非糖尿病成人中有机磷农药暴露与胰岛素抵抗的关联及交互作用研究

朱秀玲; 王正陆; 张艳孜; 李凯; 曾文倩; 郭冰

doi:10.12182/20260360103

非糖尿病成人中有机磷农药暴露与胰岛素抵抗的关联及交互作用研究

A Study of the Association and Interaction Between Organophosphorus Pesticide Exposure and Insulin Resistance in Non-diabetic Adults

摘要

摘要:
目的探究非糖尿病成人中有机磷农药多种代谢物与胰岛素抵抗的关联及交互作用。
方法基于2003–2018年美国国家健康和营养调查（National Health and Nutrition Examination Survey, NHANES），共计纳入3395名研究对象，经自然对数转换后，采用多元线性回归、限制性立方样条以及分位数加权和回归模型，分别评估尿液中有机磷农药代谢物与胰岛素抵抗的单独效应与混合暴露效应，重点探索甲基类代谢物与乙基类代谢物的交互作用。其中，胰岛素抵抗指标包括甘油三酯葡萄糖（triglyceride-glucose, TyG）指数、甘油三酯葡萄糖-体质量指数（triglyceride-glucose-body mass index, TyG-BMI）、甘油三酯葡萄糖-腰高比（triglyceride-glucose-waist-height ratio, TyG-WHtR）和甘油三酯葡萄糖-腰围（triglyceride-glucose-waist circumference, TyG-WC）。
结果在自然对数尺度下，除二甲基硫代磷酸酯（dimethyl thiophosphate, DMTP）外，其余各有机磷农药代谢物浓度与TyG-BMI均呈现正向关联且具有统计学意义（P<0.05），其中甲基类（∑DMAP）、乙基类（∑DEAP）、总暴露（∑DAP）的β值及95%置信区间（confidence interval, CI）分别为0.0041（95%CI：0.0005～0.0077）、0.0064（95%CI：0.0022～0.0105）、0.0060（95%CI：0.0018～0.0102）。上述关系大多呈线性（P_overall<0.05，P_{non-linearity}>0.05）。甲基类与乙基类代谢物可能存在协同作用，但该关系并不显著。有机磷农药代谢物混合暴露与TyG-BMI、TyG-WC、TyG-WHtR均存在正向关联，其中二乙基二硫代磷酸酯（diethyl dithiophosphate, DEDTP）权重在不同胰岛素抵抗指标下占比均超过50%。
结论有机磷农药的摄入可能会导致胰岛素抵抗评估指标上升，增加了胰岛素抵抗的风险，代谢物之间的交互作用可能进一步加剧这一效应。

Abstract:
Objective To explore the association and interaction between multiple organophosphorus pesticide metabolites and insulin resistance in non-diabetic adults.
Methods Based on data from the National Health and Nutrition Examination Survey (NHANES) conducted in the United States from 2003 to 2018, a total of 3395 research subjects were included. After natural logarithmic transformation, multiple linear regression, restricted cubic spline, and quantile-weighted regression models were used to separately evaluate the individual and combined exposure effects of urinary organophosphorus pesticide metabolites on insulin resistance. The analysis focused on exploring the interaction between methyl-type and ethyl-type metabolites. Indicators of insulin resistance included the triglyceride-glucose (TyG) index, triglyceride-glucose-body mass index (TyG-BMI), triglyceride-glucose-waist-to-height ratio (TyG-WHtR), and triglyceride-glucose-waist circumference (TyG-WC).
Results On the natural logarithmic scale, except for dimethylthiophosphate (DMTP), the concentrations of all other organophosphorus pesticide metabolites were positively correlated with TyG-BMI and reached statistical significance (P < 0.05). The β values and 95% CI for the methyl group (∑DMAP), ethyl group (∑DEAP), and total exposure (∑DAP) were 0.0041 (95% CI: 0.0005-0.0077), 0.0064 (95% CI: 0.0022-0.0105), and 0.0060 (95% CI: 0.0018-0.0102), respectively. Most of these relationships were linear (P_overall < 0.05, P_{non-linearity} > 0.05). There may be a synergistic effect between the methyl and ethyl group metabolites, but this relationship was not significant. Mixed exposure to organophosphorus pesticide metabolites was positively correlated with TyG-BMI, TyG-WC, and TyG-WHtR. The weight of diethyl dithiophosphate (DEDTP) accounted for more than 50% in different insulin resistance indicators.
Conclusion The intake of organophosphorus pesticides may increase indicators used to assess insulin resistance, raising the risk of insulin resistance. Interactions between metabolites may further worsen this effect.

HTML全文

参考文献(34)

施引文献

资源附件(1)