Piecha Roman, Svačina Štěpán, Malý Marek, Vrbík Karel, Lacinová Zdenka, Haluzík Martin, Pavloušková Jana, Vavrouš Adam, Matějková Dagmar, Müllerová Dana, Mráz Miloš, Matoulek Martin
Third Internal Clinic, 1st Medical Faculty in Prague, Charles University, Prague, Czech Republic.
National Institute of Public Health in Prague, Czech Republic.
Cent Eur J Public Health. 2016 Dec;24(4):297-301. doi: 10.21101/cejph.a4704.
Human exposure to organic pollutants (some of them also called endocrine disruptors) can be associated with adverse metabolic health outcomes including type 2 diabetes. The goal of this study was to compare the urine levels of bisphenol A and phthalate metabolites in subgroups of patients with metabolic syndrome composed of patients with and without three important components of metabolic syndrome (hypertension, dyslipidemia and diabetes).
We have investigated 24 hr urine samples of 168 patients with metabolic syndrome from the Metabolic Outpatient Department of General University Hospital in Prague. Using standard metabolic syndrome criteria, we classified patients as dyslipidemic (n=87), hypertensive (n=96), and type 2 diabetic (n=58). Bisphenol A and 15 metabolites of phthalates were evaluated in relation to creatinine excretion. Samples were analysed with enzymatic cleavage of glucuronide using ultra-high-performance liquid chromatography-electrospray ionization tandem mass spectrometry in one laboratory with external quality control.
Four metabolites, mono-n-butyl phthalate, mono-(2-ethyl-5-hydroxyhexyl) phthalate, mono-(2-ethyl-5-oxohexyl) phthalate, and mono-(2-ethyl-5-carboxypentyl) phthalate showed significantly higher levels in diabetic compared to non-diabetic patients (p<0.001, p=0.002, p=0.002, and p=0.005, respectively). The differences remained significant after adjustment to hypertension, dyslipidemia, age, and BMI. No difference was found between either the hypertensive and non-hypertensive or dyslipidemic and non-dyslipidemic patients. There was no significant relation of bisphenol A level to diabetes, hypertension, dyslipidemia, age, and BMI.
Urine levels of four phthalate metabolites were significantly higher in type 2 diabetics independently on specified predictors. Phthalate levels can be in relation to beta cell dysfunction in type 2 diabetic patients but this study is not able to show if the relation is causal.
人体接触有机污染物（其中一些也被称为内分泌干扰物）可能与包括2型糖尿病在内的不良代谢健康结果相关。本研究的目的是比较代谢综合征患者亚组中双酚A和邻苯二甲酸酯代谢物的尿液水平，该亚组由患有和未患有代谢综合征三个重要组成部分（高血压、血脂异常和糖尿病）的患者组成。
我们调查了布拉格综合大学医院代谢门诊168例代谢综合征患者的24小时尿液样本。使用标准代谢综合征标准，我们将患者分类为血脂异常（n = 87）、高血压（n = 96）和2型糖尿病患者（n = 58）。评估双酚A和15种邻苯二甲酸酯代谢物与肌酐排泄的关系。样本在一个具有外部质量控制的实验室中使用超高效液相色谱 - 电喷雾电离串联质谱法通过葡糖醛酸酶解进行分析。
四种代谢物，邻苯二甲酸单正丁酯、邻苯二甲酸单（2 - 乙基 - 5 - 羟基己基）酯、邻苯二甲酸单（2 - 乙基 - 5 - 氧代己基）酯和邻苯二甲酸单（2 - 乙基 - 5 - 羧基戊基）酯在糖尿病患者中的水平显著高于非糖尿病患者（分别为p < 0.001、p = 0.002、p = 0.002和p = 0.005）。在调整高血压、血脂异常、年龄和体重指数后，差异仍然显著。高血压与非高血压患者或血脂异常与非血脂异常患者之间未发现差异。双酚A水平与糖尿病、高血压、血脂异常、年龄和体重指数之间无显著关系。
2型糖尿病患者中四种邻苯二甲酸酯代谢物的尿液水平在独立于特定预测因素的情况下显著更高。邻苯二甲酸酯水平可能与2型糖尿病患者的β细胞功能障碍有关，但本研究无法表明这种关系是否为因果关系。
