台湾高度污染区附近居民二恶英暴露与胰岛素抵抗

Dioxin exposure and insulin resistance in Taiwanese living near a highly contaminated area.

机构信息

Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

Epidemiology. 2010 Jan;21(1):56-61. doi: 10.1097/EDE.0b013e3181c2fc6e.

DOI:10.1097/EDE.0b013e3181c2fc6e

PMID:20010210

Abstract

BACKGROUND

Several epidemiologic studies suggest a slightly increased risk of type 2 diabetes in relation to background levels of dioxins. Little is known about how serum dioxins might affect insulin resistance, a hallmark of type 2 diabetes. We examined the association between exposure to dioxins and insulin resistance.

METHODS

We investigated 1234 nondiabetic persons living near a deserted pentachlorophenol factory. Using high-resolution gas chromatography/high-resolution mass spectrometry and blood biochemistry tests, we measured serum dioxins, fasting glucose, and insulin. Finally, we examined associations between serum dioxin levels and the homoeostasis model assessments of insulin resistance and pancreatic beta-cell function.

RESULTS

Participants with insulin resistance (index at or above the 75th percentile) had higher dioxin levels (24.3 vs. 19.8 pg WHO(98)-TEQ(DF)/g lipid) than those without insulin resistance. In both the crude and adjusted models, insulin resistance increased with serum polychlorinated dibenzo-p-dioxins and dibenzofuran (PCDD/F) levels. We found a slight monotonic increase in insulin resistance across the serum PCDD/F categories (P for the trend <0.001). Groups with serum dioxin levels higher than 20.5 pg WHO(98)-TEQ(DF)/g lipid had higher insulin resistance (adjusted odds ratios of 2.7, 3.5, and 5.0 for 50th to <75th, 75th to <90th, and >or=90th percentile, respectively) compared with the reference group (<9.6 pg WHO(98)-TEQ(DF)/g lipid [< 10th percentile]).

CONCLUSIONS

After adjusting for confounding factors, we found a positive association between serum dioxins and the prevalence of insulin resistance.

摘要

背景

几项流行病学研究表明，二恶英的背景水平与 2 型糖尿病的风险略有增加有关。关于血清二恶英如何影响胰岛素抵抗（2 型糖尿病的标志）知之甚少。我们研究了接触二恶英与胰岛素抵抗之间的关系。

方法

我们调查了居住在废弃五氯酚工厂附近的 1234 名非糖尿病患者。我们使用高分辨率气相色谱/高分辨率质谱和血液生化测试，测量了血清二恶英、空腹血糖和胰岛素。最后，我们检查了血清二恶英水平与胰岛素抵抗和胰岛β细胞功能的稳态模型评估之间的关联。

结果

患有胰岛素抵抗（指数在第 75 百分位或以上）的参与者的二恶英水平较高（24.3 与 19.8 pg WHO（98）-TEQ（DF）/g 脂质）高于无胰岛素抵抗的参与者。在未调整和调整模型中，胰岛素抵抗随血清多氯二苯并对二恶英和二苯并呋喃（PCDD/F）水平的升高而增加。我们发现血清 PCDD/F 类别中胰岛素抵抗呈轻微单调增加（趋势 P<0.001）。血清二恶英水平高于 20.5 pg WHO（98）-TEQ（DF）/g 脂质的组与参考组相比，胰岛素抵抗更高（50 至<75 百分位、75 至<90 百分位和>或=90 百分位的调整优势比分别为 2.7、3.5 和 5.0）。