Association of heavy metals and trace elements in carcinoma urinary bladder: A case-controlled study

Sridhar Panaiyadiyan; Javed Ahsan Quadri; Brusabhanu Nayak; Surabhi Pandit; Prabhjot Singh; Ankit Sachan; Seema Kaushal; Saba Sarwar; Amlesh Seth; Ahmadullah Shariff

doi:10.4103/iju.iju_143_23

Association of heavy metals and trace elements in carcinoma urinary bladder: A case-controlled study

Indian J Urol. 2023 Jul-Sep;39(3):236-240. doi: 10.4103/iju.iju_143_23. Epub 2023 Jun 30.

Affiliations

¹ Department of Urology, All India Institute of Medical Sciences, New Delhi, India.
² Department of Anatomy (Clinical Ecotoxicology Division), All India Institute of Medical Sciences, New Delhi, India.
³ Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.

Abstract

Introduction: Abnormal levels of heavy metals (HM) and trace elements (TE) affect body metabolism and can induce carcinogenesis. This study aims to evaluate the role of HM and TE in carcinoma urinary bladder (CAUB).

Methods: Patients with biopsy-proven CAUB (n = 100) were taken as the study group, while age-and sex-matched healthy volunteers were taken as control (n = 100). Blood and urine samples were compared for Arsenic (As), Copper (Cu), Manganese (Mn), Selenium (Se), Cadmium (Cd), Lead (Pb), and Mercury (Hg) levels. Serum glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), and lipid peroxidation (LPO) levels were assessed to know the redox status between the two groups.

Results: A significantly higher blood level of As, Mn, and Pb was observed in CAUB cases as compared to controls. Blood Se level was significantly lower in CAUB patients. On comparing urinary levels, CAUB patients had a higher As, Mn, and Pb levels compared to controls. Further, 68% and 59% of patients had their blood and urinary HM and TE levels above the permitted level, respectively. CAUB cases also had a lower GSH-Px (113.5 ± 44.7 vs. 163.9 ± 120.5, P = 0.0002), lower SOD levels (11.35 ± 5.6 vs. 13.75 ± 3.9, P = 0.008), and a higher LPO levels (15.5 ± 14.7 vs. 11.18 ± 11.2, P = 0.02) in the serum.

Conclusions: A significantly higher concentration of As, Mn, and Pb was noted in the blood and urine of CAUB patients compared to controls. CAUB cases also had lower serum GSH-Px and SOD levels with a concomitant increased serum LPO assay suggesting underlying oxidative stress.