Acute large-dose exposure to organophosphates in patients with and without diabetes mellitus: analysis of mortality rate and new-onset diabetes mellitus

Environmental Health

Research

Chih-Chun Chang¹  Hsin-Lan Shen²  Shou-Hsuan Liu³  Ja-Liang Lin³  Wen-Hung Huang³  Ching-Wei Hsu³  Cheng-Hao Weng³  Tzung-Hai Yen⁴  I-Kuan Wang⁵  Chih-Chia Liang⁵ 

[1] Department of Clinical Pathology, Far Eastern Memorial Hospital, Banciao, New Taipei City, Taiwan;Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Linkou, Taiwan;Department of Nephrology and Division of Clinical Toxicology, Chang Gung Memorial Hospital and Chang Gung University, Taipei, Taiwan;Department of Nephrology and Division of Clinical Toxicology, Chang Gung Memorial Hospital and Chang Gung University, Taipei, Taiwan;Kidney Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan;Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, Taiwan;Department of Nephrology, China Medical University Hospital and China Medical University, Taichung, Taiwan;

关键词: Organophosphate poisoning;    Suicide;    Diabetes mellitus;    Mortality;    New-onset diabetes mellitus;   

DOI  :  10.1186/1476-069X-13-11

 received in 2013-07-03, accepted in 2014-02-28,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundWe investigated the mortality rates of patients with and without diabetes mellitus after acute large-dose exposure to organophosphate insecticides. All patients without diabetes mellitus were traced to examine the long-term risk of new-onset diabetes mellitus. Previous reports indicated that organophosphate exposure might increase the risk of new-onset diabetes mellitus.MethodsWe analyzed the records of 118 patients referred to Chang Gung Memorial Hospital for management of intentional organophosphate poisoning between 2000 and 2011. Patients were stratified by diabetes mellitus status. Demographic, clinical, laboratory and mortality data were analyzed.ResultsMost patients were middle aged (53.45 ± 16.20 years) and male (65.3%) and were referred to our hospital after a relatively short amount of time had elapsed since poisoning (median 3.0 hours). 18 (15.2%) of 118 patients died, including 15 (13.8%) of 109 patients without diabetes mellitus and 3 (33.3%) of 9 with diabetes mellitus. There was no significant difference in mortality between these groups (P = 0.117). In a multivariate Cox regression model, hypotension (P = 0.000), respiratory failure (P = 0.042), coma (P = 0.023), and corrected QT interval prolongation (P = 0.002) were significant risk factors for mortality. Conversely, diabetes mellitus status was not a significant variable in this model. At routine outpatient follow up a median of 1.25 months post exposure, random blood glucose measurements gave no evidence of new-onset diabetes in patients without pre-existing diabetes.ConclusionsDiabetes mellitus status might not increase mortality risk following acute large-dose exposure to organophosphates, and the risk of new-onset diabetes mellitus also might be minimal in the short term. Larger prospective studies with formal testing for diabetes at later times post-exposure are required.

【 授权许可】

Unknown   
© Liu et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.