Everett Charles J, Thompson Olivia M, Dismuke Clara E
US Department of Veterans Affairs, Ralph H. Johnson VA Medical Center, Charleston, SC, USA; Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
Mayor Joseph P. Riley Institute for Livable Communities, College of Charleston, Charleston, SC, USA.
Environ Pollut. 2017 Mar;222:132-137. doi: 10.1016/j.envpol.2016.12.069. Epub 2017 Jan 5.
Concentrations of the pesticide DDT (dichlorodiphenyltrichloroethane) and its metabolite DDE (dichlorodiphenyldichloroethylene), in the blood of Mexican Americans, were evaluated to determine their relationships with diabetes and diabetic nephropathy. The data were derived from the National Health and Nutrition Examination Survey (NHANES) 1999-2004 (unweighted N = 1,411, population estimate = 13,760,609). The sample included teens, 12-19 years old, which accounted for 19.8% of the data. The time of the study overlapped the banning of DDT in Mexico in the year 2000, and those participants born in Mexico were exposed to DDT before they immigrated to the US. We sought to better understand the relationship of DDT with diabetes in a race/ethnicity group prone to develop diabetes and exposed to DDT. In this study, nephropathy was defined as urinary albumin to creatinine ratio >30 mg/g, representing microalbuminuria and macroalbuminuria, and total diabetes was defined as diagnosed and undiagnosed diabetes (glycohemoglobin, A1c ≥ 6.5%). The proportion with the isomer p,p'-DDT >0.086 ng/g (above the maximum limit of detection) was 13.3% for Mexican Americans born in the US, and 36.9% for those born in Mexico. Levels of p,p'-DDT >0.086 ng/g were associated with total diabetes with nephropathy (odds ratio = 4.42, 95% CI 2.23-8.76), and with total diabetes without nephropathy (odds ratio = 2.02, 95% CI 1.19-3.44). The third quartile of p,p'-DDE (2.99-7.67 ng/g) and the fourth quartile of p,p'-DDE (≥7.68 ng/g) were associated with diabetic nephropathy and had odds ratios of 5.32 (95% CI 1.05-26.87) and 14.95 (95% CI 2.96-75.48) compared to less than the median, respectively, whereas p,p'-DDE was not associated with total diabetes without nephropathy. The findings of this study differ from those of a prior investigation of the general adult US population in that there were more associations found with the Mexican Americans sample.
对墨西哥裔美国人血液中农药滴滴涕（二氯二苯三氯乙烷）及其代谢物滴滴伊（二氯二苯二氯乙烯）的浓度进行了评估，以确定它们与糖尿病及糖尿病肾病之间的关系。数据来源于1999 - 2004年国家健康与营养检查调查（NHANES）（未加权N = 1411，总体估计数 = 13760609）。样本包括12 - 19岁的青少年，占数据的19.8%。研究时间与2000年墨西哥禁止使用滴滴涕的时间重叠，那些在墨西哥出生的参与者在移民到美国之前接触过滴滴涕。我们试图更好地了解在一个易患糖尿病且接触过滴滴涕的种族/族裔群体中，滴滴涕与糖尿病的关系。在本研究中，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，总体糖尿病定义为已诊断和未诊断的糖尿病（糖化血红蛋白，A1c≥6.5%）。在美国出生的墨西哥裔美国人中，异构体p,p'-滴滴涕>0.086 ng/g（高于检测上限）的比例为13.3%，在墨西哥出生的为36.9%。p,p'-滴滴涕>0.086 ng/g的水平与伴有肾病的总体糖尿病相关（比值比 = 4.42，95%置信区间2.23 - 8.76），与不伴有肾病的总体糖尿病相关（比值比 = 2.02，95%置信区间1.19 - 3.44）。p,p'-滴滴伊的第三个四分位数（2.99 - 7.67 ng/g）和第四个四分位数（≥7.68 ng/g）与糖尿病肾病相关，与低于中位数相比，比值比分别为5.32（95%置信区间1.05 - 26.87）和14.95（95%置信区间2.96 - 75.48），而p,p'-滴滴伊与不伴有肾病的总体糖尿病无关。本研究的结果与之前对美国成年普通人群的调查结果不同，因为在墨西哥裔美国人样本中发现了更多的关联。
