Abstract：
Epidemiological studies have related exposure to pesticides to increased risk of diabetes. However, few studies have evaluated the health effects of mixed pesticides exposure, especially in an elderly population. Here, we utilized gas chromatography-tandem mass spectrometry to quantify the levels of 39 pesticides in 4 categories in a Chinese elderly population. Then we used general linear models to explore the association between individual pesticide exposure and type 2 diabetes mellitus (T2DM). Restricted cubic spline (RCS) models were fitted to identify potential non-linearities between those associations. Furthermore, stratified analysis by gender was conducted to explore the gender-specific associations. Finally, we used weighted quantile sum (WQS) regression, quantile-based g computation (qgcomp), and Bayesian kernel machine regression (BKMR) to evaluate the effects of mixed exposure to 39 pesticides. The results showed that exposure to pesticides was associated with high risk of T2DM, with β-Hexachlorocyclohexane (β-BHC) and oxadiazon being the most significant independent contributors, which was pronounced among elderly women. Moreover, the association of β-BHC and oxadiazon with T2DM was linear. These indicated that it is an urgent need to take practical measures to control these harmful pesticides.
摘要：
流行病学研究表明，接触杀虫剂会增加患糖尿病的风险。然而,很少有研究评估混合农药暴露对健康的影响，尤其是老年人。这里,我们利用气相色谱-串联质谱法定量了中国老年人群中4类39种农药的水平。然后，我们使用一般线性模型来探讨个体农药暴露与2型糖尿病（T2DM）之间的关系。拟合受限三次样条（RCS）模型以识别这些关联之间的潜在非线性。此外，我们进行了性别分层分析,以探讨性别特异性关联.最后,我们使用加权分位数和(WQS)回归，基于分位数的g计算(qgcomp)，和贝叶斯核机回归(BKMR)来评估混合暴露对39种农药的影响。结果表明，接触农药与T2DM的高风险相关，β-六氯环己烷（β-BHC）和恶二嗪是最重要的独立贡献者，这在老年妇女中很明显。此外，β-BHC和恶二嗪与T2DM呈线性关系。这些表明，迫切需要采取切实可行的措施来控制这些有害农药。
