Association of trace elements mixture exposure with childhood myopia risk: potential role of glycolysis metabolic dysregulation.

This study aimed to investigate the associations between multiple urinary trace elements and the risk of childhood myopia, accompanied by the identification of metabolic biomarkers. Urine trace element concentrations were quantified and comprehensive metabolomic profiles were constructed. Results showed that urinary zinc (Zn) concentration was significantly increased, whereas nickel (Ni) was reduced in the myopia group compared to controls. A positive correlation was identified between urinary Zn concentration and the elevated risk of myopia (OR: 2.30, 95% CI: 1.10-4.81). Conversely, Ni exposure was inversely associated with prevalent myopia (OR: 0.85, 95% CI: 0.74-0.98). Machine Learning analysis consistently demonstrated that urinary Zn, Ni, Cobalt (Co), and Strontium (Sr) exposure were key trace elements associated with myopia risk. Metabolomic analysis revealed that Glycolysis, Citrate cycle (TCA cycle), and Urea cycle metabolism disorders were the differential metabolic pathways. Furthermore, fumaric acid and 3-phosphoglyceric acid significantly mediated the association between Zn and Sr and myopia risk. This study provided the new insights of trace elements-associated alterations in glycolysis metabolism disorder on the childhood myopia.