환경적 벤젠 노출과 관련된 S-phenylmercapturic Acid와 당뇨병 간의 연관성: 제8기 국민건강영양조사(2020∼2021)
Association between S-phenylmercapturic Acid Related to Environmental Benzene Exposure and Diabetes: 8th Korea National Health and Nutrition Examination Survey (2020~2021)
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초록
이 연구는 8기 국민건강영양조사(Korean National Health and Nutrition Examination Survey) 2020∼2021년 데이터를 활용하여 벤젠 노출과 당뇨병 유병률 간의 연관성을 조사하고자 했다. 벤젠 노출의 바이오마커인 S-페닐머캅투르산(S-phenylmercapturic acid, SPMA)은 소변 샘플에서 액체크로마토그래피-탠덤 질량분석법(liquid chromatographytandem mass spectrometry)을 통해 측정되었다. 연구 결과, 높은 SPMA 수준과 당뇨병 유병률 사이에 유의한 연관성이 있음을 확인하였다. 다변량 로지스틱 회귀 분석의 비보정 모델에서SPMA 수치가 높은 남성 그룹의 당뇨병 발생에 대한 오즈비는 5.55 (95% 신뢰 구간: 3.26∼9.45)였으며, 여성의 경우 2.73 (95% 신뢰 구간: 1.62∼4.59)이었다. 나이, 체질량지수, 총콜레스테롤/HDL 콜레스테롤 비율, 수축기 및 이완기 혈압, 신체 활동, 흡연 상태, 음주 상태, 교육 수준 및 가구 소득과 같은 교란변수를 보정한 후에도 이러한 위험 증가는 특히 남성에서 유의미하게 유지되었다. 또한, SPMA 수준과 성별 간의 상호작용 효과(P for interaction ＜0.001)가 유의미하게 나타나 SPMA와 당뇨병 위험 간의 관계가 남성에서 더 강하게 나타남을 의미한다. 이 연구는 특히 당뇨병과 같은 대사 질환과 관련하여 벤젠 노출이 남성에게 건강에 미치는 잠재적 위험성을 강조한다.
Abstract
This study aimed to investigate the association between benzene exposure and the prevalence of diabetes using data from the Korea National Health and Nutrition Examination Survey. S-phenylmercapturic acid (SPMA), a biomarker for benzene exposure, was measured in urine samples using liquid chromatography-tandem mass spectrometry. The study found a significant association between higher SPMA levels and the prevalence of diabetes. In unadjusted models based on complex samples multiple logistic regression, the odds ratio for diabetes in the high SPMA group was 5.55 (95% confidence interval: 3.26∼9.45) for males and 2.73 (95% confidence interval: 1.62∼4.59) for females. Even after adjusting for confounding factors such as age, body mass index, total cholesterol/HDL-cholesterol ratio, systolic and diastolic blood pressure, physical activity, smoking status, drinking status, education level, and household income, the elevated risk remained significant, particularly in males. Moreover, a significant interaction effect between the SPMA levels and the sex (P for interaction ＜0.001) was observed, indicating that the relationship between SPMA and diabetes risk is stronger in males than in females. This study highlights the potential health risks of benzene exposure, particularly for males, in relation to metabolic diseases such as diabetes.
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