基于NHANES数据库的血液氯仿与糖尿病及相关糖脂代谢指标的关联性研究  

The correlation between blood chloroform and diabetes and related glycemic and lipid metabolic parameters based on NHANES database

作　　者：李嘉怡 刘学奎[2] 耿厚法 梁军 LI Jiayi;LIU Xuekui;GENG Houfa;LIANG Jun(Graduate School of Bengbu Medical College,Bengbu Anhui 233000;Department of Endocrinology,Xuzhou Central Hospital,Xuzhou Jiangsu 221000,China)

机构地区：[1]蚌埠医学院研究生院,安徽蚌埠233000 [2]徐州市中心医院内分泌科,江苏徐州221000

出　　处：《江苏大学学报（医学版）》2023年第5期426-431,448,共7页Journal of Jiangsu University：Medicine Edition

基　　金：江苏省中医药科技发展计划项目(MS2021050);徐州市科技项目(KC21231)。

摘　　要：目的:探讨人群血液中氯仿浓度与糖尿病患病风险的相关性,为糖尿病的预防和控制提供依据。方法:使用2017至2018年美国国家健康和营养调查(National Health and Nutrition Examination Survey,NHANES)数据。排除妊娠期妇女和年龄<18周岁的青少年,以及氯仿浓度缺失和未完成糖尿病调查的参与者,共622人纳入本次分析。将所有参与者根据血液中氯仿浓度按照三分位法分为T1组(氯仿<0.011μg/L),T2组(0.011μg/L≤氯仿<0.017μg/L)和T3组(氯仿≥0.017μg/L),使用Logistic回归分析3组间糖尿病患病率的差异,并利用立方样条图展示氯仿与糖尿病患病风险之间的相关性。结果:糖尿病发生风险随氯仿浓度的增高而增加(T3组比T1组增加约1.23倍);使用限制性立方样条分析结果显示,氯仿与空腹血糖、稳态模型评估胰岛素抵抗指数(homeostatic model assessment of insulin resistance,HOMA-IR)和糖尿病发生风险呈正相关且具有统计学意义;进一步使用偏相关分析也同样发现氯仿与空腹血糖和HOMA-IR之间存在正相关;此外,亚组分析结果也显示氯仿是糖尿病的风险因素。结论:氯仿暴露是糖尿病的独立危险因素,可以增加胰岛素抵抗,从而加重糖尿病的患病风险。Objective:To explore the correlation between blood chloroform concentration in the human body and the risk of diabetes,and provide a basis for the prevention and control of diabetes.Methods:The data,extracted from 2017—2018 year of the United States National Health and Nutrition Examination Survey database,was used for the study.After excluding pregnant women,teenagers under 18 years old,participants with missing chloroform concentrations,and incomplete diabetes survey,a total of 622 participants were included for further analysis.The participants were divided into T1(<0.011μg/L),T2(≥0.011,and<0.017μg/L),and T3(≥0.017μg/L)groups based on their blood chloroform concentrations using the quartile method.The logistic regression was used to analyze the incidence rate of diabetes among the three groups,and a cubic spline graph was utilized to demonstrate the correlation between chloroform and the risk of diabetes.Results:The risk of developing diabetes increases with the increasing of chloroform concentration(the T3 group was 1.23 times higher than the T1 group).The results of restricted cubic spline analysis showed that chloroform exposure was positive correlation with fasting blood glucose,homeostatic model assessment of insulin resistance(HOMA-IR),which was an index for insulin resistance.Furthermore,partial correlation analysis also indicated that there was a positive correlation between chloroform concentration and both fasting blood glucose levels and HOMA-IR.Additionally,the risk of developing diabetes was found to be positively associated with chloroform concentration.In addition,subgroup analysis results also showed that blood chloroform was a risk factor for diabetes.Conclusion:Chloroform exposure is an independent risk factor for diabetes,which can increase insulin resistance and thereby increase the risk of developing diabetes.

关 键 词：氯仿 糖尿病 胰岛素抵抗 消毒剂 

分 类 号：R587.1[医药卫生—内分泌]