氧化应激损伤在砷暴露与糖尿病之间的中介作用研究

The mediating effect of oxidative stress injury between arsenic exposure and diabetes mellitus

目的:探讨砷暴露、糖尿病患病和氧化应激损伤之间的关系。方法:选取218名在巴彦淖尔市杭锦后旗生活20年以上且无明确砷暴露史者为调查对象,按照居民尿砷含量分为低砷组73例(<13.55μg/g Cr),中砷组73例(13.56~36.24μg/g Cr),高砷组72例(>36.25μg/g Cr)。采集研究对象血、尿液,测定尿砷、血清中超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)和丙二醛(MDA)含量。将研究对象中的25例糖尿病患者纳入病例组;对照组例数采用倾向评分匹配法(PSM)按照1∶5的比例进行匹配,选择125例居民纳入对照组。采用趋势性检验比较尿砷浓度与糖尿病患病率之间的变化趋势;构建中介效应模型探讨氧化应激损伤在不同砷暴露水平与糖尿病患病之间的间接效应。结果:(1)高砷组糖尿病患病率(20.83%)高于中砷组糖尿病患病率(12.33%)和低砷组糖尿病患病率(1.37%),中砷组糖尿病患病率高于低砷组糖尿病患病率,差异具有统计学意义(P<0.05);尿砷水平与糖尿病患病率呈正相关(P<0.05);(2)GSH-Px活力、SOD和MDA在尿砷水平与糖尿病患病中起中介作用(P<0.05)。结论:砷暴露可能通过影响居民机体氧化应激机制从而导致了糖尿病的发生。

Objective:To explore the relationship between arsenic exposure,diabetes mellitus and oxidative stress injury.Methods:A total of 218 people who had lived in Hangjin Houqi,Bayannur City for more than 20 years and had no clear history of exposure to arsenic were selected as the investigation subjects.According to the urinary arsenic content of residents,they were divided into low arsenic group(73 residents,<13.55μg/g Cr)medium arsenic group(73 residents,13.56~36.24μg/g Cr),and high arsenic group(72 residents,>36.25μg/g Cr).The blood and urine of the subjects were collected,and the contents of superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)and malondialdehyde(MDA)in urine and serum were determined.Of 25 diabetic mellitus patients in the study were included in the case group.The number of cases in the control group was matched by propensity score matching(PSM)in a ratio of 1∶5,and 125 residents were selected as the control group.Trend test was used to compare the trend between urinary arsenic concentration and the prevalence of diabetes mellitus.A mediating effect model was constructed to explore the indirect effects of oxidative stress injury between different arsenic exposure levels and diabetes mellitus.Results:(1)The prevalence of diabetes mellitus in the high arsenic group(20.83%)was higher than that in the medium arsenic group(12.33%)and the low arsenic group(1.37%),while the prevalence of diabetes mellitus in the medium arsenic group was higher than that in the low arsenic group,and the difference was statistically significant(P<0.05).Urinary arsenic level was positively correlated with the prevalence of diabetes mellitus(P<0.05).(2)GSH-Px activity,SOD and MDA played mediating roles between urinary arsenic level and diabetes mellitus(P<0.05).Conclusion:Arsenic exposure may lead to the occurrence of diabetes mellitus by affecting the mechanism of oxidative stress in residents.