职业接触镉对工人胰岛素水平的影响

The effects of cadmium on the levels of insulin in smelters

目的研究镉对职业暴露人群胰岛素和血糖水平的影响。方法以我国中南地区某冶炼厂98名镉作业工人为职业接触对象,同时选取该厂职工医院未接触镉的健康医生作为对照。按照研究对象镉接触工龄及血镉、尿镉分组,调查了不同接触工龄组及不同血镉、尿镉组工人血清胰岛素水平的变化,同时检测机体血锌、尿锌水平的改变,并就血镉、血锌及血胰岛素等水平之间的相关关系进行分析。结果接触工龄20-年组血糖水平[(4．9±0．6)mmol／L]明显高于对照组[(4．6±0．5) mmol／L],差异有统计学意义(P<0．01)。接触工龄10～年组血清胰岛素水平[(8．58±4．91)μIU/ml]明显低于对照组[(11．57±5．42)μIU/ml],差异有统计学意义(P<0．05);且随血镉、尿镉水平的增加,血清胰岛素水平明显降低。接触工龄20-年者尿锌水平明显增高。相关分析显示,胰岛素与血镉、尿镉呈明显的负相关关系,血糖与胰岛素、C肽水平之间呈正相关关系。结论职业接触镉可以导致血清胰岛素水平的降低,可能影响血糖水平。

Objective To investigate the effects of cadmium on the levels of insulin and blood glucose in exposed workers. Methods Ninety-eight cadmium-exposed workers in a smeltery in the mid-south district of our country were selected as the exposed subjects while the healthy doctors in the workers hospital who were not exposed to the cadmium were treated as the control. The subjects were grouped according to the exposure time, the blood cadmium and the urine cadmium. The variety of the level of serum insulin was investigated for the workers in different groups of the exposure time, the blood cadmium and the urine cadmium. The variety of the levels of the blood zinc and urine zinc were also determined. The relationships among the blood cadmium, the blood zinc and the serum insulin were analyzed. Results The level of blood glucose in the group of the exposure time of mere than 20 years [ （ 4.9 ± 0.6 ） mmol/L ] was signitlcanfly higher than that in the control group [ （4.6 ± 0.60） mmol/L ] with significantly statistical difference （ P 〈 0.01 ）. The level of serum insulin in the group of the exposure time of more than 10 years [ （8.58 ± 4.91）μIU/ml] was significantly lower than that in the control group [ （ 11.57 ± 5. 42）μIU] with the significantly statistical difference （P 〈 0.05） and the level of serum insulin would be decreased significantly with the increase of the blood cadmium and urinary cadmium. The level of the urine zinc was increased significantly in the workers of the exposure time of mere than 20 years. The correlation analysis indicated that the negative correlation was found between the level of serum insulin and the level of blood cadmium, as well as between the level of the serum insulin and the level of the urinary cadmium; the positive correlation was found between the level of blood glucose and the level of insulin, as well as between the level of blood glucose and the level of C peptide in serum. Conclusion The exposure to cadmium can cause the decrease of serum insulin and may affect the level of blood glucose.