Int J Epidemiol. 2015 Feb;44(1):240-8. doi: 10.1093/ije/dyu200.
Nickel exposure can induce hyperglycaemia in rodents, but little is known about its association with abnormal glucose metabolism in humans. We aimed to investigate the association of nickel exposure with the prevalence of type 2 diabetes in Chinese adults.
A total of 2115 non-institutionalized men and women aged 55 to 76 years from Beijing and Shanghai were included, and urinary nickel concentration was assessed by inductively coupled plasma mass spectroscopy. The prevalence of type 2 diabetes was compared across urinary nickel quartiles. Fasting plasma glucose, insulin, lipids, C-reactive protein and glycated haemoglobin A1c, as well as urinary albumin and creatinine were measured.
The median concentration of urinary nickel was 3.63 mg/l (interquartile range: 2.29–5.89 mg/l), and the prevalence of diabetes was 35.3% (747 cases/2115 persons). Elevated levels of urinary nickel were associated with higher fasting glucose, glycated haemoglobin A1c, insulin and homeostatic model assessment of insulin resistance (all P<0.01). The odds ratios (95% confidence interval) for diabetes across the increasing urinary nickel quartiles were 1.27 (0.97–1.67), 1.78 (1.36–2.32) and 1.68 (1.29–2.20), respectively (referencing to 1.00), after multivariate adjustment including lifestyle factors, body mass index and family history of diabetes (P for trend <0.001). The association remained unchanged after further controlling for urinary creatinine and C-reactive protein (P for trend <0.001).
Increased urinary nickel concentration is associated with elevated prevalence of type 2 diabetes in humans.
镍暴露可诱发啮齿动物高血糖，但人们对其与人类葡萄糖代谢异常的关系知之甚少。本研究旨在探讨镍暴露与中国成年人 2 型糖尿病患病率之间的关系。
共纳入北京和上海 2115 名年龄 55 至 76 岁的非住院男性和女性，采用电感耦合等离子体质谱法检测尿镍浓度。比较了尿镍四分位组间 2 型糖尿病的患病率。检测了空腹血糖、胰岛素、血脂、C 反应蛋白和糖化血红蛋白 A1c，以及尿白蛋白和肌酐。
尿镍中位数为 3.63mg/L（四分位间距：2.29-5.89mg/L），糖尿病患病率为 35.3%（747 例/2115 人）。尿镍水平升高与空腹血糖、糖化血红蛋白 A1c、胰岛素和稳态模型评估的胰岛素抵抗均升高相关（均 P<0.01）。按尿镍四分位组递增，糖尿病的比值比（95%置信区间）分别为 1.27（0.97-1.67）、1.78（1.36-2.32）和 1.68（1.29-2.20）（参考值为 1.00），经包括生活方式因素、体重指数和糖尿病家族史在内的多变量调整后（趋势 P<0.001）。进一步控制尿肌酐和 C 反应蛋白后，该相关性仍然不变（趋势 P<0.001）。
尿镍浓度升高与人类 2 型糖尿病患病率升高相关。
