Tatsukawa Yoshimi, Sposto Richard, Yamada Michiko, Ohishi Waka, Imaizumi Misa, Hida Ayumi, Sakata Ritsu, Fujiwara Saeko, Nakanishi Shuhei, Ohno Haruya
Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima 732-0815, Japan.
Department of Statistics, Radiation Effects Research Foundation, Hiroshima 732-0815, Japan.
J Clin Endocrinol Metab. 2025 May 19;110(6):e1943-e1950. doi: 10.1210/clinem/dgae621.
In recent studies of childhood cancer survivors, diabetes has been considered a late effect associated with high therapeutic doses of radiation therapy. Our recent study of atomic bomb (A-bomb) survivors also suggested an association between radiation dose and diabetes incidence, with exposure city and age at exposure as radiation dose effect modifiers. Insulin resistance mediated by systemic inflammation and abnormal body composition has been suggested as a possible primary mechanism for the incidence of diabetes after total body irradiation; however, no studies have examined low to moderate radiation exposure (<4 Gy) and insulin resistance in A-bomb survivors.
To examine the association between radiation dose and markers of inflammation and insulin resistance.
This study investigated 3152 survivors who underwent a health examination between 2008 and 2012 and who were younger than 15 years at exposure. Multivariate linear regression analyses were used to evaluate the radiation effects on levels of markers of inflammation and insulin resistance.
Radiation dose was significantly and positively associated with levels of C-reactive protein, triglycerides, homeostasis model assessment of β-cell function (HOMA-β), and HOMA of insulin resistance (HOMA-IR) after adjustment for relevant covariates including sex, city, and age at exposure. Adiponectin and high-density lipoprotein cholesterol levels were also associated significantly and negatively with radiation dose. However, city was not a dose modifier of the radiation response on these markers of inflammation and insulin resistance.
Insulin resistance might be a possible factor in radiation-related diabetes incidence in A-bomb survivors.
在近期针对儿童癌症幸存者的研究中，糖尿病被视为与高剂量放射治疗相关的晚期效应。我们近期对原子弹幸存者的研究也表明，辐射剂量与糖尿病发病率之间存在关联，暴露城市和暴露时的年龄可作为辐射剂量效应修饰因素。全身照射后糖尿病发病的一种可能主要机制是由全身炎症和异常身体组成介导的胰岛素抵抗；然而，尚无研究探讨低至中等辐射暴露（<4戈瑞）与原子弹幸存者胰岛素抵抗之间的关系。
研究辐射剂量与炎症标志物及胰岛素抵抗之间的关联。
本研究调查了2008年至2012年间接受健康检查且暴露时年龄小于15岁的3152名幸存者。采用多变量线性回归分析评估辐射对炎症标志物和胰岛素抵抗水平的影响。
在对包括性别、城市和暴露时年龄等相关协变量进行调整后，辐射剂量与C反应蛋白、甘油三酯、β细胞功能稳态模型评估（HOMA-β）以及胰岛素抵抗稳态模型评估（HOMA-IR）水平呈显著正相关。脂联素和高密度脂蛋白胆固醇水平也与辐射剂量呈显著负相关。然而，城市并非这些炎症和胰岛素抵抗标志物辐射反应的剂量修饰因素。
胰岛素抵抗可能是原子弹幸存者辐射相关糖尿病发病的一个潜在因素。
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