College of Earth and Environmental Sciences, Lanzhou University, Lanzhou 730000, China.
Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong SAR, China.
Nutrients. 2022 Apr 8;14(8):1552. doi: 10.3390/nu14081552.
Growing evidence supports the associations of metal exposures with risk of type 2 diabetes (T2D), but the methodological limitations overlook the complexity of relationships within the metal mixtures. We identified and estimated the single and combined effects of urinary metals and their interactions with prevalence of T2D among 3078 participants in the NHANES 2011-2016. We analyzed 15 urinary metals and identified eight metals by elastic-net regression model for further analysis of the prevalence of T2D. Bayesian kernel machine regression and the weighted quantile sum (WQS) regression models identified four metals that had greater importance in T2D, namely cobalt (Co), tin (Sn), uranium (U) and strontium (Sr). The overall OR of T2D was 1.05 (95% CI: 1.01-1.08) for the positive effects and 1.00 (95% CI: 0.98-1.02) for the negative effect in the WQS models. We observed positive ( = 0.008 and = 0.100 for Co, = 0.011 and = 0.138 for Sn) and inverse ( = 0.001, = 0.209 for Sr) linear dose-response relationships with T2D by restricted cubic spline analysis. Both additive and multiplicative interactions were found in urinary Sn and Sr. In conclusion, urinary Co, Sn, U and Sr played important roles in the development of T2D. The levels of Sn might modify the effect of Sr on T2D risk.
越来越多的证据支持金属暴露与 2 型糖尿病（T2D）风险之间的关联，但方法学上的局限性忽略了金属混合物内部关系的复杂性。我们在 2011-2016 年 NHANES 中识别并估计了 3078 名参与者中尿液金属的单一和联合作用及其与 T2D 患病率的相互作用。我们分析了 15 种尿液金属，并通过弹性网回归模型确定了 8 种金属，以进一步分析 T2D 的患病率。贝叶斯核机器回归和加权分位数和（WQS）回归模型确定了在 T2D 中更为重要的四种金属，即钴（Co）、锡（Sn）、铀（U）和锶（Sr）。在 WQS 模型中，T2D 的总 OR 为 1.05（95%CI：1.01-1.08），正向效应为 1.00（95%CI：0.98-1.02），负向效应为 1.00（95%CI：0.98-1.02）。我们通过限制性立方样条分析观察到与 T2D 呈正相关（Co 为 0.008 和 0.100，Sn 为 0.011 和 0.138）和负相关（Sr 为 0.001，0.209）的线性剂量-反应关系。在尿 Sn 和 Sr 中均发现了加性和乘法相互作用。总之，尿 Co、Sn、U 和 Sr 在 T2D 的发展中起重要作用。Sn 的水平可能会改变 Sr 对 T2D 风险的影响。
