Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, PR China.
Internal Medicine, AMITA Health Saint Joseph Hospital Chicago, 2900 N. Lake Shore Drive, Chicago, IL, 60657, USA.
Chemosphere. 2022 Aug;301:134471. doi: 10.1016/j.chemosphere.2022.134471. Epub 2022 Mar 31.
Organophosphorus pesticides (OPPs) are commonly used pesticides across the world, however there is little epidemiological evidence linking their exposure to diabetes. Hence, this study aimed at investigating the effect of OPP exposure on the prevalence of diabetes in American adults.
Adults (≥20 years old) were eligible for this study from the National Health and Nutrition Examination Survey (NHANES). Multivariate logistic regression model was employed to explore the associations of six main urinary OPPs metabolites with diabetes. Subgroup analyses were performed by age and gender. Combined effect of OPPs metabolites on the overall association with diabetes was evaluated by weighted quantile sum regression (WQS). Furthermore, Bayesian kernel machine regression (BKMR) model was implemented to explore joint effect of multiple OPPs metabolites on diabetes.
Ultimately, 6,593 adults were included in our analysis. Of them, 1,044 participants were determined as diabetes patients. The results of logistic regression shown that urinary OPPs metabolites concentrations, whether taken as continuous variables or quantiles, were in positive correlation with diabetes. Notably, the p for trend of diethylphosphate (DEP), a kind of OPPs metabolites, was less than 0.05 indicated that a linear trend may exist between levels of DEP and prevalence of diabetes among adults while this trend was not obversed in other OPPs metabolites. In the WQS model, combined exposure of OPPs metabolites had a significantly positive association with diabetes (OR: 1.057; 95% CI: 1.002, 1.114) and diethylphosphate (36.84%) made the largest contributor to the WQS index. The result of BKMR also suggested a positive trend of association between mixed OPPs metabolites and diabetes.
Our results add credibility to the argument that OPP exposure might trigger diabetes. Certainly, prospective data are required to corroborate our findings.
有机磷农药（OPPs）是世界范围内广泛使用的农药，但目前很少有流行病学证据表明其暴露与糖尿病有关。因此，本研究旨在调查 OPP 暴露对美国成年人糖尿病患病率的影响。
本研究从国家健康和营养调查（NHANES）中选取了符合条件的成年人（≥20 岁）。采用多变量逻辑回归模型探讨了六种主要尿中 OPP 代谢物与糖尿病的关系。按年龄和性别进行亚组分析。采用加权分位数和回归（WQS）评估 OPP 代谢物对糖尿病总体关联的综合效应。此外，还实施了贝叶斯核机器回归（BKMR）模型来探索多种 OPP 代谢物对糖尿病的联合作用。
最终纳入了 6593 名成年人进行分析。其中，1044 名参与者被确诊为糖尿病患者。逻辑回归结果表明，尿中 OPP 代谢物浓度无论是作为连续变量还是分位数，均与糖尿病呈正相关。值得注意的是，二乙基磷酸酯（DEP）一种 OPP 代谢物的趋势检验 p 值小于 0.05，表明 DEP 水平与成年人糖尿病患病率之间可能存在线性趋势，但在其他 OPP 代谢物中未观察到这种趋势。在 WQS 模型中，OPPs 代谢物的联合暴露与糖尿病有显著的正相关（OR：1.057；95%CI：1.002，1.114），二乙基磷酸酯（36.84%）对 WQS 指数的贡献最大。BKMR 的结果也表明，混合 OPPs 代谢物与糖尿病之间存在正相关趋势。
我们的研究结果为 OPP 暴露可能引发糖尿病这一观点提供了可信度。当然，需要前瞻性数据来证实我们的发现。
