二噁英类化合物暴露与人空腹血糖水平的关联  

Associations between PCDD/Fs exposure and fasting blood glucose levels

作　　者：宋文静 张庄[1] 史廷明[2] 刘潇 张素坤 何金铜 陈卫红[1] SONG Wen-jing;ZHANG Zhuang;SHI Ting-ming;LIU Xiao;ZHANG Su-kun;HE Jin-tong;CHEN Wei-hong(Department of Occupational and Environmental Health,Key Laboratory of Environment and Health,Ministry of Education,and State Key Laboratory of Environmental Health(Incubating),School of Public Health,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430030,China;Department of Personal Science and Education,Hubei Provincial Center for Disease Control and Prevention,Wuhan,Hubei 430079,China;Institute of Health Inspection and Testing,Hubei Provincial Academy of Preventive Medicine,Hubei Provincial Center for Disease Control and Prevention,Wuhan,Hubei 430079,China;South China Center of Environmental Monitoring and Analysis,South China Institute of Environmental Sciences,MEE,Guangzhou,Guangdong 510655,China;Department of Occupational Health,Zhuhai Center for Chronic Disease Control,Zhuhai,Guangdong 519060,China)

机构地区：[1]华中科技大学同济医学院公共卫生学院劳动卫生与环境卫生学系,环境与健康教育部重点实验室,国家环境保护环境与健康重点实验室(武汉),湖北武汉430030 [2]湖北省预防医学科学院,湖北省疾病预防控制中心人事科教处,湖北武汉430079 [3]湖北省预防医学科学院,湖北省疾病预防控制中心卫生检验检测研究所,湖北武汉430079 [4]生态环境部华南环境科学研究所华南环境监测分析中心,广东广州510655 [5]珠海市慢性病防治中心职业卫生科,广东珠海519060

出　　处：《环境与职业医学》2019年第11期1010-1016,共7页Journal of Environmental and Occupational Medicine

基　　金：环保公益性行业科研专项（201309046）;中央高校基本科研业务费专项资金资助（HUST2016JCTD116）

摘　　要：[背景]糖尿病是环境与机体交互作用的结果,而空腹血糖水平是筛选糖尿病的早期指标。近年来,研究者开始关注二噁英类化合物(PCDD/Fs)暴露与血糖水平改变及糖尿病之间的关联,但结果并不一致。[目的]了解湖北省某市职业暴露环境和居住环境中PCDD/Fs暴露水平,探讨PCDD/Fs暴露量与空腹血糖水平的关联性。[方法]采用横断面研究,调查时间为2013年8月和2014年9月。选择湖北省某垃圾焚烧厂和钢铁铸造厂的一线工人共381名作为职业暴露组,工厂周围5 km以外的居民共381名作为对照组,对所有研究对象进行问卷资料收集以及空腹血糖的测定,以研究对象经空气吸入和食物摄入的PCDD/Fs暴露量之和作为个体PCDD/Fs暴露量。应用广义线性回归模型分析PCDD/Fs暴露量与空腹血糖水平的相关性,并对空腹血糖影响因素进行交互作用检验。[结果]职业暴露组和对照组的PCDD/Fs暴露量分别为0.22(0.13~0.48)、0.09(0.05~0.10)pg TEQ/(kg·d),空腹血糖水平分别为(5.15±0.62)、(4.90±0.71)mmol/L,差异均有统计学意义(P <0.05)。广义线性回归模型分析结果表明,调整年龄、性别、体质量指数、吸烟、饮酒、锻炼、糖尿病患病情况和糖尿病家族史后,PCDD/Fs暴露量与人群的空腹血糖水平呈现明显的正相关关系(P趋势<0.05),PCDD/Fs每升高一个自然对数单位,空腹血糖水平升高0.10 mmol/L。锻炼或年龄与PCDD/Fs暴露量存在交互作用(P交互<0.05),在缺乏锻炼者(b=0.178,95%CI:0.096~0.260)或年龄<40岁的人群(b=0.080,95%CI:0.015~0.145)中,空腹血糖水平随PCDD/Fs暴露量升高而升高,而在锻炼者或年龄>40岁的人中二者的关联性无统计学意义。[结论]PCDD/Fs暴露量与人群空腹血糖水平呈正相关,锻炼可适度减弱这一影响。[Background] Diabetes is resulted from the interaction between environment and organism, and fasting blood glucose is an early indicator for screening diabetes. In recent years, researchers have focused on the associations of diabetes with exposure to polychlorinated dibenzo-dioxins and polychlorinated dibenzo-furans(PCDD/Fs) and blood glucose level changes, but the results are inconsistent.[Objective] This study measures the exposure levels of PCDD/Fs in workplaces and living environments in a city of Hubei Province, and investigates the correlation between PCDD/Fs exposure and fasting blood glucose levels.[Methods] A cross-sectional study in Hubei Province was conducted in August 2013 and September 2014. The participants consisted of 381 incineration workers or foundry workers in a solid waste incinerator and a steel plant as the occupational exposure group, and 381 residents living 5 km away as the control group. Questionnaire data were collected and fasting blood glucose levels were measured. PCDD/Fs exposure levels through inhalation and food intake were summed up to represent individual PCDD/Fs exposure level. Generalized linear regression models were used to examine the correlation between PCDD/Fs exposure and fasting blood glucose levels, and interaction tests were performed with considering selected influencing factors of fasting blood glucose.[Results] The PCDD/Fs exposure level [M(P25-P75)] in the occupational exposure group [0.22(0.13-0.48) pg TEQ/(kg·d)] was significantly higher than that in the control group [0.09(0.05-0.10) pg TEQ/(kg·d)](P < 0.05), and so was the fasting blood glucose level [(5.15±0.62) and(4.90±0.71) mmol/L, respectively, P < 0.05]. The results of generalized linear regression model showed that there was a significant positive correlation between PCDD/Fs exposure level and fasting glucose level(Ptrend < 0.05), after adjusting for age, gender, body mass index, smoking, drinking, exercise, diabetes prevalence, and family history of diabetes. Each 1-unit increase in ln-transform

关 键 词：二噁英类化合物 暴露 空腹血糖 锻炼 交互作用 

分 类 号：R126.8[医药卫生—环境卫生学]