山东省某市老年人血浆金属浓度与空腹血糖的相关性分析

Correlation between plasma metal concentrations and fasting blood glucose levels in urban elderly in a city of Shandong province,China

目的探讨山东省淄博市某市区60岁及以上老年人血浆多金属浓度与空腹血糖浓度的关系。方法以2020年8月至2021年6月在山东省淄博市某市区进行体检的1523名60岁及以上老年人为研究对象,通过问卷调查获得调查对象的人口学特征、生活方式及健康状况等信息,使用全自动生化分析仪测量空腹血糖。使用电感耦合等离子体质谱法检测血浆中钙、镁和锌等22种金属的浓度。根据血浆金属浓度三分位数将研究对象分为低、中、高浓度3组(T1、T2和T3),采用单一金属线性回归模型、多种金属线性回归模型和贝叶斯核机器回归模型(Bayesian kernel machine regression,BKMR)分析老年人血浆多金属浓度与空腹血糖浓度的相关性。结果1523名研究对象年龄中位数为70岁,其中男性678(44.52%)人,女性845(55.48%)人,老年人空腹血糖浓度中位数为5.98 mmol/L。多金属线性回归分析显示:和T1组相比,T3组血浆钙、铜、铷、铬与空腹血糖浓度呈正向关联,β(95%CI)分别为0.32(0.02,0.61)、0.29(0.03,0.54)、0.42(0.16,0.69)、0.34(0.04,0.63);T3组血浆镁、砷与空腹血糖浓度呈负向关联,β(95%CI)分别为:-0.90(-1.16,-0.64)、-0.24(-0.46,-0.02)。BK-MR分析显示,血浆22种金属及11种必需金属复合高浓度时与老年人空腹血糖浓度呈正相关趋势,11种非必需金属复合浓度与老年人空腹血糖浓度呈正相关趋势。结论本研究发现山东省淄博市老年人血浆镁浓度与空腹血糖浓度呈负向关联趋势,血浆铜、铷浓度与其呈正向关联趋势,血浆金属复合高浓度时与空腹血糖浓度呈正相关趋势,其中钙、镁、铜、铷、铬、砷起独立作用。本研究可为血糖控制和糖尿病的预防提供参考依据。

Objective To investigate the relationship between plasma polymetallic concentrations and fasting blood glucose levels in elderly aged≥60 years in an urban area of Zibo,Shandong province,China.Methods A total of 1523 elderly aged≥60 years who underwent physical examination in urban Zibo,Shandong province from August 2020 to June 2021,were selected to collect their information on demographic characteristics,lifestyle,and health status by questionnaire survey,and their fasting blood glucose levels were measured by automated blood biochemistry analyzer.The concentrations of 22 metals including calcium,magnesium,and zinc in plasma were determined by inductively coupled plasma mass spectrometry.Based on the tertiles of plasma metal concentrations,the participants were divided into three groups:low-concentration(T1),medium-concentration(T2),and high-concentration(T3).The relationship between plasma metal concentrations and fasting blood glucose levels in the elderly was analyzed through single-metal linear regression,multiple-metal linear regression,and Bayesian kernel machine regression(BKMR)models.Results The median age of the 1523 participants was 70 years,with 678(44.52%)males and 845(55.48%)females.The median fasting blood glucose con-centration in the elderly was 5.98 mmol/L.The multivariable linear regression analysis showed that,compared with the T1 group,the levels of calcium,copper,rubidium,and chromium in plasma were positively associated with fasting blood glucose levels in the T3 group,withβ(95%confidence interval(CI))being 0.32(0.02,0.61),0.29(0.03,0.54),0.42(0.16,0.69),and 0.34(0.04,0.63),respectively;plasma magnesium and arsenic concentrations were negatively associated with fasting blood glucose levels in the T3 group,withβ(95%CI)being-0.90(-1.16,-0.64)and-0.24(-0.46,-0.02),respectively.The BKMR analysis showed that the composite concentrations of 22 metals and 11 essential metals at high levels in plasma were positively associated with fasting blood glucose levels in the elderly,and the composite concentration of 11 nonessential metals was positively associated with fast-ing blood glucose levels in the elderly.Conclusion In this study,it was found that the plasma magnesium was negatively associated with fasting blood glucose concentration in the elderly in Zibo,while plasma copper and rubidium concentrations were positively associ-ated with fasting blood glucose concentration.The composite concentration of plasma metals was positively associated with fasting blood glucose concentration,in which calcium,magnesium,copper,rubidium,chromium,and arsenic played independent roles.This study provides a reference for blood glucose control and diabetes prevention.