PM_(2.5)组分长期暴露对2型糖尿病发病的影响研究  

Effects of long-term exposure to fine particulate matter components on the incidence of type 2 diabetes

作　　者：谢文涵 李元 苏宇腾 欧阳逸馨 薛咏茜 李舒婷 胡美玲 周航 刘相佟[1,2] XIE Wen-han;LI Yuan;SU Yu-teng;OU′YANG Yi-xin;XUE Yong-xi;LI Shu-ting;HU Mei-ling;ZHOU Hang;LIU Xiang-tong(School of Public Health,Capital Medical University,Beijing 100069,China;Beijing Municipal Key Laboratory of Clinical Epidemiology)

机构地区：[1]首都医科大学公共卫生学院,北京100069 [2]临床流行病学北京市重点实验室

出　　处：《环境卫生学杂志》2023年第9期650-658,共9页JOURNAL OF ENVIRONMENTAL HYGIENE

基　　金：国家自然科学基金(82003559)。

摘　　要：目的评估长期暴露于细颗粒物(fine particulate matter,PM_(2.5))五种组分对2型糖尿病发病的影响。方法基于中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS)2011年和2015年的数据,纳入3788名中老年人。采用贝叶斯核机器回归(Bayesian kernel machine regression,BKMR)分析黑碳、铵盐、硝酸盐、有机物、硫酸盐对空腹血糖、糖化血红蛋白和2型糖尿病发病风险的单独效应、交互效应和联合效应。使用后验包含概率(posterior inclusion probabilities,PIP)估计组分的重要程度,PIP>0.5被认定为重要变量。结果研究结果表明黑碳对空腹血糖的影响较大(PIP=0.75),并未发现与糖化血红蛋白和2型糖尿病发病风险有关的重要变量。当其余组分位于第25、50和75百分位数(P_(25),P_(50),P_(75))时,黑碳每升高1个四分位数间距(interquartile range,IQR),空腹血糖分别升高0.59(95%CI:0.13,1.05)、0.61(95%CI:0.19,1.03)和0.57(95%CI:0.11,1.03)mmol/L。五种组分之间不存在交互效应。联合效应分析显示,与所有组分浓度都固定在P_(50)相比,当所有组分浓度都处于P_(70)时,空腹血糖值改变最大,提高0.12(95%CI:0.02,0.21)mmol/L。结论本研究提示PM_(2.5)组分长期暴露对糖化血红蛋白和2型糖尿病发病风险无明显影响,仅黑碳单独暴露和PM_(2.5)组分联合暴露可以提高我国中老年人的空腹血糖,要加强对PM_(2.5)中黑碳的防控,为进一步预防2型糖尿病提供依据。Objective To assess the effects of long-term exposure to five components of fine particulate matter(PM_(2.5))on the incidence of type 2 diabetes.Methods A total of 3788 middle-aged and elderly adults were enrolled by the survey based on the data in China Health and Retirement Longitudinal Study(CHARLS)in 2011 and 2015.Bayesian kernel machine regression(BKMR)was performed to analyze the individual,interactive,and joint effects of black carbon,ammonium,nitrate,organic matter,and sulfate on fasting blood glucose,glycated hemoglobin and the incidence risks of type 2 diabetes.Posterior inclusion probability(PIP)was used to estimate the significance of each component,and the component with PIP more than 0.5 was considered a significant variable.Results The result showed that black carbon had a significant effect on fasting blood glucose(PIP=0.75),and there were no significant variables associated with glycated hemoglobin or the incidence risk of type 2 diabetes.When the other components were at the 25th,50th,and 75th percentiles(P_(25),P_(50),P_(75)),for every interquartile range(IQR)increase in the concentration of black carbon,fasting blood glucose was increased by 0.59(95%CI:0.13,1.05),0.61(95%CI:0.19,1.03)and 0.57(95%CI:0.11,1.03)mmol/L,respectively.There were no interactive effects among the five components.The joint effect analysis showed that compared with the concentrations fixed at P_(50)for all components,the concentrations of all components at P_(70)induced the greatest change in fasting blood glucose,which was increased by 0.12(95%CI:0.02,0.21)mmol/L.Conclusion This study suggests that long-term exposure to black carbon alone may increase fasting blood glucose in middle-aged and elderly Chinese people.It is necessary to strengthen the prevention and control of black carbon in PM_(2.5),which provides a basis for further prevention of the incidence risk of type 2 diabetes.This study suggests that long-term exposure to PM_(2.5)components is not associated with glycated hemoglobin and the incidence risk of type

关 键 词：贝叶斯核机器回归 细颗粒物 黑碳 空腹血糖 2型糖尿病 

分 类 号：R12[医药卫生—环境卫生学]