School of Public Health, University of Illinois at Chicago, Chicago, IL.
College of Medicine, University of Illinois at Chicago, Chicago, IL.
Diabetes Care. 2024 Nov 1;47(11):1908-1915. doi: 10.2337/dc24-0646.
Metal and metalloid exposures (hereafter "metals") are associated with adverse health outcomes, including type 2 diabetes; however, previous studies were largely cross-sectional or underpowered. Furthermore, underserved racial and ethnic groups are underrepresented in environmental health research despite having higher rates of type 2 diabetes and a greater risk of metal exposures. Consequently, we evaluated continuous glycemic traits in relation to baseline urinary toxic metal, essential metal, and metal mixtures in a cohort of Mexican American adults.
A total of 510 participants were selected based upon self-reported diabetes status and followed over 3 years. Urinary metals were assessed at baseline. Linear mixed-effects models were used to estimate per-month changes in hemoglobin A1c, fasting plasma glucose, and postload glucose in relation to urinary metal levels. Multiple statistical approaches were used to assess the associations between glycemic traits and metal mixtures.
After adjustment, higher urinary levels of arsenic, selenium, copper, molybdenum, nickel, and tin were associated with faster increases in measures of glycemia. The toxic metal mixture composed of arsenic, lead, cadmium, nickel, and tin was associated with faster increases in postload glucose. Using postload glucose criteria, highest versus lowest arsenic was predicted to accelerate conversion of normoglycemia to prediabetes and diabetes by 23 and 65 months, respectively.
In this underrepresented, high-risk Mexican American population, exposure to toxic metals and alterations in essential metal homeostasis were associated with faster increases in glycemia over time that may accelerate type 2 diabetes development.
金属和类金属暴露（以下简称“金属”）与包括 2 型糖尿病在内的不良健康结果有关；然而，以前的研究大多是横断面研究或研究力度不足。此外，在环境健康研究中，服务不足的种族和族裔群体代表性不足，尽管他们 2 型糖尿病的发病率更高，而且金属暴露的风险更大。因此，我们评估了墨西哥裔美国成年人队列中基线尿中毒金属、必需金属和金属混合物与连续血糖特征之间的关系。
根据自我报告的糖尿病状况，共选择了 510 名参与者进行随访，随访时间超过 3 年。基线时评估尿液中的金属含量。线性混合效应模型用于估计血红蛋白 A1c、空腹血浆葡萄糖和负荷后血糖与尿金属水平相关的每月变化。采用多种统计方法评估血糖特征与金属混合物之间的关联。
调整后，较高的尿砷、硒、铜、钼、镍和锡水平与血糖指标的更快增加有关。由砷、铅、镉、镍和锡组成的有毒金属混合物与负荷后血糖的更快增加有关。使用负荷后血糖标准，最高砷与最低砷相比，分别预测将正常血糖值加速转化为糖尿病前期和糖尿病的时间提前 23 个月和 65 个月。
在这个代表性不足、高危的墨西哥裔美国人群中，有毒金属暴露和必需金属内稳态的改变与血糖随时间的更快增加有关，这可能加速 2 型糖尿病的发展。
