exposed to arsenic.Design Case–control study.Setting Three arsenic-exposed villages in Wuyuan County, Hetao Plain, Inner Mongolia, China were evaluated.Participants Among the 450 residents aged 18–79 years, who were chronically exposed to arsenic via drinking water, 56 were diagnosed as having AISL (defined as cases). Another 56 participants without AISL, matched by gender and age (±1 year) from the same population, were examined as controls.Main outcome measures and methods AA levels were determined by ultra-high-performance liquid chromatography–quadrupole time-of-flight mass spectrometry-based metabolomics analysis. Potential confounding variables were identified via a standardised questionnaire and clinical examination. Multivariable conditional logistic regression model and receiver operating characteristic curve analyses were performed to investigate the relationship between specific AAs and AISL.Results Tryptophan and phenylalanine levels were negatively associated with AISL (p<0.05). Compared with that in the first quartile, the adjusted OR of AISL in the second, third and fourth quartiles were decreased by 44%, 88% and 79% for tryptophan and 30%, 80% and 80% for phenylalanine, respectively. The combination of these two higher-level AAs showed the lowest OR for AISL (OR=0.08; 95% CI 0.02 to 0.25; p<0.001). Furthermore, both AAs showed a moderate ability to distinguish patients with AISL from the control, with the area under the curve (AUC; 95% CI) as 0.67 (0.57 to 0.77) for tryptophan and 0.70 (0.60 to 0.80) for phenylalanine (p<0.05). The combined pattern with AUC (95% CI) was 0.72 (0.62 to 0.81), showing a sensitivity of 76.79% and specificity of 58.93% (p<0.001).Conclusions Specific AAs may be linked to AISL and play important roles in early AISL identification.Trial Registration number NCT02235948.
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spelling doaj-art-2b2e590a0d004a39b6681e8a6c65d9392024-12-13T17:45:12ZengBMJ Publishing GroupBMJ Open2044-60552019-10-0191010.1136/bmjopen-2018-025336The association of tryptophan and phenylalanine are associated with arsenic-induced skin lesions in a Chinese population chronically exposed to arsenic via drinking water: a case–control studyYaping Wei0Chaonan Jia1Yuan Lan2Xiangqing Hou3Jingjing Zuo4Jushuang Li5Guangyun Mao62 Center on Evidence–Based Medicine & Clinical Epidemiological Research, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China1 Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, ChinaThe Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China2 Center on Evidence–Based Medicine & Clinical Epidemiological Research, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China4 School of Ophthalmology & Optometry, Wenzhou Medical University, Wenzhou, China1 Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China5 Center on Clinical Research, the Affiliated Eye Hospital of Wenzhou Medical University, Wenzhou, ChinaObjectives We investigated the association of specific serum amino acids (AAs) with the odds of arsenic-induced skin lesions (AISL) and their ability to distinguish patients with AISL from people chronically exposed to arsenic.Design Case–control study.Setting Three arsenic-exposed villages in Wuyuan County, Hetao Plain, Inner Mongolia, China were evaluated.Participants Among the 450 residents aged 18–79 years, who were chronically exposed to arsenic via drinking water, 56 were diagnosed as having AISL (defined as cases). Another 56 participants without AISL, matched by gender and age (±1 year) from the same population, were examined as controls.Main outcome measures and methods AA levels were determined by ultra-high-performance liquid chromatography–quadrupole time-of-flight mass spectrometry-based metabolomics analysis. Potential confounding variables were identified via a standardised questionnaire and clinical examination. Multivariable conditional logistic regression model and receiver operating characteristic curve analyses were performed to investigate the relationship between specific AAs and AISL.Results Tryptophan and phenylalanine levels were negatively associated with AISL (p<0.05). Compared with that in the first quartile, the adjusted OR of AISL in the second, third and fourth quartiles were decreased by 44%, 88% and 79% for tryptophan and 30%, 80% and 80% for phenylalanine, respectively. The combination of these two higher-level AAs showed the lowest OR for AISL (OR=0.08; 95% CI 0.02 to 0.25; p<0.001). Furthermore, both AAs showed a moderate ability to distinguish patients with AISL from the control, with the area under the curve (AUC; 95% CI) as 0.67 (0.57 to 0.77) for tryptophan and 0.70 (0.60 to 0.80) for phenylalanine (p<0.05). The combined pattern with AUC (95% CI) was 0.72 (0.62 to 0.81), showing a sensitivity of 76.79% and specificity of 58.93% (p<0.001).Conclusions Specific AAs may be linked to AISL and play important roles in early AISL identification.Trial Registration number NCT02235948.https://bmjopen.bmj.com/content/9/10/e025336.full
spellingShingle Yaping Wei
Chaonan Jia
Yuan Lan
Xiangqing Hou
Jingjing Zuo
Jushuang Li
Guangyun Mao
The association of tryptophan and phenylalanine are associated with arsenic-induced skin lesions in a Chinese population chronically exposed to arsenic via drinking water: a case–control study
BMJ Open
title The association of tryptophan and phenylalanine are associated with arsenic-induced skin lesions in a Chinese population chronically exposed to arsenic via drinking water: a case–control study
title_full The association of tryptophan and phenylalanine are associated with arsenic-induced skin lesions in a Chinese population chronically exposed to arsenic via drinking water: a case–control study
title_fullStr The association of tryptophan and phenylalanine are associated with arsenic-induced skin lesions in a Chinese population chronically exposed to arsenic via drinking water: a case–control study
title_full_unstemmed The association of tryptophan and phenylalanine are associated with arsenic-induced skin lesions in a Chinese population chronically exposed to arsenic via drinking water: a case–control study
title_short The association of tryptophan and phenylalanine are associated with arsenic-induced skin lesions in a Chinese population chronically exposed to arsenic via drinking water: a case–control study
title_sort association of tryptophan and phenylalanine are associated with arsenic induced skin lesions in a chinese population chronically exposed to arsenic via drinking water a case control study
url https://bmjopen.bmj.com/content/9/10/e025336.full
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