Diabetes Care：邻苯二甲酸盐可致糖尿病风险提高

近日，乌普萨拉大学的研究人员在《糖尿病护理》杂志上发表论文称：化妆品和塑料中的邻苯二甲酸盐和与老年人患糖尿病的风险之间有关联。即使血液循环中邻苯二甲酸盐含量适度增加的话，患糖尿病的风险也会增加一倍。

乌普萨拉大学环境医学职业与环境医学科副教授Monica Lind表示：虽然我们的研究结果还需要进行更多的研究证实，但这项研究结果至少证实某些情况下，化学物质可以促进糖尿病的发展。

乌普萨拉大学的医学教授与Lars Lind合作，Monica Lind分析了PIVUS研究数据，PIVUS研究有超过1,000名乌普萨拉70岁妇女和男子参与。

研究人员检查了参与者空腹血糖和各种胰岛素测量。从血液样本中分析各种环境中的毒素，包括邻苯二甲酸盐对上述指标的影响。大多数人每天都接触邻苯二甲酸盐，因为它可用作农药载体、驱虫剂、化妆品、香味品、润滑剂和去污剂的生产原料，其中用量最大的是塑料增塑剂，约占80％。

正如预期的那样，糖尿病在那些超重、高血脂的参与者中更常见。但研究人员还发现邻苯二甲酸盐的血药浓度与糖尿病患病率增加之间的关系。比那些水平较低较低的人，邻苯二甲酸盐含量升高的人患糖尿病的风险增高了两倍。

Monica Lind表示：然而，为了找出邻苯二甲酸盐是否真正的是糖尿病的危险因素还需要进一步的研究。到目前为止，除了目前的这项研究外，只有一项研究针对墨西哥妇女开展的相关研究，还需要动物和细胞实验研究阐述邻苯二甲酸盐增加患糖尿病风险的有关生物机制。（生物谷：Bioon.com）

doi:10.2337/dc11-2396
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Circulating Levels of Phthalate Metabolites Are Associated With Prevalent Diabetes in the Elderly

P. Monica Lind, PHD, Bjrn Zethelius, MD, PHD and Lars Lind, MD, PHD

OBJECTIVE Phthalates are ubiquitous industrial high-volume chemicals known as ligands to peroxisome proliferator–activated receptors (PPARs). Because PPAR-γ agonists modulate insulin sensitivity and are used to treat type 2 diabetes, we investigated whether circulating levels of phthalate metabolites are related to prevalent type 2 diabetes.

RESEARCH DESIGN AND METHODS A total of 1,016 subjects, aged 70 years, were investigated in the Prospective Investigation of the Vasculature in Uppsala Seniors Study. Four phthalate metabolites were detected in almost all participant sera by an API 4000 liquid chromatograph/tandem mass spectrometer. Type 2 diabetes was defined as the use of pharmacological hypoglycemic agents or a fasting plasma glucose >7.0 mmol/L.

RESULTS A total of 114 subjects were shown to have diabetes. Following adjustment for sex, BMI, serum cholesterol and triglycerides, educational level, and smoking and exercise habits, high levels of the phthalate metabolites monomethyl phthalate (MMP) (P < 0.01), monoisobutyl phthalate (MiBP) (P < 0.05), and monoethyl phthalate (MEP) (P < 0.05), but not mono(2-ethylhexyl) phthalate, were associated with an increased prevalence of diabetes. Using the fasting proinsulin–to–insulin ratio as a marker of insulin secretion and the homeostasis model assessment-insulin resistance index as a marker of insulin resistance, MiBP was mainly related to poor insulin secretion, whereas MEP and MMP mainly were related to insulin resistance.

CONCLUSIONS The findings in this cross-sectional study showed that several phthalate metabolites are related to diabetes prevalence, as well as to markers of insulin secretion and resistance. These findings support the view that these commonly used chemicals might influence major factors that are regulating glucose metabolism in humans at the level of exposure of phthalate metabolites seen in the general elderly population.