Department of Chemistry, DST Unit of Nanoscience and Thematic Unit of Excellence in Water Research, Indian Institute of Technology Madras, Chennai, Tamil Nadu, India.
KMCH Research Foundation, Kovai Medical Centre and Hospital, Coimbatore, Tamil Nadu, India.
Occup Environ Med. 2018 Sep;75(9):661-667. doi: 10.1136/oemed-2018-104996. Epub 2018 Apr 19.
Diabetes and cardiovascular diseases are growing burdens in rural communities worldwide. We have observed a high prevalence of diabetes among rural farming communities in India and sought to evaluate the association of non-traditional risk factors, such as metals, with diabetes and other cardiometabolic risk factors in this community.
Anthropometric measurements, chemistries and carotid intima-media thickness were determined in 865 participants of the Kovai Medical Center and Hospital-Nallampatti Non-Communicable Disease Study-I (KMCH-NNCD-I, 2015), a cross-sectional study conducted in a farming village in South India. Urinary metal levels were determined by inductively couped plasma-mass spectrometry analysis and corrected to urinary creatinine level. Statistical analyses were performed to study the association between urinary metal levels and clinical parameters.
82.5% of the study population were involved in farming and high levels of toxic metals were detected in the synthetic fertilisers used in the study village. The prevalence of pre-diabetes, diabetes and atherosclerosis was 43.4%, 16.2% and 10.3%, respectively. On logistic regression analysis, no association of traditional risk factors such as body mass index, blood pressure and total cholesterol with disease conditions was observed, but urinary levels of metals such as arsenic, chromium, aluminium and zinc showed an association with diabetes, while arsenic and zinc showed an association with pre-diabetes and atherosclerosis.
Our data suggest a probable role of metals in the aetiology of diabetes and cardiovascular diseases in rural communities. Identifying and eliminating the causes of increased levels of these environmental chemicals could have a beneficial impact on the burden of non-communicable diseases in rural population.
糖尿病和心血管疾病在全球农村社区的负担日益加重。我们观察到印度农村农业社区的糖尿病患病率很高，因此试图评估非传统危险因素（如金属）与该社区糖尿病和其他心血管代谢危险因素之间的关联。
在印度南部一个农业村庄进行的横断面研究 Kovai 医疗中心和医院-纳尔兰帕蒂非传染性疾病研究-I（KMCH-NNCD-I，2015 年）中，对 865 名参与者进行了人体测量学测量、化学分析和颈动脉内膜中层厚度测定。通过电感耦合等离子体质谱分析测定尿金属水平，并校正至尿肌酐水平。进行统计分析以研究尿金属水平与临床参数之间的关系。
研究人群中有 82.5%的人从事农业，研究村庄使用的合成肥料中检测到高浓度的有毒金属。糖尿病前期、糖尿病和动脉粥样硬化的患病率分别为 43.4%、16.2%和 10.3%。在逻辑回归分析中，未观察到传统危险因素（如体重指数、血压和总胆固醇）与疾病状况之间的关联，但金属如砷、铬、铝和锌的尿水平与糖尿病有关，而砷和锌与糖尿病前期和动脉粥样硬化有关。
我们的数据表明，金属可能在农村社区糖尿病和心血管疾病的发病机制中起作用。确定和消除这些环境化学物质水平升高的原因可能对农村人口的非传染性疾病负担产生有益影响。
