Comarca Lagunera 지방(북부)의 식수 내 비소와 비만, 당뇨병 및 고혈압의 연관성

Mar 18, 2023

Scientific Reports 13권, 기사 번호: 9244(2023) 이 기사 인용

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만성 풍토병성 지역 수비소증(CERHA)은 식수 내 비소(As)에 노출된 2억 명 이상의 사람들에게 영향을 미치는 세계적인 문제입니다. 여기에는 멕시코 중북부 지역인 La Comarca Lagunera에 거주하는 175만 명이 포함됩니다. 이 지역의 비소 수준은 일반적으로 WHO 지침인 10 µg L−1을 초과합니다. 인간의 As 대사와 관련된 생화학적 변화는 과체중 및 비만(O&O), 제2형 당뇨병(T2D) 및 고혈압(AHT)의 위험을 증가시킬 수 있습니다. 우리 연구에서 우리는 이러한 대사 질환의 위험 요소로서 식수에서 As의 역할을 조사했습니다. 우리는 역사적으로 중간 정도(San Pedro) 및 낮은(Lerdo) 식수 As 수준을 가진 인구와 As 수질 오염에 대한 역사적 증거가 없는 사람들에 초점을 맞췄습니다. As에 대한 노출 평가는 여성(9.4, 5.3, 0.8 µg L−1)과 남성(18.1, 4.8, 1.0)의 식수(중앙값 67.2, 21.0, 4.3 µg L−1) 및 요중 As 농도 측정을 기반으로 했습니다. μg L−1). 식수 내 As와 소변 내 As 사이의 유의한 상관관계는 인구 집단의 As 노출을 입증합니다(R2 = 0.72). 95% 신뢰 구간으로 조정된 승산비는 Lerdo에 거주하는 개인보다 San Pedro에 거주하는 개인에서 T2D(1.7, 1.2–2.0) 및 AHT(1.8, 1.7–1.9)로 진단될 가능성이 더 높다는 것을 입증했습니다. 그럼에도 불구하고 비만과의 유의미한 연관성은 발견되지 않았습니다. CERHA 타운에 거주하는 개인은 CERHA 타운에 거주하지 않는 사람들에 비해 비만(1.3~1.9), T2D(1.5~3.3), AHT(1.4~2.4) 위험이 더 높은 것으로 나타났습니다. 마지막으로 남성에 비해 여성[OR의 역수 및 95%CI 0.4(0.2–0.7)]에서 비만이 발생할 확률이 더 높은 반면, 남성은 T2D[OR = 2.0(1.4–2.3)] 및 AHT로 진단될 가능성이 더 높습니다. OR = 2.0(1.5–2.3)], 지방자치단체와 관계없이 여성보다 높습니다.

과체중 및 비만(O&O), 제2형 당뇨병(T2D) 및 고혈압(AHT)의 유병률은 1970년대 이후 크게 증가하여 멕시코의 주요 건강 문제가 되었으며 여전히 증가하고 있습니다. 2016~2018년 국민 건강 및 영양 조사(ENSANUT)1에 따르면 O&O 환자는 9,600만 명(71.3~75.2%, 즉 성인 4명 중 3명)에 달합니다. 또한 1,350만 명(10.4%)이 제2형 당뇨병 진단을 받았고, 1,520만 명(12%)이 AHT를 앓고 있습니다. T2D는 멕시코에서 두 번째로 큰 사망 원인으로, 2018년에 106,525명의 사망자가 보고되었습니다2. 멕시코는 전 세계적으로 T2D 유병률이 6번째로 높으며 인구가 많은 국가 중에서 사망 발생률이 가장 높습니다3.

O&O, T2D 및 AHT의 다인자 결정 요인에는 고칼로리, 고탄수화물, 고지방 식품의 섭취로 인한 가속화된 변형 식단, 좌식 생활 방식 패턴, 특히 아메리카 원주민 출신 인구의 유전적 감수성이 포함됩니다3,4,5 . 그러나 환경 요인도 유전적 소인에 영향을 미칠 수 있으며 O&O, T2D 및 AHT의 급격한 증가에 기여할 수 있습니다[예:6,7,8,9].

만성 풍토병 지역 수비소증(CERHA)은 인간이 소비하는 지하수에 자연적으로 존재하는 비소(As)와 관련이 있으며 전 세계 많은 국가에서 널리 퍼져 있습니다10,11,12,13. 2억 명이 넘는 사람들이 세계보건기구(WHO)의 식수 지침인 10 µg L−1을 초과하는 수준의 식수에 있는 As에 만성적으로 노출되어 있습니다10, 14, 15. 전 세계적으로 CERHA에 의해 가장 심각한 영향을 받는 인구는 낮은 사회경제적 지위의 가구로 구성됩니다. . 아메리카 대륙의 CERHA 지역에는 아르헨티나, 볼리비아, 칠레, 엘살바도르, 미국, 니카라과, 페루, 멕시코가 포함됩니다. CERHA 지역은 멕시코 중북부, 특히 La Comarca Lagunera 지방에 위치하고 있습니다. Coahuila 및 Durango 주 내 9개 지방자치단체(인구 175만 명2)가 70년 동안 지하수 비소의 영향을 받았습니다. La Comarca Lagunera 지방 지하수의 일반적인 As 농도 범위는 0.7 ~ > 800 µg L−1 [예: 16,17,18,19,20]입니다. As 노출과 관련된 건강에 대한 악영향은 1960년대부터 문서화되었습니다.

1100 mm y−1), and average summer and winter temperatures of 31 and 16 ºC, respectively. Higher and lower precipitation occurs in July–August (13–52 mm/d, Julian days 190–220) and April (4 mm d−1, Julian 90–120). Before the Nazas and Aguanaval rivers were dammed, their flow discharges formed 13 ephemeral lagoons, including the Mayran lagoon, the largest in Latin America. These lagoons disappeared after the construction of the dams in the 1940s–1960s. In addition, the aquifer recharge in the region lowered rapidly after the 1960s. At the same time, the water demand tripled in the last 70 years due to the growth of agricultural and dairy cattle activities and the human population. Currently, water uses are agricultural-dairy cattle (91%) and urban and industrial activities (9%), with 60.6% of the volume extracted from the aquifers and 39.4% from the dams23./p> 200 mg dL−1 indicates T2D. We defined T2D prevalence as diagnosed T2D when T2D diagnosis was self-reported in the questionnaires and undiagnosed T2D for participants who answered "NO" in the self-reported questionnaire, but had an FSBG result ≥ 126 mg dL−1./p> 95%, and the coefficient of variation was < 10% in both CRMs. The method detection limits were < 10 ng L−1 for As. We normalized As levels in urine by creatinine concentration (units in µg of As per gram of creatinine)./p> 25 to 125 µg L−1), low (> 10–25 µg L−1), and below the WHO guideline value of 10 µg L−1./p> 1 indicates that exposure may be a risk factor for the disease. Conversely, an OR < 1 implies exposure may be a protective factor against the disease. Wald X2 test was employed to assess the significance of each variable. The Wald test is a significance test for individual regression coefficients in LRM. All statistical analyses were performed using JMP version 14 software (SAS Institute, Cary, NC, USA) with p values < 0.05 considered statistically significant./p> 0.05)./p> 0.05)./p> 0.05). However, As levels in San Pedro were three times higher than those in Lerdo municipality (p < 0.05). In Nazas, Cuencame, Simon Bolivar, and Mapimi, the As levels in groundwater (2.0–10.7 µg L−1) were significantly lower than in San Pedro and Lerdo municipalities (p < 0.05). Regarding As levels in drinking water, values in San Pedro (30.0–42.2 µg L−1) were two times higher than those in Lerdo (16.8–19.4 µg L−1). Arsenic levels in tap water in non-CERHA municipalities (1.2–10.0 µg L−1), were significantly lower than in Lerdo and San Pedro (p < 0.05). No significant differences were observed in the median As levels in groundwater collected from CERHA and non-CERHA municipalities in the La Comarca region during our 2005–2007 and 2015–2017 surveys, as well as in the compilated historical dataset (p > 0.05)./p> 10 times (0.8–1.0 µg U-As L−1) than in non-exposed people (Table 2). Non-significant differences were observed between the sexes. Comparatively, the medians of the urine creatinine levels showed not significant differences between localities exposed and non-exposed to As in drinking water and sex (medians 0.6 to 0.8 g L−1), except in non-exposed women with minimum of 0.29(0.12–0.68) g L−1 (Table 2). Levels of As in urine normalized to creatinine (µg U-As g−1 U-creat), also included in Table 2, showed a large variability with medians from 6.8 to 15.9 µg U-As g−1 U-creat. Non-significant differences were observed in the normalized As in urine exposure and non-exposure or between the sexes (p > 0.05)./p> 0.05). Diagnosed T2D adults showed higher urinary As levels than non-diagnosed T2D (p < 0.05). High variability in the urinary As levels were observed between diagnosed and undiagnosed AHT adults without significant differences. In Lerdo, non-significant differences were observed between sex for the same pathology or among pathologies for the same sex (p > 0.05). The urinary As excretion in non-exposed people neither showed significant differences between sex and pathologies. In all groups in San Pedro, the levels of urinary As were significantly higher than in Lerdo people (p < 0.05). Likewise, all the urinary As excretion values in non-exposed people were significantly lower than people with moderate and low exposure to As in drinking water in San Pedro (7–13 times higher) and Lerdo (2–5 times higher) (p < 0.05), respectively./p> 0.05), however, both were higher than people in non-CERHA municipalities in La Comarca (p < 0.05)./p> 126 mg dL−1). In addition, 13–17% of participants showed values that indicate uncontrolled diabetes (FSBG > 200 mg dL−1). The declared AHT prevalence accounted for 34.9% in San Pedro (women 30.8% and men 40.2%), 29.9% in Lerdo city (women 18.2 and men 33.5%), and 21.7% (women 17.2 and 28.3% men) in non-CERHA municipalities. Based on measurements of SBP and DBP, 2–3% of participants declaring "NO" to AHT questions were added to the AHT percentages in both cities. Although probable errors in the diagnostic could occur in this study (non-diagnosed or misdiagnosed), the prevalence of T2D and AHT in adults increased slightly regarding the questionary declarations. A higher prevalence of T2D and AHT was observed in San Pedro concerning Lerdo municipality. Besides, non-exposed people showed significantly lower incidence of T2D and AHT than exposed people to moderate and low As levels in drinking water in San Pedro and Lerdo, respectively./p> 130 villages and communities in the CERHA municipalities [Fig. 1;23]. However, the intensive extraction of groundwater, mainly from the clean water polygon in the metropolitan zone of Torreon-Gómez Palacio-Lerdo and its surroundings, progressively has caused the aquifer deficit (> 120–183 million m3 y−1) and groundwater depletion (> 1 to 3 m y−1) in the past decades25. Large-volume pumping creates unnatural groundwater gradients that mobilize the waters from the "dirty" (e.g., Francisco I Madero and San Pedro municipalities) to "clean" (e.g., Torreón and Lerdo municipalities) zone, promoting the intrusion of water with high contents of solutes, including As. The progressive groundwater depletion hypothetically increases the As levels because the pumped waters have interacted for a longer time with volcanic and intrusive rocks, one of the probable sources of As in the region. Consequently, the continuous movement and mixing of water masses from dirty to clean zones could increases the As levels in the clean water reservoir groundwater polygon. Given the severe health implications associated with exposure to As, it is imperative that a systematic and continuous monitoring program be implemented in the region./p>

In high-level CERHA municipalities, most wells showed As levels above the Mexican health standard for As in drinking water of 25 µg L−130, a non-safeguard human health standard." href="/articles/s41598-023-36166-5#ref-CR31" id="ref-link-section-d18969088e4862"31 2.5 times higher than the WHO recommendation. In low-level CERHA municipalities, most wells are below the Mexican health standard; however, > 80% of the analyzed wells had higher levels than the WHO guideline. In addition, practically all groundwater wells in the CERHA region are significantly enriched in As concerning typical values in natural waters of 1–2 μg L−110, 11, 32, 33./p>

Because the toxicological effects associated with prolonged exposure to As is drinking waters are very variable and can lead to severe skin damage (e.g., hyperkeratosis or hyperhidrosis), vascular and hematological lesions (anemia), neurological disorders, decreased sexual activity, malformations congenital and cancer (skin, lung, kidney, gallbladder)8, 11, 15, the WHO recommended a restrictive quality standard of 10 µg L−1 in drinking water15, ." href="/articles/s41598-023-36166-5#ref-CR31" id="ref-link-section-d18969088e4909"31, 33. Mexico maintained the previously WHO recommended limit in drinking water of 25 µg L−1 for several decades. Since May 2, 2023, the more stringent WHO quality standard of 10 µg L−1 has been mandatory in Mexico34./p> 2 times as likely to be obese than men, independent of the exposition As level or residence municipality./p> 104 μg L−1, respectively. Our logistic regression model revealed that people in San Pedro (moderate As level in drinking water) showed more chances of being diagnosed with T2D regarding Lerdo municipality (low exposition level). Also, the chances for T2D in exposed people in CERHA municipalities are 1.5–3.3 higher for people in non-CERHA municipalities. Besides, the chances of being T2D diagnosed are double in men than in women. Thus, our prospective findings support an association of As exposure from drinking water with a higher risk of T2D in the range of levels observed./p> > MMA > TMA). The degree of methylation varies with age (adults > children) and sex (women > men, especially during pregnancy)54, 56. Determining the As species in urine provides valuables insights into the transformation and metabolism of As within the body. Studies conducted in the exposed population of CERHA municipalities in La Comarca Lagunera province have reported high concentrations of As in urine, predominantly DMA (75–78%), followed by MMA (10–12%) and inorganic As (10–15%)19, 55./p> women) and residence place (San Pedro > Lerdo > non-CERHA municipalities people)./p>

./p>

이전의: 생화학 시약 시장 2023 미래 성장 공개, 새로운 동향 및 예측 탐구 다음: 생화학 시약 냉장고 시장 2023~2029년: 전세계 산업 분석, 미래 수요 및 예측

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