Occupational metal exposures, smoking and risk of diabetes and prediabetes.
Occupational metal exposures, smoking and risk of diabetes and prediabetes.
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DOI：
10.1093/occmed/kqw078
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发表时间：
2017-04
期刊：
影响因子：
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通讯作者：
A. Yang;A. Yang;Ning Cheng;H. Pu;Simin Liu;Min Dai;Tongzhang Zheng;Yana Bai
中科院分区：
文献类型：
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作者：
A. Yang;A. Yang;Ning Cheng;H. Pu;Simin Liu;Min Dai;Tongzhang Zheng;Yana Bai
背景金属暴露和吸烟与糖尿病独立相关，但尚未进行研究来调查它们之间的相互作用对糖尿病风险的影响。目的 调查中国男性工人中职业接触金属以及吸烟对糖尿病和糖尿病前期风险的潜在影响。方法 我们评估了金昌队列男性工人的基线金属暴露和吸烟情况。我们使用泊松回归分析来估计吸烟与基于职业的金属暴露之间的相互作用，并根据测量的尿液金属水平进行分组。结果 在 26008 名研究对象中，与非吸烟者相比，吸烟量 > 40 包年的吸烟者的糖尿病调整后患病率 (PR) 为 1.8 [95% 置信区间 (CI) 1.3-2.4]。与上班族相比，调整后的采矿/生产工人的 PR 为 1.2 (95% CI 1.1-1.4)，冶炼/精炼工人的调整后 PR 为 2.7 (95% CI 2.4-3.0)。在累加模型下，吸烟和金属暴露对糖尿病患病率存在显着影响（Pinteraction = 0.001），对于那些吸烟年数超过 40 包、金属暴露量最高的人，调整后的 PR 为 3.6（95% CI 2.4-5.4），而对于糖尿病前期则没有观察到显着的相互作用。结论 在这一大群男性工人中，接触金属和大量吸烟都与糖尿病患病率增加有关。这两种暴露在影响糖尿病风险方面也存在很强的相互作用，这一点应在未来的研究中得到证实。
BACKGROUND Metal exposure and tobacco smoking have been independently associated with diabetes, but no study has been conducted to investigate the interaction between them on the risk of diabetes. AIMS To investigate the effect of occupational exposure to metals, and potential effect modification by smoking, on the risk of diabetes and prediabetes in a cohort of Chinese male workers. METHODS We assessed metal exposure and tobacco smoking at baseline in the Jinchang Cohort of male workers. We used Poisson regression analyses to estimate the interaction between smoking and metal exposures based on occupations, which we grouped according to the measured urinary metal levels. RESULTS Among the 26008 study subjects, compared with non-smokers, the adjusted prevalence ratio (PR) for diabetes was 1.8 [95% confidence interval (CI) 1.3-2.4] for smokers of >40 pack-years. The adjusted PRs were 1.2 (95% CI 1.1-1.4) among mining/production workers and 2.7 (95% CI 2.4-3.0) among smelting/refining workers, both compared with office workers. There was significant effect modification under the additive model between smoking and metal exposure on the prevalence of diabetes (Pinteraction = 0.001), with an adjusted PR of 3.6 (95% CI 2.4-5.4) for those with >40 pack-years of smoking who had the highest metal exposures, whereas no significant interaction was observed for prediabetes. CONCLUSIONS Both exposure to metals and heavy smoking were associated with an increased prevalence of diabetes in this large cohort of male workers. There was also strong interaction between these two exposures in affecting diabetes risk that should be confirmed in future studies.