Li Yujie, Zhang Yun, Wang Weijing, Wu Yili
Department of Epidemiology and Health Statistics, Qingdao University Medical College, No. 38 Deng Zhou Road, Qingdao, 266021, China.
Department of Social Medicine and Health Service Management, Affiliated Hospital of Qingdao University, Qingdao, China.
Environ Sci Pollut Res Int. 2017 Apr;24(11):10083-10090. doi: 10.1007/s11356-017-8610-8. Epub 2017 Feb 23.
The association between urinary cadmium and diabetes risk remains controversial. PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang Data updated on 21 June 2016 were searched for eligible publications. Pooled odds ratio (OR) with 95% confidence interval (CI) of diabetes for highest versus lowest level of urinary cadmium was calculated by using fixed-effect model or random-effect model. Dose-response relationship between urinary cadmium and diabetes was estimated by restricted cubic spline. A total of nine studies with 28,691 participants were included in this meta-analysis. The pooled OR of diabetes for the highest versus lowest level of urinary cadmium was 1.02 (95% CI, 1.00, 1.05; I = 42.3%). In subgroup analysis, the ORs were 1.02 (95% CI 1.00, 1.05; I = 0.9%) for studies conducted in Asia and 1.11 (95% CI 0.88, 1.41; I = 86.3%) in America. For dose-response analysis, a linear relationship was found between urinary cadmium and the risk of diabetes (P = 0.5856). For every l μg/g creatinine increment of urinary cadmium, the risk of diabetes increased by 16% (1.16, 95% CI 1.08, 1.25). This meta-analysis suggests that cadmium exposure might be significantly associated with prevalence of diabetes, but large prospective studies are needed to confirm this finding.
尿镉与糖尿病风险之间的关联仍存在争议。检索了截至2016年6月21日更新的PubMed、科学网、中国知网和万方数据，以查找符合条件的出版物。采用固定效应模型或随机效应模型计算尿镉最高水平与最低水平相比的糖尿病合并优势比（OR）及95%置信区间（CI）。通过受限立方样条估计尿镉与糖尿病之间的剂量反应关系。本荟萃分析共纳入9项研究，涉及28,691名参与者。尿镉最高水平与最低水平相比的糖尿病合并OR为1.02（95%CI，1.00，1.05；I² = 42.3%）。亚组分析中，亚洲开展的研究的OR为1.02（95%CI 1.00，1.05；I² = 0.9%），美洲开展的研究的OR为1.11（95%CI 0.88，1.41；I² = 86.3%）。剂量反应分析显示，尿镉与糖尿病风险之间存在线性关系（P = 0.5856）。尿镉每增加1μg/g肌酐，糖尿病风险增加16%（1.16，95%CI 1.08，1.25）。本荟萃分析表明，镉暴露可能与糖尿病患病率显著相关，但需要大型前瞻性研究来证实这一发现。
