Diagnostic performance of serum vitamin D metabolites and 14 inorganic elements in early prediction of kidney neoplasm.
This study aimed to identify potential biomarkers by profiling serum vitamin D (VitD) metabolites and fourteen trace elements, with the goal of screening kidney neoplasm (KN) before symptom onset.
The study included 57 renal cell carcinoma (RCC) patients, 43 patients with benign KN (BKN), and 50 healthy controls. Serum levels of VitD metabolites, including 25(OH)D2, 25(OH)D3, and C3-epi-25(OH)D3, were quantified using UPLC-MS/MS. The t-25(OH)D was calculated, and f-25(OH)D level was measured by ELISA. Serum concentrations of 14 inorganic elements, including calcium (Ca), magnesium (Mg), copper (Cu), iron (Fe), zinc (Zn), selenium (Se), manganese (Mn), cobalt (Co), silver (Ag), gallium (Ga), cesium (Cs), lead (Pb), cadmium (Cd), and arsenic (As), were determined by ICP-MS.
RCC and BKN patients exhibited significantly lower serum levels of t-25(OH)D, 25(OH)D3, f-25(OH)D, Ca, Mg, Fe, Zn, and Ag compared to healthy controls, while C3-epi-25(OH)D3 levels were significantly elevated (P < 0.05). Additionally, RCC patients had significantly lower levels of Zn and Se, but higher levels of Ga, than BKN patients (P < 0.05). Correlation analysis revealed significant positive associations between Fe and Cs with t-25(OH)D, 25(OH)D3, C3-epi, and f-25(OH)D, as well as between Ca and t-25(OH)D and f-25(OH)D (P < 0.05). Logistic regression analysis identified f-25(OH)D (OR = 0.762, P < 0.040), Fe (OR = 0.943, P < 0.028), and Zn (OR = 0.945, P = 0.001) as protective factors against KN, while C3-epi-25(OH)D3 (OR = 84.974, P < 0.001) was a risk factor. Receiver operating characteristic (ROC) curve analysis showed that the combination of C3-epi, f-25(OH)D, and Zn (AUC = 0.895), or C3-epi, Fe, and Zn (AUC = 0.912), did not significantly differ from the four-marker combination of C3-epi, f-25(OH)D, Fe, and Zn (AUC = 0.924). All combined approaches outperformed individual or two-marker assays (all P < 0.05).
KN patients exhibit altered VitD metabolites and trace element profiles, with low Zn and Se potentially promoting malignancy. Free-25(OH)D, Fe, and Zn serve as protective factors, while C3-epi predisposes to disease. Combining C3-epi with f-25(OH)D and Zn, or with Fe and Zn, provides strong diagnostic accuracy for KN.
The study included 57 renal cell carcinoma (RCC) patients, 43 patients with benign KN (BKN), and 50 healthy controls. Serum levels of VitD metabolites, including 25(OH)D2, 25(OH)D3, and C3-epi-25(OH)D3, were quantified using UPLC-MS/MS. The t-25(OH)D was calculated, and f-25(OH)D level was measured by ELISA. Serum concentrations of 14 inorganic elements, including calcium (Ca), magnesium (Mg), copper (Cu), iron (Fe), zinc (Zn), selenium (Se), manganese (Mn), cobalt (Co), silver (Ag), gallium (Ga), cesium (Cs), lead (Pb), cadmium (Cd), and arsenic (As), were determined by ICP-MS.
RCC and BKN patients exhibited significantly lower serum levels of t-25(OH)D, 25(OH)D3, f-25(OH)D, Ca, Mg, Fe, Zn, and Ag compared to healthy controls, while C3-epi-25(OH)D3 levels were significantly elevated (P < 0.05). Additionally, RCC patients had significantly lower levels of Zn and Se, but higher levels of Ga, than BKN patients (P < 0.05). Correlation analysis revealed significant positive associations between Fe and Cs with t-25(OH)D, 25(OH)D3, C3-epi, and f-25(OH)D, as well as between Ca and t-25(OH)D and f-25(OH)D (P < 0.05). Logistic regression analysis identified f-25(OH)D (OR = 0.762, P < 0.040), Fe (OR = 0.943, P < 0.028), and Zn (OR = 0.945, P = 0.001) as protective factors against KN, while C3-epi-25(OH)D3 (OR = 84.974, P < 0.001) was a risk factor. Receiver operating characteristic (ROC) curve analysis showed that the combination of C3-epi, f-25(OH)D, and Zn (AUC = 0.895), or C3-epi, Fe, and Zn (AUC = 0.912), did not significantly differ from the four-marker combination of C3-epi, f-25(OH)D, Fe, and Zn (AUC = 0.924). All combined approaches outperformed individual or two-marker assays (all P < 0.05).
KN patients exhibit altered VitD metabolites and trace element profiles, with low Zn and Se potentially promoting malignancy. Free-25(OH)D, Fe, and Zn serve as protective factors, while C3-epi predisposes to disease. Combining C3-epi with f-25(OH)D and Zn, or with Fe and Zn, provides strong diagnostic accuracy for KN.