Xiangya School of Medicine, Central South University, Changsha, Hunan, China.
Department of Management Science, School of Management, Fudan University, Shanghai, China.
Front Public Health. 2024 May 24;12:1401347. doi: 10.3389/fpubh.2024.1401347. eCollection 2024.
The rising prevalence of diabetes underscores the need for identifying effective prevention strategies. Recent research suggests environmental factors, particularly heavy metals like copper, significantly influence health outcomes, including diabetes, through mechanisms involving inflammation and oxidative stress. This study aims to explore how serum copper levels affect blood glucose, employing NHANES data from 2011 to 2016, to provide insights into environmental health's role in diabetes prevention and management.
The study analyzed data from 2,318 NHANES participants across three cycles (2011-2016), focusing on those with available data on serum copper, inflammatory markers, and blood glucose levels. We utilized principal component analysis for selecting inflammatory markers, mediation analysis to examine direct and indirect effects, multiple linear regression for assessing relationships between markers and glucose levels, and weighted quantile sum regression for evaluating individual and collective marker effects, adjusting for demographic variables and serum copper.
Participants averaged 42.70 years of age, with a near-even split between genders. Average serum copper was 119.50 μg/dL, white blood cell count 6.82 × 109/L, and fasting blood glucose 107.10 mg/dL. Analyses identified significant mediation by inflammatory markers (especially white blood cells: 39.78%) in the copper-blood glucose relationship. Regression analyses highlighted a positive correlation between white blood cells (estimate: 1.077, 95% CI: 0.432 to 2.490, = 0.013) and copper levels and a negative correlation for monocyte percentage (estimate: -1.573, 95% CI: 0.520 to -3.025, = 0.003). Neutrophil percentage was notably influential in glucose levels. Sensitive analyses confirmed the study's findings.
Serum copper levels significantly impact blood glucose through inflammatory marker mediation, highlighting the importance of considering environmental factors in diabetes management and prevention. These findings advocate for public health interventions and policies targeting environmental monitoring and heavy metal exposure reduction, emphasizing the potential of environmental health measures in combating diabetes incidence.
糖尿病患病率的上升突显出需要寻找有效的预防策略。最近的研究表明，环境因素，特别是铜等重金属，通过涉及炎症和氧化应激的机制，对健康结果产生重大影响，包括糖尿病。本研究旨在利用 2011 年至 2016 年的 NHANES 数据，探讨血清铜水平如何影响血糖，以深入了解环境健康在糖尿病预防和管理中的作用。
该研究分析了来自三个周期（2011-2016 年）的 2318 名 NHANES 参与者的数据，重点关注那些具有血清铜、炎症标志物和血糖水平可用数据的参与者。我们利用主成分分析选择炎症标志物，利用中介分析检验直接和间接效应，利用多元线性回归评估标志物与血糖水平之间的关系，利用加权分位数和回归评估个体和集体标志物的效应，同时调整了人口统计学变量和血清铜。
参与者的平均年龄为 42.70 岁，性别比例接近均等。平均血清铜为 119.50μg/dL，白细胞计数为 6.82×109/L，空腹血糖为 107.10mg/dL。分析发现，炎症标志物（尤其是白细胞：39.78%）在铜与血糖关系中存在显著的中介作用。回归分析突出了白细胞（估计值：1.077，95%置信区间：0.432 至 2.490， = 0.013）和铜水平之间的正相关，以及单核细胞百分比（估计值：-1.573，95%置信区间：0.520 至 -3.025， = 0.003）的负相关。中性粒细胞百分比对血糖水平有显著影响。敏感性分析证实了该研究的发现。
血清铜水平通过炎症标志物中介显著影响血糖，强调了在糖尿病管理和预防中考虑环境因素的重要性。这些发现主张采取公共卫生干预和政策，以针对环境监测和重金属暴露减少，强调环境健康措施在防治糖尿病发病率方面的潜力。
