韩国普通人群血清中全氟烷基和多氟烷基浓度与糖尿病之间的关系:来自 2018-2020 年韩国全国环境健康调查的启示

IF 4.5 2区 医学 Q1 INFECTIOUS DISEASES International journal of hygiene and environmental health Pub Date : 2024-04-26 DOI:10.1016/j.ijheh.2024.114385
Habyeong Kang , Shin-Hye Kim
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引用次数: 0

摘要

目的最近的流行病学研究对全氟烷基和多氟烷基物质(PFAS)与糖尿病之间的关系进行了调查,但结果并不确定。在这项横断面研究中,我们旨在探讨韩国普通人群中血清 PFAS 浓度与糖尿病前期和诊断前糖尿病患病率之间的关系,以及暴露于混合 PFAS 化合物的综合影响。为尽量减少潜在偏倚,我们排除了已确诊患有糖尿病的个体。我们根据 HbA1c 水平≥6.5% 确定了诊断前糖尿病病例,并根据 HbA1c 水平 5.7-6.49% 确定了糖尿病前期病例。采用高效液相色谱-串联质谱法对血清中的全氟辛酸 (PFOA)、全氟壬酸 (PFNA)、全氟癸酸 (PFDeA)、全氟己烷磺酸 (PFHxS) 和全氟辛烷磺酸 (PFOS) 等 PFAS 浓度进行了定量分析。采用调查加权逻辑回归模型评估全氟辛烷磺酸水平与糖尿病风险之间的关系,并对协变量进行调整。此外,还使用贝叶斯核机器回归(BKMR)来研究暴露于混合 PFAS 化合物的综合影响。结果在不包括已确诊糖尿病的参与者(n = 2709)的研究人群中,诊断前糖尿病和糖尿病前期的患病率分别为 4.8% 和 30.1%。血清全氟己烷磺酸和全氟辛烷磺酸四分位数与诊断前糖尿病风险之间存在显著的正相关。同样,在未确诊或诊断前患有糖尿病的人(n = 2579)中,PFDeA、PFHxS 和 PFOS 的最高四分位数以及 PFAS 的总体水平与最低四分位数相比,与糖尿病前期风险增加有关。BKMR 分析表明,血清中全氟辛烷磺酸的总体水平与糖尿病前期风险之间存在显著的正相关,其中以全氟辛烷磺酸最为明显。要验证这些关联并确定潜在的机理途径,还需要进一步的研究。
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Associations between serum perfluoroalkyl and polyfluoroalkyl concentrations and diabetes mellitus in the Korean general population: Insights from the Korean National Environmental Health Survey 2018–2020

Aims

Recent epidemiologic research has examined the relationship between perfluoroalkyl and polyfluoroalkyl substances (PFAS) and diabetes mellitus with inconclusive findings. In this cross-sectional study, we aimed to explore the association between serum PFAS concentrations and the prevalence of prediabetes and pre-diagnostic diabetes in the general Korean population as well as the combined effects of exposure to mixed PFAS compounds.

Methods

We analyzed data from participants aged ≥19 years enrolled in the Korean National Environmental Health Survey Cycle 4 (2018–2020). Individuals diagnosed with diabetes were excluded to minimize potential bias. We identified cases of pre-diagnostic diabetes based on the HbA1c level ≥6.5% and prediabetes as HbA1c levels of 5.7–6.49%. Serum concentrations of PFAS, including perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDeA), perfluorohexane sulfonic acid (PFHxS), and perfluorooctane sulfonic acid (PFOS), were quantified using high-performance liquid chromatography-tandem mass spectrometry. Survey-weighted logistic regression models were used to assess the relationships between PFAS levels and diabetes risk, adjusting for covariates. Additionally, Bayesian kernel machine regression (BKMR) was used to investigate the combined effects of exposure to mixed PFAS compounds.

Results

In the study population excluding participants with diagnosed diabetes (n = 2709), the prevalence of pre-diagnostic diabetes and prediabetes was 4.8% and 30.1%, respectively. Significant positive associations were found between serum PFHxS and PFOS quartiles and pre-diagnostic diabetes risk. Likewise, among those without diagnosed or pre-diagnostic diabetes (n = 2579), the highest quartiles of PFDeA, PFHxS, and PFOS and the overall PFAS level were associated with an increased risk of prediabetes compared with the lowest quartiles. BKMR analysis revealed a significant positive association between overall serum PFAS level and prediabetes risk, which was most marked for PFOS.

Conclusions

These findings highlight the potential health implications of PFAS exposure and prediabetes risk. Further research is needed to validate these associations and identify potential mechanistic pathways.

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来源期刊
CiteScore
11.50
自引率
5.00%
发文量
151
审稿时长
22 days
期刊介绍: The International Journal of Hygiene and Environmental Health serves as a multidisciplinary forum for original reports on exposure assessment and the reactions to and consequences of human exposure to the biological, chemical, and physical environment. Research reports, short communications, reviews, scientific comments, technical notes, and editorials will be peer-reviewed before acceptance for publication. Priority will be given to articles on epidemiological aspects of environmental toxicology, health risk assessments, susceptible (sub) populations, sanitation and clean water, human biomonitoring, environmental medicine, and public health aspects of exposure-related outcomes.
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