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Assessing the trend of diabetes mellitus by analyzing metformin as a biomarker in wastewater
- Xiao, Yang, Shao, Xue-Ting, Tan, Dong-Qin, Yan, Ji-Hao, Pei, Wei, Wang, Zhuang, Yang, Meng, Wang, De-Gao
- The Science of the total environment 2019 v.688 pp. 281-287
- biomarkers, derivatization, drug therapy, epidemiology, gas chromatography-mass spectrometry, metformin, monitoring, noninsulin-dependent diabetes mellitus, solid phase extraction, surveys, wastewater, wastewater treatment, China
- According to International Diabetes Federation estimates, China has the highest rate of diabetes in the world. To monitor the prevalence of diabetes mellitus (DM) in near real-time, a first-line medication for the treatment of type 2 diabetes, metformin, was used. Wastewater-based epidemiology (WBE) was applied to estimate the consumption of metformin in Dalian from 2015 to 2018. Quantification of metformin was undertaken using solid-phase extraction (SPE) and N-methyl-bis (trifluoroacetamide) derivatization prior to GC–MS analysis. The concentrations of metformin in eleven wastewater treatment plants (WWTPs) ranged from 1.7 μg/L to 239.0 μg/L, with an average value of 68.3 μg/L. For metformin consumption, there was a gradual increase from 12.1 mg/d/capita in 2015 to 28.4 mg/d/capita in 2018. Meanwhile, the prevalence of metformin in the Dalian population ranged from 1.6% in 2015 to 3.8% in 2018. Similarly, the prevalence of DM showed an increasing trend from 12.2% in 2015 to 21.6% in 2018, which is consistent with the data predicted by traditional surveys (15.2–19.8%). Additionally, the prevalence of DM in 2015 estimated based on WBE was 12.2%, which agreed with the results from the traditional survey (12.3%). These results indicated that the proposed method provided a feasible way to reveal the prevalence of DM through metformin monitoring by the WBE approach.