Everett Charles J, Thompson Olivia M
Rev Environ Health. 2015;30(2):93-7. doi: 10.1515/reveh-2015-0003.
Six organochlorine pesticides and pesticide metabolites in human blood were tested to determine their relationships with diabetic nephropathy. The data were derived from the National Health and Nutrition Examination Survey (NHANES) 1999-2004 (unweighted, n=2992, population estimate=133,088,752). The six chemicals were p,p'-DDT (dichlorodiphenyltrichloroethane), p,p'-DDE (dichlorodiphenyltrichloroethylene), beta-hexachlorocyclohexane, oxychlordane, trans-nonachlor and heptachlor epoxide. In this research, total diabetes included diagnosed and undiagnosed diabetes (glycohemoglobin, A1c ≥6.5%), and nephropathy was defined as a urinary albumin to creatinine ratio >30 mg/g, representing microalbuminuria and macroalbuminuria. The pesticide p,p'-DDT and pesticide metabolite heptachlor epoxide were significantly associated with total diabetes with nephropathy, with odds ratios of 2.08 (95% CI 1.06-4.11) and 1.75 (95% CI 1.05-2.93), respectively. Organochlorine pesticides are thought to act through the constitutive androstane receptor/pregnane X receptor disease pathway, but this is not well established. When p,p'-DDT and heptachlor epoxide were both elevated, the odds ratio for diabetic nephropathy was 2.76 (95% CI 1.31-5.81), and when six of six organochlorine pesticides and pesticide metabolites, were elevated, the odds ratio for diabetic nephropathy was 3.00 (95% CI 1.08-8.36). The differences in the odds ratios for these groups appear to be due to differences in the mean heptachlor epoxide concentration of each category. Organochlorine pesticides and pesticide metabolites are known to have estrogenic, antiestrogenic or antiandrogenic activity. The constitutive androstane receptor/pregnane X receptor pathway is thought to interact with the aryl hydrocarbon receptor pathway, and the associations noted may be due to that interaction.
对人体血液中的六种有机氯农药及其代谢物进行了检测，以确定它们与糖尿病肾病之间的关系。数据来源于1999 - 2004年的美国国家健康与营养检查调查（NHANES）（未加权，n = 2992，总体估计数 = 133,088,752）。这六种化学物质分别是p,p'-滴滴涕（二氯二苯基三氯乙烷）、p,p'-滴滴伊（二氯二苯基三氯乙烯）、β-六氯环己烷、氧氯丹、反式九氯和七氯环氧化物。在本研究中，总糖尿病包括已诊断和未诊断的糖尿病（糖化血红蛋白，A1c≥6.5%），肾病定义为尿白蛋白与肌酐比值>30 mg/g，代表微量白蛋白尿和大量白蛋白尿。农药p,p'-滴滴涕和农药代谢物七氯环氧化物与伴有肾病的总糖尿病显著相关，比值比分别为2.08（95%置信区间1.06 - 4.11）和1.75（95%置信区间1.05 - 2.93）。有机氯农药被认为通过组成型雄甾烷受体/孕烷X受体疾病途径起作用，但这一点尚未完全确立。当p,p'-滴滴涕和七氯环氧化物均升高时，糖尿病肾病的比值比为2.76（95%置信区间1.31 - 5.81），当六种有机氯农药及其代谢物全部升高时，糖尿病肾病的比值比为3.00（95%置信区间1.08 - 8.36）。这些组的比值比差异似乎是由于每组七氯环氧化物平均浓度的差异所致。已知有机氯农药及其代谢物具有雌激素、抗雌激素或抗雄激素活性。组成型雄甾烷受体/孕烷X受体途径被认为与芳烃受体途径相互作用，所观察到的关联可能归因于这种相互作用。
