Singh Shefali, Verma Juhi, Gupta Nikhil, Pathak Anumesh K, Rajput Manish Singh, Tiwari Vandana, Kulshrestha Manish Raj
Department of Biotechnology, Dr. A P J Abdul Kalam Technical University, Uttar Pradesh, Lucknow, India.
Department of Biochemistry, Dr. Ram Manohar Lohia Institute of Medical Science, Uttar Pradesh, Lucknow, 226010, India.
Biol Trace Elem Res. 2025 Mar 25. doi: 10.1007/s12011-025-04574-5.
Environmental exposure to toxic metals/metalloids (TM) has been linked to type 2 diabetes mellitus (T2DM) via mechanisms involving insulin resistance and beta cell dysfunction, especially in regions with significant industrial and agricultural activities. This study assessed the relationship between serum toxic element levels and glycemic markers, including HbA1c, insulin resistance (HOMA-IR), and beta cell function (HOMA-β%). In total, 783 participants (480 T2DM patients and 303 controls) were recruited. TM (Ni, As, Al, Pb, Cd, and Hg) was quantified using inductively coupled plasma mass spectrometry. HbA1c was measured using ion exchange high-performance liquid chromatography, while fasting insulin and glucose levels were measured using a Cobas 6000 Roche autoanalyzer to calculate HOMA-IR and HOMA-β%. Among the tested TM, As (72.2%) and Ni (66.2%) were the most prevalent and associated with T2DM. On multivariate analysis, Ni and As levels were significantly positively correlated with HbA1c (Ni: β = 0.13, As: β = 0.16) and IR (Ni: β = 0.31, As: β = 0.24), and negatively correlated with β-cell function (Ni: β = -0.09, As: β = -0.19). A significant decline in beta cell function (Ni: Q1:55.96, Q4:34.27; As: Q1:58.61, Q4:27.88) and increased IR (Ni: Q1:2.75, Q4:3.97; As: Q1:2.77, Q4:3.76) was observed across exposure quartiles. Nonfiltered water consumption and smoking were associated with higher levels of Ni, As, and IR. The risk (adjusted odds ratio) of T2DM increased 2.18-fold and 6.81-fold with Ni and As exposure, respectively. The district with the highest exposure (Bahraich) to Ni (82%) and As (88%) had the highest prevalence (82%) of T2DM among the study population. Arsenic and nickel exposure are strongly associated with impaired glycemic markers in T2DM and correspond to drinking water in the Indo-Gangetic Plain. Smoking was also associated with high Ni and As levels.
环境暴露于有毒金属/类金属（TM）已通过涉及胰岛素抵抗和β细胞功能障碍的机制与2型糖尿病（T2DM）相关联，尤其是在工农业活动显著的地区。本研究评估了血清有毒元素水平与血糖标志物之间的关系，这些标志物包括糖化血红蛋白（HbA1c）、胰岛素抵抗（HOMA-IR）和β细胞功能（HOMA-β%）。总共招募了783名参与者（480名T2DM患者和303名对照）。使用电感耦合等离子体质谱法定量测定TM（镍、砷、铝、铅、镉和汞）。使用离子交换高效液相色谱法测量HbA1c，同时使用罗氏Cobas 6000自动分析仪测量空腹胰岛素和血糖水平以计算HOMA-IR和HOMA-β%。在检测的TM中，砷（72.2%）和镍（66.2%）最为普遍且与T2DM相关。多变量分析显示，镍和砷水平与HbA1c（镍：β = 0.13，砷：β = 0.16）和胰岛素抵抗（镍：β = 0.31，砷：β = 0.24）显著正相关，与β细胞功能（镍：β = -0.09，砷：β = -0.19）负相关。在各暴露四分位数中观察到β细胞功能显著下降（镍：第一四分位数：55.96，第四四分位数：34.27；砷：第一四分位数：58.61，第四四分位数：27.88）以及胰岛素抵抗增加（镍：第一四分位数：2.75，第四四分位数：3.97；砷：第一四分位数：2.77，第四四分位数：3.76）。饮用未过滤水和吸烟与镍、砷水平及胰岛素抵抗较高有关。镍和砷暴露使T2DM风险（调整后的优势比）分别增加2.18倍和6.81倍。在研究人群中，镍（82%）和砷（88%）暴露最高的地区（巴赖）T2DM患病率最高（82%）。砷和镍暴露与T2DM患者血糖标志物受损密切相关，且与印度-恒河平原的饮用水有关。吸烟也与高镍和高砷水平有关。
