Lead exposure and physical frailty in patients with type 2 diabetes mellitus: cross-sectional results from the METAL study.

IF 3.7 3区医学 Q2 Medicine

Endocrine Pub Date : 2024-11-11 DOI:10.1007/s12020-024-04096-5

Bowei Yu, Ying Sun, Yuying Wang, Bin Wang, Kun Zhang, Yingli Lu, Ningjian Wang

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引用次数: 0

Abstract

Purpose: Chronic lead exposure continues to be a global environmental concern. Previous studies reported high levels of lead exposure in people with diabetes. Frailty is one of the vital comorbidities of type 2 diabetes mellitus (T2DM); however, researchers have not determined whether lead exposure is a risk factor for frailty in people with T2DM.

Methods: This cross-sectional study explored the association between blood lead levels and frailty in a Shanghai diabetic population cohort. Individuals who met ≥3 of 5 predefined criteria (weight loss, exhaustion, low physical activity, slow walking speed and low grip strength) were defined as frailty.

Results: A total of 884 participants with T2DM (50.6% men, mean age 70.6 ± 7.4 years) were included. Among them, 147 (16.6%) patients were frail, and the median (interquartile range) concentration of blood lead was 16.0 µg/L (12.0-23.0). Compared with the participants within the lowest quartile of serum lead, positive associations of the 2nd and 4th lead quartiles with frailty were observed (OR, 95% CI; 1.70 1.01-2.84 and 1.72 1.03-2.88, respectively) after adjusting for age, sex and body mass index (BMI). After further adjustment for drinking status, smoking status, diet, education, blood pressure, triglycerides and glycosylated hemoglobin, the associations of serum lead with frailty were still significant for the 4th and 2nd-4th quartiles of lead (1.71, 1.01-2.91 and 1.57, 1.02-2.41, respectively). In the subgroup analyses, we found positive associations of serum lead with frailty in elderly individuals (1.77, 1.13-2.79), those with obesity (2.14, 1.02-4.51), those with unhealthy diets (2.52, 1.26-5.04), and those without hyperlipidemia (2.09, 1.12-3.88), although the interactions were not statistically significant (P for interaction all >0.05).

Conclusion: This work provides evidence of an association between chronic lead exposure and physical frailty in a diabetic population in a Chinese cohort. Future prospective and mechanistic studies are warranted to confirm our findings.

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铅暴露与 2 型糖尿病患者的身体虚弱：METAL 研究的横断面结果。

目的：慢性铅暴露仍然是一个全球环境问题。以往的研究报告显示，糖尿病患者的铅暴露水平较高。虚弱是 2 型糖尿病（T2DM）的重要合并症之一；然而，研究人员尚未确定铅暴露是否是导致 T2DM 患者虚弱的风险因素：这项横断面研究探讨了上海糖尿病人群中血铅水平与虚弱之间的关系。符合 5 项预定义标准（体重减轻、疲惫、体力活动少、行走速度慢和握力弱）中≥3 项标准的个体被定义为虚弱：共纳入 884 名 T2DM 患者（50.6% 为男性，平均年龄为 70.6 ± 7.4 岁）。其中，147 名（16.6%）患者体质虚弱，血铅浓度的中位数（四分位距）为 16.0 µg/L (12.0-23.0)。与血清铅含量处于最低四分位数的参与者相比，在调整年龄、性别和体重指数（BMI）后，铅含量处于第二和第四四分位数的参与者与体弱呈正相关（OR，95% CI；分别为 1.70 1.01-2.84 和 1.72 1.03-2.88）。在对饮酒状况、吸烟状况、饮食、教育程度、血压、甘油三酯和糖化血红蛋白进行进一步调整后，血清铅与虚弱的相关性在铅含量的第4和第2-4四分位数中仍然显著（分别为1.71，1.01-2.91和1.57，1.02-2.41）。在亚组分析中，我们发现老年人（1.77，1.13-2.79）、肥胖者（2.14，1.02-4.51）、饮食不健康者（2.52，1.26-5.04）和无高脂血症者（2.09，1.12-3.88）的血清铅与虚弱呈正相关，但交互作用无统计学意义（交互作用的 P 均大于 0.05）：这项研究为中国队列中糖尿病人群的慢性铅暴露与身体虚弱之间的关系提供了证据。今后有必要开展前瞻性和机理研究，以证实我们的发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.