The relationship between heavy metal exposure and type 2 diabetes: a large-scale retrospective cohort study using occupational health examinations

Objectives: To investigate the associations between heavy metal exposure and serum ferritin levels, physical measurements, and type 2 diabetes mellitus (DM). Design: A retrospective cohort study. Setting: Changwon, the location of this study, is a Korean representative industrial city. Data were obtained from medical check-ups between 2002 and 2018. Participants: A total of 34,814 male subjects were included. Of them, 1,035 subjects with lead exposure, 200 subjects with cadmium exposure, and the 33,579 remaining were assigned to cohort A, cohort B, and the control cohort, respectively. Data including personal history of alcohol and smoking, age, height, weight, the follow-up duration, HbA1c, fasting blood sugar (FBS), ferritin levels, and lead and cadmium levels within one year after exposure were collected. Primary Outcome Measure: In subjects without diabetes, changes in FBS and HbA1c were analyzed through repeated tests at intervals of one year or longer after the oc...研究目的：探讨重金属暴露与血清铁蛋白水平、体格测量指标以及2型糖尿病（type 2 diabetes mellitus, DM）之间的关联。 研究设计：回顾性队列研究。 研究地点：本研究开展于韩国代表性工业城市昌原（Changwon）。研究数据取自2002年至2018年间的健康体检数据。 研究对象：共纳入34814名男性受试者。其中1035名铅暴露受试者、200名镉暴露受试者及剩余33579名受试者，分别被纳入队列A、队列B及对照队列。收集的资料包括烟酒个人史、年龄、身高、体重、随访时长、糖化血红蛋白（HbA1c）、空腹血糖（fasting blood sugar, FBS）、铁蛋白水平，以及暴露后1年内的铅、镉水平。 主要结局指标：在未患糖尿病的受试者中，通过间隔1年及以上的重复检测，分析其空腹血糖与糖化血红蛋白的变化……