Association between Urinary 3-Phenoxybenzoic Acid Concentrations and Self-Reported Diabetes in Korean Adults: Korean National Environmental Health Survey (KoNEHS) Cycle 2~3 (2012~2017)

Y. Choi, K. Moon
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Abstract

Background: Pyrethroid insecticides account for more than 30% of the global insecticide market and are frequently used in agricultural settings and residential and public pest control among the general population. While several animal studies have suggested that exposure to pyrethroids can alter glucose homeostasis, there is only limited evidence of the association between environmental pyrethroid exposure and diabetes in humans. Objectives: This study aimed to report environmental 3-phenoxybenzoic acid (3-PBA) concentrations in urine and evaluate its association with the risk of diabetes in Korean adults. Methods: We analyzed data from the Korean National Environmental Health Survey (KoNEHS) Cycle 2 (2012~2014) and Cycle 3 (2015~2017). A total of 10,123 participants aged ≥19 years were included. Multiple logistic regressions were used to calculate the odds ratios (ORs) for diabetes according to log-transformed urinary 3-PBA levels. We also evaluated age, sex, education, monthly income, marital status, alcohol drinking, physical activity, urinary cotinine, body mass index, and sampling season as potential effect modifiers of these associations. Results: After adjusting for all the covariates, we found significant dose-response relationships between urinary 3-PBA as quartile and the prevalence of diabetes in pooled data of KoNEHS Cycles 2 and 3. In subgroup analyses, the adverse effects of pyrethroid exposure on diabetes were significantly stronger among those aged 19~39 years (p-interaction<0.001) and those who consumed high levels of cotinine (p-interaction= 0.020). Conclusions: Our findings highlight the potential diabetes risk of environmental exposure to pyrethroids and should be confirmed in large prospective studies in different populations in the future.
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韩国成人尿3-苯氧苯甲酸浓度与自述糖尿病的关系:韩国国家环境健康调查(KoNEHS)第2~3周期(2012~2017)
背景:拟除虫菊酯类杀虫剂占全球杀虫剂市场的30%以上,经常用于农业环境以及普通人群的住宅和公共虫害防治。虽然一些动物研究表明,接触拟除虫菊酯可以改变葡萄糖稳态,但只有有限的证据表明环境中接触拟除虫菊酯与人类糖尿病之间存在关联。目的:本研究旨在报道韩国成年人尿液中环境中的3-苯氧苯甲酸(3-PBA)浓度,并评估其与糖尿病风险的关系。方法:分析韩国国家环境卫生调查(KoNEHS)第2周期(2012~2014年)和第3周期(2015~2017年)的数据。共纳入10123名年龄≥19岁的受试者。根据尿3-PBA的对数转化水平,采用多元logistic回归计算糖尿病的优势比(ORs)。我们还评估了年龄、性别、教育程度、月收入、婚姻状况、饮酒、体育活动、尿可替宁、体重指数和采样季节作为这些关联的潜在影响调节因素。结果:在对所有协变量进行调整后,我们发现在koonehs周期2和3的汇总数据中,尿3- pba作为四分位数与糖尿病患病率之间存在显著的剂量-反应关系。在亚组分析中,拟除虫菊酯暴露对糖尿病的不良影响在19~39岁(p-相互作用<0.001)和摄入高水平可替宁(p-相互作用= 0.020)的人群中明显更强。结论:我们的研究结果强调了环境暴露于拟除虫菊酯的潜在糖尿病风险,未来应在不同人群的大型前瞻性研究中得到证实。
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