Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, IBIMA, Málaga, Spain.
Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain.
Eur J Endocrinol. 2019 May 1;180(5):273-280. doi: 10.1530/EJE-18-0818.
Objective The activity of brown adipose tissue is sensitive to changes in ambient temperature. A lower exposure to cold could result in an increased risk of developing diabetes at population level, although this factor has not yet been sufficiently studied. Design We studied 5072 subjects, participants in a national, cross-sectional population-based study representative of the Spanish adult population (Di@bet.es study). All subjects underwent a clinical, demographic and lifestyle survey, a physical examination and blood sampling (75 g oral glucose tolerance test). Insulin resistance was estimated with the homeostasis model assessment (HOMA-IR). The mean annual temperature (°C) in each individual municipality was collected from the Spanish National Meteorology Agency. Results Linear regression analysis showed a significant positive association between mean annual temperature and fasting plasma glucose (β: 0.087, P < 0.001), 2 h plasma glucose (β: 0.049, P = 0.008) and HOMA-IR (β: 0.046, P = 0.008) in multivariate adjusted models. Logistic regression analyses controlled by multiple socio-demographic variables, lifestyle, adiposity (BMI) and geographical elevation showed increasing odds ratios for prediabetes (WHO 1999), ORs 1, 1.26 (0.95-1.66), 1.08 (0.81-1.44) and 1.37 (1.01-1.85) P for trend = 0.086, diabetes (WHO 1999) ORs 1, 1.05 (0.79-1.39), 1.20 (0.91-1.59) and 1.39 (1.02-1.90) P = 0.037, and insulin resistance (HOMA-IR ≥75th percentile of the non-diabetic population): ORs 1, 1.03 (0.82-1.30), 1.22 (0.96-1.55), 1.26 (0.98-1.63) (P for trend = 0.046) as the mean annual temperature (into quartiles) rose. Conclusions Our study reports an association between ambient temperature and the prevalence of dysglycemia and insulin resistance in Spanish adults, consistent with the hypothesis that a lower exposure to cold could be associated with a higher risk of metabolic derangements.
目的 棕色脂肪组织的活性对外界温度的变化很敏感。人群中较低的寒冷暴露可能会增加患糖尿病的风险，尽管这一因素尚未得到充分研究。 设计 我们研究了 5072 名受试者，他们是全国性、横断面、基于人群的西班牙成年人代表性研究（Di@bet.es 研究）的参与者。所有受试者都接受了临床、人口统计学和生活方式调查、体检和血液采样（75g 口服葡萄糖耐量试验）。胰岛素抵抗用稳态模型评估（HOMA-IR）来估计。从西班牙国家气象局收集了每个个体城市的平均年温度（℃）。 结果 线性回归分析显示，在多变量调整模型中，平均年温度与空腹血糖（β：0.087，P <0.001）、2 小时血糖（β：0.049，P =0.008）和 HOMA-IR（β：0.046，P =0.008）呈显著正相关。经过多个社会人口统计学变量、生活方式、肥胖（BMI）和地理位置海拔校正的逻辑回归分析显示，对于糖尿病前期（1999 年 WHO），ORs 1、1.26（0.95-1.66）、1.08（0.81-1.44）和 1.37（1.01-1.85），趋势 P =0.086；对于糖尿病（1999 年 WHO），ORs 1、1.05（0.79-1.39）、1.20（0.91-1.59）和 1.39（1.02-1.90），P =0.037；以及对于胰岛素抵抗（HOMA-IR≥非糖尿病人群第 75 百分位数），ORs 1、1.03（0.82-1.30）、1.22（0.96-1.55）、1.26（0.98-1.63），趋势 P =0.046，随着平均年温度（分为四等份）升高。 结论 我们的研究报告了环境温度与西班牙成年人糖代谢异常和胰岛素抵抗患病率之间的关联，这与低温暴露可能与代谢紊乱风险增加的假设一致。
