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糖尿病风险增加与多氯联苯和二噁英:对“油症”队列的24年随访研究

Increased risk of diabetes and polychlorinated biphenyls and dioxins: a 24-year follow-up study of the Yucheng cohort.

作者信息

Wang Shu-Li, Tsai Pei-Chien, Yang Chiu-Yueh, Guo Yueliang Leon

机构信息

Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Miaoli, Taiwan.

出版信息

Diabetes Care. 2008 Aug;31(8):1574-9. doi: 10.2337/dc07-2449. Epub 2008 May 16.

Abstract

OBJECTIVE

Polychlorinated biphenyls (PCBs) and polychlorinated dibenzofurans (PCDFs) are important and persistent organic pollutants (POPs) in humans. Recent cross-sectional studies have detected increased concentrations of serum POPs in diabetic patients. We aimed to examine the association between previous high exposures to PCBs and PCDFs and the cumulative incidence of type 2 diabetes and hypertension.

RESEARCH DESIGN AND METHODS

During the late 1970s, the consumption of rice-bran oil laced with PCBs poisoned thousands of Taiwanese. Between 1993 and 2003, we examined 1,054 Yucheng ("oil disease") victims against neighborhood reference subjects using a protocol blinded for POP exposure. Here, we report the results derived from 378 Yucheng subjects and 370 matched references.

RESULTS

The diabetes risk to members of the Yucheng cohort relative to their reference subjects was significantly increased for women (odds ratio [OR] 2.1 [95% CI 1.1-4.5]) but not for men after considering age, BMI, cigarette smoking, and alcohol intake. Yucheng women diagnosed with chloracne had adjusted ORs of 5.5 (95% CI 2.3-13.4) for diabetes and 3.5 (1.7-7.2) for hypertension compared with those who were chloracne free.

CONCLUSIONS

Yucheng women, who had endured previous exposure to PCBs and PCDFs, suffered from increased incidences of diabetes, particularly those who had retained significant levels of pollutant as evident from chloracne. When planning treatments against diabetes, the body burden of PCBs and dioxins should be carefully considered, especially for women.

摘要

目的

多氯联苯(PCBs)和多氯二苯并呋喃(PCDFs)是人体内重要的持久性有机污染物(POPs)。近期的横断面研究检测到糖尿病患者血清中POPs浓度升高。我们旨在研究既往高暴露于PCBs和PCDFs与2型糖尿病及高血压累积发病率之间的关联。

研究设计与方法

20世纪70年代末,食用被PCBs污染的米糠油致使数千名台湾人中毒。1993年至2003年期间,我们采用对POP暴露情况不知情的方案,对1054名“油症”(玉城事件受害者)与邻里对照对象进行了检查。在此,我们报告来自378名玉城受试者和370名匹配对照的结果。

结果

在考虑年龄、体重指数、吸烟和饮酒情况后,玉城队列中的女性相对于其对照对象患糖尿病的风险显著增加(优势比[OR]为2.1[95%可信区间1.1 - 4.5]),而男性则未增加。与未患氯痤疮的玉城女性相比,被诊断患有氯痤疮的女性患糖尿病的校正OR为5.5(95%可信区间2.3 - 13.4),患高血压的校正OR为3.5(1.7 - 7.2)。

结论

曾暴露于PCBs和PCDFs的玉城女性患糖尿病的发病率增加,尤其是那些因氯痤疮而体内污染物残留水平较高的女性。在制定糖尿病治疗方案时,应仔细考虑PCBs和二恶英的身体负担,尤其是对女性而言。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b6e/2494618/9dca45101b98/zdc0080870970001.jpg

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