宁夏农村居民不同血糖水平与血清矿物元素的关系

The relationship between blood glucose levels and serum mineral elements of rural residents in Ningxia

目的 比较不同血糖水平下血清中14种矿物质元素含量及血清矿物质元素与血糖水平之间的关系。方法 采用分层整群抽样方法在宁夏4个村中共调查3 391人进行体格检查,采集血液样本1 612例进行血液生化指标的测定,采用电感耦合等离子体发射光谱法（inductively coupled plasma emission spectrometry,ICP-AES）测定1 493例血清中14种矿物质元素的含量。结果 血清Cr表现为正常空腹血糖（normal fasting glucose,NFG）组（6.35±2.75）μg/ml显著高于糖尿病（diabetes mellitus,DM）组（5.47±2.09）μg/ml,Sr为空腹血糖受损（impaired fasting glucose,IFG）1组（0.13±0.04）μg/ml高于NFG组（0.11±0.05）μg/ml。Cu含量为NFG组（0.99±2.14）μg/ml低于IFG1组（1.00±2.24）μg/ml、IFG 2组（1.03±2.06）μg/ml和DM组（1.07±2.48）μg/ml三组,DM组高于IFG2组。Ga含量为DM组（0.16±0.08）μg/ml高于NFG组（0.12±0.08）μg/ml、IFG1组（0.13±0.08）μg/ml和IFG2组（0.13±0.08）μg/ml三组。Cu（r=0.083,P=0.017）和Ga（r=0.081,P=0.019）与血糖呈正相关,Cr（r=-0.074,P=0.032）与血糖呈负相关;Cu（r=0.098,P=0.005）和Sr（r=0.087,P=0.012）与胰岛素抵抗指数呈正相关。Cu（OR=1.518,95%CI：1.072~2.151）和Ca（OR=1.618,95%CI：1.076~2.432）是血糖异常的危险因素,且Ca位于最高浓度时,血糖异常的风险最高;Sr（OR=0.800,95%CI：0.678~0.944）是其保护因素。结论 血清铜、镓、铬与血糖水平密切相关,并且铜、锶和钙是血糖异常的独立影响因素。

Objective To compare the concentrations of 14 mineral elements in different blood glucose levels, and to analyse the relationship between serum mineral elements and the blood glucose. Methods A total of 3 391 persons from four villages in Ningxia were selected by the stratified cluster sampling method. A number of 1 612 blood samples were collected. Inductively coupled plasma emission spectrometry （ICP-AES） was used to determine the contents of 14 serum mineral elements in 1 493 subjects. Results The serum chromium in NFG（6. 35 ±2.75） μg/ml was significantly higher than that in DM （5.47 ±2.09） μg/ml and the serum strontium in IFG1 （0. 13 ±0. 04） was higher than that in NFG（0. 11 ±0.05 ） μg/ml. Serum copper in NFG （0. 99 ±2. 14） μg/ml was lower than IFG1 （ 1.00 ±2. 24 ） μg/ml, IFG2 （ 1.03 ± 2. 06） μg/ml and DM（ 1.07 ±2. 48）μg/ml in the groups and serum copper in DM was higher than IFG2. Serum gallium in DM group（0. 16 ±0.08） μg/ml was higher than the three groups of NFG （0. 12 ±0.08） μg/ml, IFGI（0. 13 ±0.08） μg/ml and IFG2 （0. 13 ±0. 08） μg/ml. Partial correlation analysis showed that serum copper（r =0. 083, P =0. 017） and gallium （r = 0. 081, P = 0. 019） were positively correlated with blood sugar. While serum chromium （r = -0. 074, P = 0. 032） was negatively correlated with blood sugar; While serum copper（r =0. 098,P =0. 005） and strontium（r =0. 087, P = 0. 012） indexes were positively correlated with insulin resistance. Logistic regression analysis showed that Cu （OR = 1. 511% ,95% CI：I. 072-2. 151 ） and Ca（ OR = 1. 618,95% CI： 1. 076-2. 432） were risk factors for abnormal blood sugar, when Ca reached the highest concentration, the risk of abnormal blood sugar showed highest. As a contrast, Sr （ OR = 0. 800,95% CI：0. 678-0. 944） was the protective factor of abnormal blood sugar. Conclusions The serum copper, gallium and chromium are closely related to blood sugar levels. Copper, strontium and calcium are independent influencing factors of abnormal blood sugar.