Zhang Shiyang, Cheng Xu, Jia Chengyong, An Jun, Zhang Xin, Li Peiwen, Guan Youbing, Yan Yan, Zhao Zhuoya, Liu Yuenan, Jing Tao, He Meian
Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China.
Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China.
Ecotoxicol Environ Saf. 2023 Oct 15;265:115493. doi: 10.1016/j.ecoenv.2023.115493. Epub 2023 Sep 18.
Prospective epidemiological evidence was lacking on the association of phthalates (PAEs) exposure with incident type 2 diabetes mellitus (T2DM) risk. In present nested case-control study, we identified 1006 T2DM cases and matched 1006 controls based on Dongfeng-Tongji cohort study, and 6 PAEs were detected in baseline serum. The conditional logistic regression model, Bayesian kernel machine regression (BKMR) model and Quantile-based g-computation were applied to evaluate the associations of determined PAEs, either as individuals or as a mixture, with incident T2DM risk. Subgroup analysis was conducted to identify the potential sensitive population of PAEs effects on T2DM. After multiple adjustment, no statistically significant association was observed between single or mixture of PAEs and incident T2DM risk in the whole population. However, serum levels of Di-n-butyl phthalate (DnBP) [OR= 2.06; 95% CI: (1.11-3.96)], Σdibutyl phthalate (ΣDBP) [OR= 1.96; 95% CI: (1.06-3.76)], and Σlow-molecular- weight phthalate (ΣLMW) [OR= 2.27; 95% CI: (1.17-4.57)] were significantly associated with T2DM in current drinker group. Moreover, significant potential interactions were observed among Di-iso-butyl phthalate (DiBP), DnBP, Butyl-benzyl phthalate (BBP), ΣDBP, and ΣLMW with drinking status on T2DM risk (P for interaction = 0.036, 0.005, 0.049. 0.010, and 0.005). We did not find significant associations between serum PAEs levels and T2DM in the whole population. However, current alcohol drinkers expose to higher levels of DnBP, ΣDBP, and ΣLMW had higher risk of T2DM.
关于邻苯二甲酸酯（PAEs）暴露与2型糖尿病（T2DM）发病风险之间的关联，缺乏前瞻性流行病学证据。在本巢式病例对照研究中，我们基于东风-同济队列研究确定了1006例T2DM病例，并匹配了1006例对照，且在基线血清中检测到6种PAEs。应用条件逻辑回归模型、贝叶斯核机器回归（BKMR）模型和基于分位数的g计算法来评估所测定的PAEs作为个体或混合物与T2DM发病风险之间的关联。进行亚组分析以确定PAEs对T2DM影响的潜在敏感人群。经过多重调整后，在整个人群中未观察到PAEs单一物质或混合物与T2DM发病风险之间存在统计学显著关联。然而，在当前饮酒人群中，邻苯二甲酸二丁酯（DnBP）[比值比（OR）=2.06；95%置信区间（CI）：（1.11 - 3.96）]、邻苯二甲酸二丁酯总和（ΣDBP）[OR = 1.96；95% CI：（1.06 - 3.76）]以及低分子量邻苯二甲酸酯总和（ΣLMW）[OR = 2.27；95% CI：（1.17 - 4.57）]与T2DM显著相关。此外，观察到邻苯二甲酸二异丁酯（DiBP）、DnBP、邻苯二甲酸丁苄酯（BBP）、ΣDBP和ΣLMW与饮酒状态在T2DM风险上存在显著的潜在交互作用（交互作用P值分别为0.036、0.005、0.049、0.010和0.005）。我们在整个人群中未发现血清PAEs水平与T2DM之间存在显著关联。然而，当前饮酒者中暴露于较高水平DnBP、ΣDBP和ΣLMW的人群患T2DM的风险更高。
