Integrated Analysis of Trace Elements, Vitamins, and Hormones in Pancreatic Cancer Patients in Thi-Qar Province

الملخص

Background: Pancreatic ductal adenocarcinoma (PDAC) has one of the highest mortality rates and the worst prognoses of any cancer. Some causes of PDAC are related to metabolic dysfunctions, deficiency of certain micronutrients, and accumulation of certain toxic trace metals.

Objective: This study aimed to analyze and compare through assessment of blood trace elements, micronutrients and hormones, levels of PDAC with age-matched healthy controls of PDAC males from the Middle East.

Methods: This study was conducted on a sample of 200 men from the 50-70 age cohort from the Governorate of Thi-Qar, Iraq, 100 were PDAC patients and the other 100 were healthy controls. Peripheral samples from patients were taken after fasting for 12-14 hours. The test of atomic absorption spectrophotometry and inductively coupled plasma-mass spectrometry were used to assess presence of trace elements and heavy metals, and serum levels of retinol and all-trans retinoic acid (ATRA) and 25-hydroxyvitamin D were done using HPLC and ELISA methods, while serum levels of the vitamins B2, B6, B9, and B12 were done by ELISA. The hormones, testosterone, FSH, LH, estradiol (E2), progesterone, androstenedione, and insulin  and the IGF-1 and IGFBP-3 were assessed using CLIA and ELISA methods. For statistical analysis SPSS was used and a p-value < 0.05 was significant.

Results: The concentrations of Fe, Zn, Se, Mg, and Ca as well as vitamin A, ATRA, and 25-hydroxyvitamin D were significantly reduced in PDAC patients, while the concentrations of the toxic metals As, Pb, Cd, and Mo were increased. Cholinesterase concentrations were unchanged, while copper and mercury concentrations were unchanged and decreased, respectively. Reduced levels of testosterone, progesterone, androstenedione, and IGFBP-3 were correlated with increased levels of FSH, LH, estradiol (E2), and insulin. The increase in IGF-1 was minimal and statistically insignificant.

Conclusion: There are multiple dimensions of the gauntlet PDAC patients face, including nutritional deficiencies, an excess of toxic metals, and severe dysregulation of hormones. These findings highlight markers of disease progression, and potential targets for dietary or hormonal interventions.