School of Public Health, Xinjiang Medical University, 567 Shangde North Road, Urumqi 830000, China.
Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
Nutrients. 2023 Mar 5;15(5):1290. doi: 10.3390/nu15051290.
Although previous studies have shown an association between clinically used antibiotics and type 2 diabetes, the relationship between antibiotic exposure from food and drinking water and type 2 diabetes in middle-aged and older adults is unclear.
This study was aimed at exploring the relationship between antibiotic exposures from different sources and type 2 diabetes in middle-aged and older people, through urinary antibiotic biomonitoring.
A total of 525 adults who were 45-75 years of age were recruited from Xinjiang in 2019. The total urinary concentrations of 18 antibiotics in five classes (tetracyclines, fluoroquinolones, macrolides, sulfonamides and chloramphenicol) commonly used in daily life were measured via isotope dilution ultraperformance liquid chromatography coupled with high-resolution quadrupole time-of-flight mass spectrometry. The antibiotics included four human antibiotics, four veterinary antibiotics and ten preferred veterinary antibiotics. The hazard quotient (HQ) of each antibiotic and the hazard index (HI) based on the mode of antibiotic use and effect endpoint classification were also calculated. Type 2 diabetes was defined on the basis of international levels.
The overall detection rate of the 18 antibiotics in middle-aged and older adults was 51.0%. The concentration, daily exposure dose, HQ, and HI were relatively high in participants with type 2 diabetes. After model adjustment for covariates, participants with HI > 1 for microbial effects ( = 3.442, 95%: 1.423-8.327), HI > 1 for preferred veterinary antibiotic use ( = 3.348, 95%: 1.386-8.083), HQ > 1 for norfloxacin ( = 10.511, 96%: 1.571-70.344) and HQ > 1 for ciprofloxacin ( = 6.565, 95%: 1.676-25.715) had a higher risk of developing type 2 diabetes mellitus.
Certain antibiotic exposures, mainly those from sources associated with food and drinking water, generate health risks and are associated with type 2 diabetes in middle-aged and older adults. Because of this study's cross-sectional design, additional prospective studies and experimental studies are needed to validate these findings.
尽管先前的研究表明，临床使用的抗生素与 2 型糖尿病之间存在关联，但食物和饮用水中抗生素暴露与中老年人 2 型糖尿病之间的关系尚不清楚。
本研究旨在通过尿抗生素生物监测，探讨不同来源的抗生素暴露与中老年人 2 型糖尿病之间的关系。
2019 年，从新疆招募了 525 名年龄在 45-75 岁的成年人。采用同位素稀释超高效液相色谱-高分辨四极杆飞行时间质谱法测定了五类（四环素类、氟喹诺酮类、大环内酯类、磺胺类和氯霉素）日常生活中常用的 18 种抗生素的总尿浓度。抗生素包括四种人用抗生素、四种兽用抗生素和十种首选兽用抗生素。还计算了基于抗生素使用模式和效应终点分类的每种抗生素的危害商（HQ）和危害指数（HI）。2 型糖尿病的定义基于国际标准。
中老年人群中 18 种抗生素的总检出率为 51.0%。患有 2 型糖尿病的患者中，抗生素的浓度、日暴露剂量、HQ 和 HI 相对较高。调整协变量后，微生物效应 HI > 1（ = 3.442，95%CI：1.423-8.327）、首选兽用抗生素使用 HI > 1（ = 3.348，95%CI：1.386-8.083）、诺氟沙星 HQ > 1（ = 10.511，96%CI：1.571-70.344）和环丙沙星 HQ > 1（ = 6.565，95%CI：1.676-25.715）的参与者发生 2 型糖尿病的风险更高。
某些抗生素暴露，主要是与食物和饮用水相关的来源，会产生健康风险，并与中老年人 2 型糖尿病有关。由于本研究为横断面设计，需要进一步的前瞻性研究和实验研究来验证这些发现。
