邻苯二甲酸酯暴露与中老年2型糖尿病相关性研究
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摘要
【目的】研究上海市中老年人群2型糖尿病与尿中邻苯二甲酸酯及其代谢产物含量的相关性。【方法】病例组来自上海市某社区医院管理健康档案登记在册,年满50岁及以上,已诊断糖尿病病史>3个月,无严重心脏、肾脏等疾病糖尿病患者;对照组的健康人群来源于复旦大学公共卫生学院2012到2014年进行的"上海市食物消费量调查"项目中的2 642名居民,年满50岁及以上,未患糖尿病,且无严重心脏、肾脏等其他疾患。将病例组与对照组通过年龄、性别进行配对,对病例组及对照组尿中邻苯二甲酸酯代谢产物差异进行统计分析。【结果】尿中邻苯二甲酸酯代谢物除邻苯二甲酸单苄基酯(MBzP)和单(2-羧基己基)邻苯二甲酸酯(MCMHP)外,其余代谢物的水平都与糖尿病患病呈相关性(P<0.05),且糖尿病患者尿中邻苯二甲酸酯代谢物水平高于健康人群(OR>1)。其中,邻苯二甲酸单甲酯(MMP)OR值为1.099(1.069,1.130)(P<0.01),邻苯二甲酸单乙酯(MEP)OR值为1.013(1.009,1.017)(P<0.01),邻苯二甲酸单异丁酯(MiBP)OR值为1.066(1.016,1.119)(P<0.01),邻苯二甲酸单正丁酯(MnBP)OR值为1.034(1.021,1.047)(P<0.01),邻苯二甲酸单(2-乙基己基)酯(MEHP)OR值为1.006(1.002,1.010)(P<0.01),MEOHP的OR值为1.074(1.049,1.099),MECPP的OR值为1.013(1.006,1.020)(P<0.01),MEHHP的OR值为1.015(1.008,1.022)(P<0.01)。【结论】邻苯二甲酸酯暴露与中老年2型糖尿病之间可能存在一定的相关性。
[Objective] To investigate the relationship between type 2 diabetes and phthalates in urine and its metabolites in middle and old age people in Shanghai. [Methods] The subjects in the case group were selected from a community in shanghai who registered in a health management file with history of diagnosed diabetes for >3 months and at the age of 50 years or older but without serious heart and kidney diseases.The healthy subjects in the control group were from 2 642 residents in the "Shanghai Food Consumption Survey" project conducted by Fudan University School of Public Health from 2012 to 2014.The candidates were 50 years of age or older,no diabetes,and no serious heart,kidney and other diseases.The case group and the control group were paired by age and sex,and then the differences in urinary phthalate metabolites between case group and control group were statistically analyzed. [Results] The metabolic concentrations of phthalates in urine except MBzP and MCMHP proved to be significantly correlated with diabetes(P<0.05),and are risk factors for diabetes(OR>1).The odds ratio(OR) of MMP was 1.099(1.069,1.130)(P<0.01),OR of MEP was 1.013(1.009,1.017)(P<0.01),OR of MiBP was 1.066(1.016,1.119)(P<0.01),OR of MnBP was 1.034(1.021,1.047)(P<0.01),OR of MEHP was 1.006(1.002,1.010)(P<0.01),OR of MEOHP was 1.074(1.049,1.099)(P<0.01),OR of MECPP was 1.013(1.006,1.020)(P<0.01),OR of MEHHP was 1.015(1.008,1.022)(P<0.01). [Conclusion] It is found there may be some associations between exposure to phthalates and type 2 diabetes in middle and old age.
[Objective] To investigate the relationship between type 2 diabetes and phthalates in urine and its metabolites in middle and old age people in Shanghai. [Methods] The subjects in the case group were selected from a community in shanghai who registered in a health management file with history of diagnosed diabetes for >3 months and at the age of 50 years or older but without serious heart and kidney diseases.The healthy subjects in the control group were from 2 642 residents in the "Shanghai Food Consumption Survey" project conducted by Fudan University School of Public Health from 2012 to 2014.The candidates were 50 years of age or older,no diabetes,and no serious heart,kidney and other diseases.The case group and the control group were paired by age and sex,and then the differences in urinary phthalate metabolites between case group and control group were statistically analyzed. [Results] The metabolic concentrations of phthalates in urine except MBzP and MCMHP proved to be significantly correlated with diabetes(P<0.05),and are risk factors for diabetes(OR>1).The odds ratio(OR) of MMP was 1.099(1.069,1.130)(P<0.01),OR of MEP was 1.013(1.009,1.017)(P<0.01),OR of MiBP was 1.066(1.016,1.119)(P<0.01),OR of MnBP was 1.034(1.021,1.047)(P<0.01),OR of MEHP was 1.006(1.002,1.010)(P<0.01),OR of MEOHP was 1.074(1.049,1.099)(P<0.01),OR of MECPP was 1.013(1.006,1.020)(P<0.01),OR of MEHHP was 1.015(1.008,1.022)(P<0.01). [Conclusion] It is found there may be some associations between exposure to phthalates and type 2 diabetes in middle and old age.
引文
[1]SILVA M J,BARR D B,REIDY J A,et al.Urinary levels of seven phthalate metabolites in the U.S.population from the national health and nutrition examination survey (NHANES) 1999-2000[J].Environ Health Perspect,2004,112(3):331-338.
[2]HINES E P,CALAFAT A M,SILVA M J,et al.Concentrations of phthalate metabolites in milk,urine,saliva,and Serum of lactating North Carolina women[J].Environ Health Perspect,2009,117(1):86-92.
[3]SILVA M J,REIDY J A,PREAU J J,et al.Oxidative metabolites of diisononyl phthalate as biomarkers for human exposure assessment[J].Environ Health Perspect,2006,114(8):1158-1161.
[4]KOCH H M,BOLT H M,PREUSS R,et al.New metabolites of di(2-ethylhexyl)phthalate (DEHP) in human urine and serum after single oral doses of deuterium-labelled DEHP[J].Arch Toxicol,2005,79(7):367-376.
[5]FREDERIKSEN H,SKAKKEBAEK N E,ANDERSSON A M.Metabolism of phthalates in humans[J].Mol Nutr Food Res,2007,51(7):899-911.
[6]王正,何继瑞,罗天雯.邻苯二甲酸二丁酯(DBP)与2型糖尿病的研究进展[J].中外医疗,2015,34(17):194-195,198.
[7]吕子全,黄素丽,张艳炜,等.塑化剂DEHP诱导HepG2细胞胰岛素抵抗作用的研究[J].职业与健康,2016,32(12):1644-1647.
[8]塑料化学物或增加儿童肥胖及糖尿病风险[J].工程塑料应用,2013,41(9):105.
[9]刘晓荻.美容保养产品恐增加女性糖尿病风险[J].基础医学与临床,2013,33(11):1503.
[10]DONG R H,ZHAO S Z,ZHANG H,et al.Sex differences in the association of urinary concentrations of phthalates metabolites with self-reported diabetes and cardiovascular diseases in Shanghai adults[J].Int J Environ Res Public Health,2017,14(6):598.
[11]张晗.上海市社区居民邻苯二甲酸酯累积暴露风险评估[D].上海:复旦大学,2016.
[12]DONG R H,CHEN J S,ZHENG J H,et al.The role of oxidative stress in cardiometabolic risk related to phthalate exposure in elderly diabetic patients from Shanghai[J].Environ Int,2018,121:340-348.
[13]SUN Q,CORNELIS M C,TOWNSEND M K,et al.Association of urinary concentrations of bisphenol A and phthalate metabolites with risk of type 2 diabetes:a prospective investigation in the Nurses′ Health Study (NHS) and NHSII cohorts[J].Environ Health Perspect,2014,122(6):616-623.
[14]SVENSSON K,HERNáNDEZ-RAMíREZ R U,BURGUETE-GARCíA A,et al.Phthalate exposure associated with self-reported diabetes among Mexican women[J].Environ Res,2011,111(6):792-796.
[15]LIND P M,ZETHELIUS B,LIND L.Circulating levels of phthalate metabolites are associated with prevalent diabetes in the elderly[J].Diabetes Care,2012,35(7):1519-1524.
[16]CASALS-CASAS C,FEIGE J N,DESVERGNE B.Interference of pollutants with PPARs:endocrine disruption meets metabolism[J].Int J Obes (Lond),2008,32 Suppl 6:S53-S61.
[17]BOBERG J,METZDORFF S,WORTZIGER R,et al.Impact of diisobutyl phthalate and other PPAR agonists on steroidogenesis and plasma insulin and leptin levels in fetal rats[J].Toxicology,2008,250(2-3):75-81.
[18]RAJESH P,BALASUBRAMANIAN K.Gestational exposure to di(2-ethylhexyl) phthalate (DEHP) impairs pancreatic β-cell function in F1 rat offspring[J].Toxicol Lett,2015,232(1):46-57.
[19]钱洪智,朱心强.气相色谱-质谱法快速检测乳粉中15种邻苯二甲酸酯类塑化剂残留[J].上海预防医学,2017,29(4):277-280.
[20]张小红,吴菲,程旻娜,等.上海市自报糖尿病患者综合控制现状及与饮食状况的关系[J].上海预防医学,2019,31(2):104-110.
[2]HINES E P,CALAFAT A M,SILVA M J,et al.Concentrations of phthalate metabolites in milk,urine,saliva,and Serum of lactating North Carolina women[J].Environ Health Perspect,2009,117(1):86-92.
[3]SILVA M J,REIDY J A,PREAU J J,et al.Oxidative metabolites of diisononyl phthalate as biomarkers for human exposure assessment[J].Environ Health Perspect,2006,114(8):1158-1161.
[4]KOCH H M,BOLT H M,PREUSS R,et al.New metabolites of di(2-ethylhexyl)phthalate (DEHP) in human urine and serum after single oral doses of deuterium-labelled DEHP[J].Arch Toxicol,2005,79(7):367-376.
[5]FREDERIKSEN H,SKAKKEBAEK N E,ANDERSSON A M.Metabolism of phthalates in humans[J].Mol Nutr Food Res,2007,51(7):899-911.
[6]王正,何继瑞,罗天雯.邻苯二甲酸二丁酯(DBP)与2型糖尿病的研究进展[J].中外医疗,2015,34(17):194-195,198.
[7]吕子全,黄素丽,张艳炜,等.塑化剂DEHP诱导HepG2细胞胰岛素抵抗作用的研究[J].职业与健康,2016,32(12):1644-1647.
[8]塑料化学物或增加儿童肥胖及糖尿病风险[J].工程塑料应用,2013,41(9):105.
[9]刘晓荻.美容保养产品恐增加女性糖尿病风险[J].基础医学与临床,2013,33(11):1503.
[10]DONG R H,ZHAO S Z,ZHANG H,et al.Sex differences in the association of urinary concentrations of phthalates metabolites with self-reported diabetes and cardiovascular diseases in Shanghai adults[J].Int J Environ Res Public Health,2017,14(6):598.
[11]张晗.上海市社区居民邻苯二甲酸酯累积暴露风险评估[D].上海:复旦大学,2016.
[12]DONG R H,CHEN J S,ZHENG J H,et al.The role of oxidative stress in cardiometabolic risk related to phthalate exposure in elderly diabetic patients from Shanghai[J].Environ Int,2018,121:340-348.
[13]SUN Q,CORNELIS M C,TOWNSEND M K,et al.Association of urinary concentrations of bisphenol A and phthalate metabolites with risk of type 2 diabetes:a prospective investigation in the Nurses′ Health Study (NHS) and NHSII cohorts[J].Environ Health Perspect,2014,122(6):616-623.
[14]SVENSSON K,HERNáNDEZ-RAMíREZ R U,BURGUETE-GARCíA A,et al.Phthalate exposure associated with self-reported diabetes among Mexican women[J].Environ Res,2011,111(6):792-796.
[15]LIND P M,ZETHELIUS B,LIND L.Circulating levels of phthalate metabolites are associated with prevalent diabetes in the elderly[J].Diabetes Care,2012,35(7):1519-1524.
[16]CASALS-CASAS C,FEIGE J N,DESVERGNE B.Interference of pollutants with PPARs:endocrine disruption meets metabolism[J].Int J Obes (Lond),2008,32 Suppl 6:S53-S61.
[17]BOBERG J,METZDORFF S,WORTZIGER R,et al.Impact of diisobutyl phthalate and other PPAR agonists on steroidogenesis and plasma insulin and leptin levels in fetal rats[J].Toxicology,2008,250(2-3):75-81.
[18]RAJESH P,BALASUBRAMANIAN K.Gestational exposure to di(2-ethylhexyl) phthalate (DEHP) impairs pancreatic β-cell function in F1 rat offspring[J].Toxicol Lett,2015,232(1):46-57.
[19]钱洪智,朱心强.气相色谱-质谱法快速检测乳粉中15种邻苯二甲酸酯类塑化剂残留[J].上海预防医学,2017,29(4):277-280.
[20]张小红,吴菲,程旻娜,等.上海市自报糖尿病患者综合控制现状及与饮食状况的关系[J].上海预防医学,2019,31(2):104-110.
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