Article(id=1240633244211793927, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240633237542851387, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202311178, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1699459200000, receivedDateStr=2023-11-09, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773719615271, onlineDateStr=2026-03-17, pubDate=1716566400000, pubDateStr=2024-05-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773719615271, onlineIssueDateStr=2026-03-17, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773719615271, creator=13701087609, updateTime=1773719615271, updator=13701087609, issue=Issue{id=1240633237542851387, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='10', pageStart='1729', pageEnd='1920', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773719613680, creator=13701087609, updateTime=1773720039302, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240635022806405370, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240633237542851387, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240635022806405371, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240633237542851387, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1760, endPage=1765, ext={EN=ArticleExt(id=1240633246652878941, articleId=1240633244211793927, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Interaction between occupational noise exposure and type 2 diabetes risk-related genetic variations on prediabetes, columnId=1228016570660745413, journalTitle=Modern Preventive Medicine, columnName=Environmental and Occupational Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the effects of the interactions between type 2 diabetes risk-related genetic variations and occupational noise on prediabetes, and to provide the evidence for prevention of prediabetes in occupational populations.

Methods

A total of 991 workers in a tobacco plant were selected using a cluster sampling method. All subjects were classified into the control group (n=407) and exposure group (n=584) according to their noise exposure levels. The whole blood was collected for glycated hemoglobin (HbA1c) measurement and the iPLEX system was used for genotyping. The multivariable logistic regression model was used to explore the interactions of noise and type 2 diabetes risk-related genetic variations on prediabetes.

Results

A total of 143 cases of pre-diabetes were detected with a prevalence of 14.30%. With adjustment for age, gender, smoking, alcohol consumption and body mass index (BMI), the risk of prediabetes in noise-exposed workers was 1.535 times than that of non-noise-exposed workers. CDKAL1-rs2206734 TT and IGF2BP2-rs1470579 CC genotype carriers were the risk factors for prediabetes (all OR>1, all P<0.05), and there was an interaction between IGF2BP2-rs1470579 and occupational noise exposure based on multiplication models (P<0.05).

Conclusion

The CDKAL1-rs2206734 TT and IGF2BP2-rs1470579 CC genotype are susceptible genes for prediabetes, and they interact with occupational noise based on a multiplicative model.

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目的

探讨2型糖尿病相关的遗传变异与职业噪声接触的交互作用对糖尿病前期的影响,为糖尿病前期的预防提供依据。

方法

采用整群抽样方法,选择某卷烟厂991名作业人员为研究对象;按照其噪声接触水平分为对照组(407人)和噪声接触组(584人)。采集其全血检测糖化血红蛋白(Glycated hemoglobin, HbA1c)水平。采用 MassArray时间飞行质谱系统检测单核苷酸多态性 (Single nucleotide polymorphisms,SNPs)。采用多因素logistic回归模型分析2型糖尿病相关的遗传变异与噪声接触的交互作用对糖尿病前期的影响。

结果

共检出糖尿病前期143例,患病率为14.30%。调整年龄、性别、吸烟、饮酒和体质量指数(Body mass index,BMI)等混杂因素后,职业性噪声接触者患糖尿病前期的风险高于对照组(OR=1.535, 95%CI: 1.048~2.248, P<0.05)。CDKAL1-rs2206734 TT和IGF2BP2-rs1470579 CC携带者糖尿病前期风险分别高于CC和AA携带者(OR均>1, P均<0.05),且IGF2BP2-rs1470579和职业性噪声接触存在相乘交互作用(P<0.05)。

结论

CDKAL1-rs2206734 TT和IGF2BP2-rs1470579 CC是糖尿病前期的易感基因,且与噪声有基于相乘模型的交互作用。

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戴霞云,E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=X0GN/9eqjDzEdrx+zX0SbA==, magXml=06P+82HmJ19ChURb6RjfvQ==, pdfUrl=null, pdf=v7u3ZFC/4ZesvLjUaJeWRg==, pdfFileSize=485378, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=hh7hE6/i8xU2iVzn83c3iw==, mapNumber=null, authorCompany=null, fund=null, authors=

倪蕾(1973—),女,主任医师,硕士,研究方向:职业健康管理与职业流行病学

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Diabetic Medicine: a Journal of the British Diabetic Association, 2022, 39(8): e14885., articleTitle=Common single-nucleotide polymorphisms combined with a genetic risk score provide new insights regarding the etiology of gestational diabetes mellitus, refAbstract=null), Reference(id=1240633254940824119, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633244211793927, doi=null, pmid=null, pmcid=null, year=2024, volume=12, issue=1, pageStart=157, pageEnd=null, url=null, language=null, rfNumber=[14], rfOrder=14, authorNames=Cheng YF, Yang CY, Tsai MC, journalName=Biomedicines, refType=null, unstructuredReference=Cheng YF, Yang CY, Tsai MC. Shared genetics between age at menarche and type 2 diabetes mellitus: Genome-Wide genetic correlation study[J]. Biomedicines, 2024, 12(1): 157., articleTitle=Shared genetics between age at menarche and type 2 diabetes mellitus: Genome-Wide genetic correlation study, refAbstract=null), Reference(id=1240633255049876028, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633244211793927, doi=null, pmid=null, pmcid=null, year=2024, volume=23, issue=1, pageStart=56, pageEnd=null, url=null, language=null, rfNumber=[15], rfOrder=15, authorNames=Sullivan SO’, Al hageh C, Henschel A, journalName=Lipids in Health and Disease, refType=null, unstructuredReference=Sullivan SO’, Al hageh C, Henschel A, et al. HDL levels modulate the impact of type 2 diabetes susceptibility alleles in older adults[J]. 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Genes, 2022, 13(4): 645., articleTitle=Gene-environment interaction on type 2 diabetes risk among Chinese adults born in early 1960s, refAbstract=null)], funds=[Fund(id=1240633251820261823, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633244211793927, awardId=81703203, language=CN, fundingSource=国家自然科学基金(81703203), fundOrder=null, country=null), Fund(id=1240633251950285251, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633244211793927, awardId=WG16B08, language=CN, fundingSource=武汉市卫生健康科研基金资助项目(WG16B08), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1240633247344939157, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633244211793927, xref=null, ext=[AuthorCompanyExt(id=1240633247416242328, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633244211793927, companyId=1240633247344939157, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan, Hubei 430015, China), AuthorCompanyExt(id=1240633247420436633, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633244211793927, companyId=1240633247344939157, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=武汉市职业病防治院,湖北 武汉 430015)])], figs=[ArticleFig(id=1240633251107230082, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633244211793927, language=EN, label=Table 1, caption=

Characteristics of the SNPs associated with type 2 diabetes in Asians identified by GWAS

, figureFileSmall=null, figureFileBig=null, tableContent=
SNPs等位基因A/a检出例数 (AA/Aa/aa)MAF检出率(%)PHWE
rs10906115A/G399/455/1220.3598.490.661
rs1436955C/T578/364/420.2399.290.103
rs1470579A/C541/391/590.26100.000.290
rs16861329C/T656/291/370.1899.290.506
rs17584499C/T804/177/70.1099.700.416
rs2028299A/C628/309/450.2099.090.378
rs2206734C/T361/485/1310.3898.590.110
rs2283228A/C371/477/1330.3798.990.297
rs231361G/A632/303/440.2098.790.321
rs391300C/T367/465/1330.3797.380.457
rs3923113A/C743/213/220.1398.690.152
rs7172432A/G371/485/1220.3798.690.058
rs4812829G/A329/341/2980.4797.68<0.001
rs7178572A/G411/471/880.3397.880.004
rs1802295C/T780/162/170.1096.770.014
rs1359790G/A750/131/330.1092.23<0.001
), ArticleFig(id=1240633251216282000, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633244211793927, language=CN, label=表1, caption=

GWAS在亚洲人群中发现的与2型糖尿病易感性相关的遗传变异的特征

, figureFileSmall=null, figureFileBig=null, tableContent=
SNPs等位基因A/a检出例数 (AA/Aa/aa)MAF检出率(%)PHWE
rs10906115A/G399/455/1220.3598.490.661
rs1436955C/T578/364/420.2399.290.103
rs1470579A/C541/391/590.26100.000.290
rs16861329C/T656/291/370.1899.290.506
rs17584499C/T804/177/70.1099.700.416
rs2028299A/C628/309/450.2099.090.378
rs2206734C/T361/485/1310.3898.590.110
rs2283228A/C371/477/1330.3798.990.297
rs231361G/A632/303/440.2098.790.321
rs391300C/T367/465/1330.3797.380.457
rs3923113A/C743/213/220.1398.690.152
rs7172432A/G371/485/1220.3798.690.058
rs4812829G/A329/341/2980.4797.68<0.001
rs7178572A/G411/471/880.3397.880.004
rs1802295C/T780/162/170.1096.770.014
rs1359790G/A750/131/330.1092.23<0.001
), ArticleFig(id=1240633251304362389, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633244211793927, language=EN, label=Table 2, caption=

Comparison of prevalence rates of prediabetesamong the subjects from a tobacco plant

, figureFileSmall=null, figureFileBig=null, tableContent=
项目调查人数糖尿病前期例数患病率(%)χ2P
性别3.6430.056
64410315.99
3474011.53
年龄(岁)36.667<0.001
<45601548.99
≥453908922.82
总工龄(年)24.957<0.001
<20544519.38
≥204479220.58
BMI/(kg/m223.737<0.001
<24566559.72
≥244258820.71
吸烟12.330<0.001
5636211.01
4288118.93
饮酒4.2860.038
7229413.02
2694918.22
职业性噪声接触2.9020.088
5847512.84
4076816.71
rs109061153.8220.148
AA3995814.54
AG4557316.04
GG122119.02
rs14369550.0220.989
CC5788314.36
CT3645114.01
TT42614.29
rs14705793.7810.151
AA5266612.55
AC3916416.37
CC571119.30
rs168613290.8810.644
CC6569113.87
CT2914415.12
TT37718.92
rs175844991.9980.368
CC80412115.05
CT1772212.43
TT700.71
rs20282992.7990.247
AA6288814.01
AC3094915.86
CC4536.67
rs22067346.8780.032
CC3614111.36
CT4857114.64
TT1312720.61
rs22832282.6550.265
AA3716216.71
AC4776213.00
CC1331712.78
rs2313610.0300.985
GG6329014.24
GA3034414.52
AA44613.64
rs3913001.6840.431
CC3675214.17
CT4657315.70
TT1331511.28
rs39231132.7960.247
AA74311415.34
AC2132310.80
CC22313.64
rs71724321.5640.458
AA3715414.56
AG4857315.05
GG1221310.66
), ArticleFig(id=1240633251421802909, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633244211793927, language=CN, label=表2, caption=

卷烟厂作业工人糖尿病前期患病率比较

, figureFileSmall=null, figureFileBig=null, tableContent=
项目调查人数糖尿病前期例数患病率(%)χ2P
性别3.6430.056
64410315.99
3474011.53
年龄(岁)36.667<0.001
<45601548.99
≥453908922.82
总工龄(年)24.957<0.001
<20544519.38
≥204479220.58
BMI/(kg/m223.737<0.001
<24566559.72
≥244258820.71
吸烟12.330<0.001
5636211.01
4288118.93
饮酒4.2860.038
7229413.02
2694918.22
职业性噪声接触2.9020.088
5847512.84
4076816.71
rs109061153.8220.148
AA3995814.54
AG4557316.04
GG122119.02
rs14369550.0220.989
CC5788314.36
CT3645114.01
TT42614.29
rs14705793.7810.151
AA5266612.55
AC3916416.37
CC571119.30
rs168613290.8810.644
CC6569113.87
CT2914415.12
TT37718.92
rs175844991.9980.368
CC80412115.05
CT1772212.43
TT700.71
rs20282992.7990.247
AA6288814.01
AC3094915.86
CC4536.67
rs22067346.8780.032
CC3614111.36
CT4857114.64
TT1312720.61
rs22832282.6550.265
AA3716216.71
AC4776213.00
CC1331712.78
rs2313610.0300.985
GG6329014.24
GA3034414.52
AA44613.64
rs3913001.6840.431
CC3675214.17
CT4657315.70
TT1331511.28
rs39231132.7960.247
AA74311415.34
AC2132310.80
CC22313.64
rs71724321.5640.458
AA3715414.56
AG4857315.05
GG1221310.66
), ArticleFig(id=1240633251564409257, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633244211793927, language=EN, label=Table 3, caption=

Multivariable logistic regression analysis of influencing factors for prediabetes

, figureFileSmall=null, figureFileBig=null, tableContent=
变量参照组βsxWald χ2POR(95%CI
年龄(岁)
≥45<450.0710.01140.133<0.0011.074(1.051~1.098)
BMI/(kg/m2
≥24<240.1940.03138.255<0.0011.214(1.142~1.292)
职业性噪声接触
0.4280.1954.8370.0281.535(1.048~2.248)
rs2206734
CTCC0.3550.2172.6830.1011.426(0.933~2.180)
TT0.8030.2857.9660.0052.233(1.278~3.901)
rs1470579
ACAA0.3080.1972.4420.1181.361(0.925~2.004)
CC0.7840.3574.8160.0282.190(1.087~4.411)
职业性噪声接触*rs14705790.6560.3074.5700.0331.928(1.056~3.518)
常量-9.9641.08284.758<0.0010.001
), ArticleFig(id=1240633251673461168, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633244211793927, language=CN, label=表3, caption=

糖尿病前期影响因素的多因素logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量参照组βsxWald χ2POR(95%CI
年龄(岁)
≥45<450.0710.01140.133<0.0011.074(1.051~1.098)
BMI/(kg/m2
≥24<240.1940.03138.255<0.0011.214(1.142~1.292)
职业性噪声接触
0.4280.1954.8370.0281.535(1.048~2.248)
rs2206734
CTCC0.3550.2172.6830.1011.426(0.933~2.180)
TT0.8030.2857.9660.0052.233(1.278~3.901)
rs1470579
ACAA0.3080.1972.4420.1181.361(0.925~2.004)
CC0.7840.3574.8160.0282.190(1.087~4.411)
职业性噪声接触*rs14705790.6560.3074.5700.0331.928(1.056~3.518)
常量-9.9641.08284.758<0.0010.001
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职业噪声与2型糖尿病相关的遗传变异对糖尿病前期的交互作用
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倪蕾 , 陈振龙 , 戴霞云
现代预防医学 | 环境与职业卫生 2024,51(10): 1760-1765
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现代预防医学 | 环境与职业卫生 2024, 51(10): 1760-1765
职业噪声与2型糖尿病相关的遗传变异对糖尿病前期的交互作用
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倪蕾, 陈振龙, 戴霞云
作者信息
  • 武汉市职业病防治院,湖北 武汉 430015
  • 倪蕾(1973—),女,主任医师,硕士,研究方向:职业健康管理与职业流行病学

通讯作者:

戴霞云,E-mail:
Interaction between occupational noise exposure and type 2 diabetes risk-related genetic variations on prediabetes
Lei NI, Zhen-long CHEN, Xia-yun DAI
Affiliations
  • Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan, Hubei 430015, China
出版时间: 2024-05-25 doi: 10.20043/j.cnki.MPM.202311178
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目的

探讨2型糖尿病相关的遗传变异与职业噪声接触的交互作用对糖尿病前期的影响,为糖尿病前期的预防提供依据。

方法

采用整群抽样方法,选择某卷烟厂991名作业人员为研究对象;按照其噪声接触水平分为对照组(407人)和噪声接触组(584人)。采集其全血检测糖化血红蛋白(Glycated hemoglobin, HbA1c)水平。采用 MassArray时间飞行质谱系统检测单核苷酸多态性 (Single nucleotide polymorphisms,SNPs)。采用多因素logistic回归模型分析2型糖尿病相关的遗传变异与噪声接触的交互作用对糖尿病前期的影响。

结果

共检出糖尿病前期143例,患病率为14.30%。调整年龄、性别、吸烟、饮酒和体质量指数(Body mass index,BMI)等混杂因素后,职业性噪声接触者患糖尿病前期的风险高于对照组(OR=1.535, 95%CI: 1.048~2.248, P<0.05)。CDKAL1-rs2206734 TT和IGF2BP2-rs1470579 CC携带者糖尿病前期风险分别高于CC和AA携带者(OR均>1, P均<0.05),且IGF2BP2-rs1470579和职业性噪声接触存在相乘交互作用(P<0.05)。

结论

CDKAL1-rs2206734 TT和IGF2BP2-rs1470579 CC是糖尿病前期的易感基因,且与噪声有基于相乘模型的交互作用。

职业噪声  /  遗传变异  /  交互作用  /  糖尿病前期
Objective

To investigate the effects of the interactions between type 2 diabetes risk-related genetic variations and occupational noise on prediabetes, and to provide the evidence for prevention of prediabetes in occupational populations.

Methods

A total of 991 workers in a tobacco plant were selected using a cluster sampling method. All subjects were classified into the control group (n=407) and exposure group (n=584) according to their noise exposure levels. The whole blood was collected for glycated hemoglobin (HbA1c) measurement and the iPLEX system was used for genotyping. The multivariable logistic regression model was used to explore the interactions of noise and type 2 diabetes risk-related genetic variations on prediabetes.

Results

A total of 143 cases of pre-diabetes were detected with a prevalence of 14.30%. With adjustment for age, gender, smoking, alcohol consumption and body mass index (BMI), the risk of prediabetes in noise-exposed workers was 1.535 times than that of non-noise-exposed workers. CDKAL1-rs2206734 TT and IGF2BP2-rs1470579 CC genotype carriers were the risk factors for prediabetes (all OR>1, all P<0.05), and there was an interaction between IGF2BP2-rs1470579 and occupational noise exposure based on multiplication models (P<0.05).

Conclusion

The CDKAL1-rs2206734 TT and IGF2BP2-rs1470579 CC genotype are susceptible genes for prediabetes, and they interact with occupational noise based on a multiplicative model.

Occupational noise  /  Genetic variations  /  Interaction  /  Prediabetes
倪蕾, 陈振龙, 戴霞云. 职业噪声与2型糖尿病相关的遗传变异对糖尿病前期的交互作用. 现代预防医学, 2024 , 51 (10) : 1760 -1765 . DOI: 10.20043/j.cnki.MPM.202311178
Lei NI, Zhen-long CHEN, Xia-yun DAI. Interaction between occupational noise exposure and type 2 diabetes risk-related genetic variations on prediabetes[J]. Modern Preventive Medicine, 2024 , 51 (10) : 1760 -1765 . DOI: 10.20043/j.cnki.MPM.202311178
糖尿病前期是一种介于糖代谢正常和糖尿病之间的中间状态,每年约有10%的糖尿病前期患者进展为糖尿病患者[1]。糖尿病前期主要表现为空腹血糖受损和糖耐量异常[2],受环境因素、遗传因素以及二者交互作用的影响。职业性噪声接触与空腹血糖和糖化血红蛋白(Glycated hemoglobin, HbA1c)升高有关[3-4]。遗传变异也是影响糖尿病前期的因素,全基因组关联性研究(Genome-wide association studies, GWAS)发现了与糖尿病前期易感性相关的基因[5],但与2型糖尿病易感性相关的遗传变异以及与噪声的交互作用对糖尿病前期的影响还有待进一步研究。由于HbA1c代表了过去2~3个月的平均血糖水平,以HbA1c升高定义的糖尿病前期可能有更加严重的空腹糖化受损和(或)糖耐量异常[1]。因此,本研究在职业性噪声接触人群中分析GWAS报道的2型糖尿病相关的单核苷酸多态性(Single nucleotide polymorphism, SNPs)及其与噪声的交互作用对以HbA1c升高定义的糖尿病前期的影响,为筛查易感人群,预防糖尿病的发生提供理论依据。
采用整群抽样,于2017年9月至10月以湖北省某卷烟厂991名作业工人为研究对象。纳入标准:(1)在该卷烟厂的工龄 ≥ 半年;(2)无罹患糖尿病、肿瘤、冠状动脉粥样硬化性心脏病、肾衰等重大疾病;(4)HbA1c≤6.4%;(5)血红蛋白水平 ≥ 60 g/L;(6)收集到足够量(>1ml)EDTA抗凝的静脉血,并进行了遗传变异的检测。所有研究对象均知情同意。本研究通过武汉市职业病防治院伦理委员会审核批准,批号为2016-WZF01。
采用本课题组自行设计的《职业健康问卷》对所有研究对象进行职业流行病学调查,调查内容主要包括基本情况、生活方式、职业史、疾病史等,具体详细内容和吸烟、饮酒以及体质指数(Body mass index,BMI)的定义见本课题组已经发表的论文[6]
采用QUEST Noisepro型个人声暴露计(美国3M公司)对研究对象所在的工作岗位进行定点检测,详细检测方法见本课题组已经发表的论文[6]。若研究对象工作环境中噪声强度>85.0 dB(A),则将其归为噪声接触组,否则归为对照组。
依据美国糖尿病学会的糖尿病医学诊疗标准,以HbA1c≥5.7%且HbA1c≤6.4%定义为糖尿病前期[2],HbA1c的检测方法详见本课题组已经发表的论文[6]
选择GWAS报道的与亚洲人群2型糖尿病易感性相关的SNPs,在中国汉族人群中的最小等位基因频率(Minor allele frequency,MAF)≥0.05,各SNPs之间的连锁不平衡程度r2<0.8。最终共有16个SNPs满足条件,见表1。采集研究对象肘静脉血2 ml于EDTA-K2抗凝的真空采血管中,颠倒混匀后,以离心半径22.8 cm、3 000 r/min离心2 min,取下层血细胞200 μl采用全自动核酸提取仪(天根生化科技(北京)有限公司)提取基因组DNA。采用 MassArray时间飞行质谱系统 (Sequenom,圣迭哥,美国)进行基因分型,整个实验过程和质量控制均由博淼生物科技(北京)有限公司完成。
采用统计学软件SPSS 26.0进行数据分析。计数资料率的比较采用Pearson χ2检验。Hardy-Weinberg遗传平衡(Hardy-Weinberg equilibrium,HWE)采用拟合优度的卡方检验。SNPs、噪声强度及二者交互作用与糖尿病前期的关联性分析采用多因素logistic回归分析模型。检验水准α = 0.05(双侧)。
调查991人,其中男性644人,占64.98%;女性347人,占35.02%。年龄为(39.89 ± 10.11)岁;工龄为(18.52±12.21)年。BMI为(23.69±3.20) kg/m2。吸烟428人,占43.19%。饮酒269人,占27.14%。职业性噪声接触407例,占41.07%。
检出糖尿病前期143例,患病率为14.30%。被检测的16个SNPs中,rs1359790检出率 < 95%;rs4812829、rs7178572和rs1802295不符合HWE(PHWE <0.05),未纳入分析。见表1
单因素分析结果显示,不同年龄、工龄、BMI、吸烟和饮酒、rs2206734分型的工人糖尿病前期的患病率比较,差异有统计学意义(P<0.05)。见表2
以糖尿病前期为因变量,以职业性噪声接触和SNPs为自变量进行二分类logistic回归分析。调整年龄、性别、吸烟、饮酒、BMI后,职业性噪声接触、rs2206734 TT和rs1470579 CC携带者是糖尿病前期的危险因素(OR均>1,P均<0.05);且rs1470579和职业性噪声接触存在相乘交互作用(P<0.05),见表3
糖尿病前期是糖尿病发病前的亚临床症状,不仅是糖尿病危险因素,也会引发一系列的微血管和大血管并发症[7-8],其防治是公共卫生领域的重要主题之一。糖尿病前期受环境因素和遗传因素共同影响,但其具体作用机制还需要进一步研究。本研究在职业人群中发现2型糖尿病相关的遗传变异CDKAL1-rs2206734 TT和IGF2BP2-rs1470579 CC是糖尿病前期的危险因素,且后者与职业性噪声接触存在相乘交互作用,共同影响糖尿病前期的发病风险。
CDKAL1编码的蛋白是一种t-RNA调节酶,属于甲硫基转移酶家族的成员,在转录后调节和胰岛素的折叠中起着重要的作用,动物实验发现敲除小鼠CDKAL1后,其β细胞产生成熟胰岛素的能力下降,肯定了CDKAL1在糖代谢中的作用[9]。GWAS研究发现其SNPs与2型糖尿病易感性有关[10-11],SNPs的危险等位基因可干扰剪切而降低CDKAL1-v1的水平。CDKAL1-v1是一种非编码转录本,它通过与miRNA竞争性结合而调节CDKAL1水平,当CDKAL1-v1降低时,由miRNA介导的CDCAL1的抑制增加,使得CDCAL1的表达降低[12],从而干扰了胰岛素的合成,进而可能导致糖代谢异常,诱导糖尿病前期和糖尿病的发生。本研究发现CDKAL1-rs2206734 TT与糖尿病前期发病风险升高有关,与已报道的研究结果一致[13-14]。此外,rs4712523也是位于CDKAL1上的与2型糖尿病相关的SNPs[15],rs4712523和rs2206734为高度连锁不平衡的位点(r2 =0.81),进一步支持了本研究的结果。
IGF2BP2编码的蛋白可通过结合胰岛素样生长因子2即IGF2 mRNA的5’UTR区而调节其翻译,在代谢中起重要作用[16-17]。GWAS研究在欧洲和亚洲血统人群以及印第安人群中均发现了诸多与2型糖尿病相关的SNPs,这些SNPs主要与胰岛的β细胞功能受损有关。IGF2BP2的表达上调可激活TLR4通路,进而引起胰岛素敏感性降低[18]。血液中IGF2BP2转录物水平与非糖尿病参与者的空腹胰岛素水平呈正相关,表明IGF2BP2可能参与了糖尿病发病前的病理生理过程[19],本研究发现IGF2BP2-rs1470579 CC携带者糖尿病前期的发病风险升高,进一步支持了IGF2BP2在糖尿病发病过程中的作用,但IGF2BP2基因上内含子区域的SNPs是否通过修饰其本身的表达水平而影响糖尿病的发生还不清楚。
IGF2BP2基因上的SNPs与环境因素的交互作用对糖代谢调节的影响也备受关注。Song等发现IGF2BP2-rs1470579与社会经济地位的交互作用与糖耐量升高有关[20]。本课题组前期发现噪声作业与糖尿病前期发病风险升高有关[6]。本研究中rs1470579 CC与职业噪声接触存在交互作用,共同促进了糖尿病前期的发生,表明IGF2BP2基因与环境因素交互作用在糖尿病发病过程中起着重要作用,但其潜在机制还有待进一步研究。
综上所述,本研究发现了CDKAL1-rs2206734 TT和IGF2BP2-rs1470579 CC是糖尿病前期的危险因素,且rs1470579和职业性噪声接触存在交互作用,共同影响糖尿病前期的发生。本研究的结果肯定了职业性危害因素对不同遗传背景人群的效应存在差异,为保护易感人群,促进职业健康提供了理论支持。
  • 国家自然科学基金(81703203)
  • 武汉市卫生健康科研基金资助项目(WG16B08)
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2024年第51卷第10期
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doi: 10.20043/j.cnki.MPM.202311178
  • 接收时间:2023-11-09
  • 首发时间:2026-03-17
  • 出版时间:2024-05-25
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  • 收稿日期:2023-11-09
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国家自然科学基金(81703203)
武汉市卫生健康科研基金资助项目(WG16B08)
作者信息
    武汉市职业病防治院,湖北 武汉 430015

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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