Insulin resistance is closely related to many metabolic diseases and has become a serious public health problem worldwide. So, it is crucial to find its environmental pathogenic factors. Methyl tert-butyl ether (MTBE), a widely used unleaded gasoline additive, has been proven to affect glycolipid metabolism. However, results from population studies are lacking. For this purpose, the potential relationships between MTBE exposure and the triglyceride glucose (TyG) index, a useful surrogate marker of insulin resistance, were evaluated using a small-scale occupational population. In this study, 201 participants including occupational and non-occupational MTBE exposure workers were recruited from the Occupational Disease Prevention and Control Hospital of Huaibei, and their health examination information and blood samples with informed consent were collected. The internal exposure levels were assessed by detecting blood MTBE using solid-phase-micro-extraction gas chromatography-mass spectrometry. Then the adjusted linear regression model was used to assess the relationship between MTBE exposure and fasting plasma glucose (FPG), or TyG index. Then, receiver-operating-characteristic (ROC) curves were performed to calculate the optimal cut-off points. Multivariable and hierarchical logistic regression models were used to analyze the impact of MTBE exposure on the risk of insulin resistance. Obvious correlations were observed between blood MTBE levels with TyG index (p = 0.016) and FPG (p = 0.001). Further analysis showed that using the mean of the TyG index (8.77) as a cutoff value had a good effect on reflecting the risk of insulin resistance. Multivariable logistic regression analysis also indicated that MTBE exposure was an independent risk factor for a high TyG index (OR = 1.088, p = 0.038), which indicated that MTBE exposure might be a new environmental pathogenic factor leading to insulin resistance, and MTBE exposure might increase the risk of insulin resistance by independently elevating the TyG index in male gas station workers.

中文翻译：

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MTBE 暴露可能会增加男性加油站工作人员胰岛素抵抗的风险

胰岛素抵抗与多种代谢性疾病密切相关，已成为全球严重的公共卫生问题。因此，寻找其环境致病因素至关重要。甲基叔丁基醚（MTBE）是一种广泛使用的无铅汽油添加剂，已被证明会影响糖脂代谢。然而，缺乏人口研究的结果。为此，使用小规模职业人群评估了 MTBE 暴露与甘油三酯葡萄糖 (TyG) 指数（胰岛素抵抗的有用替代指标）之间的潜在关系。本研究从淮北市职业病防治医院招募了201名受试者，包括职业和非职业MTBE暴露工人，收集了他们的健康检查信息和知情同意的血样。采用固相微萃取气相色谱-质谱联用技术检测血液中的MTBE，评估内暴露水平。然后使用调整后的线性回归模型评估 MTBE 暴露与空腹血糖 (FPG) 或 TyG 指数之间的关系。然后，绘制受试者工作特征（ROC）曲线来计算最佳截止点。使用多变量和层次逻辑回归模型来分析 MTBE 暴露对胰岛素抵抗风险的影响。血液 MTBE 水平与 TyG 指数 ( p = 0.016) 和 FPG ( p = 0.001)之间存在明显的相关性。进一步分析显示，以TyG指数均值（8.77）作为截断值，对于反映胰岛素抵抗风险有良好的效果。多变量logistic回归分析还表明，MTBE暴露是高TyG指数的独立危险因素（OR = 1.088，p = 0.038），这表明MTBE暴露可能是导致胰岛素抵抗的新环境致病因素，MTBE暴露可能通过独立提高男性加油站工作人员的 TyG 指数来增加胰岛素抵抗的风险。