Analysis Of Space Consumption Characteristics Of Metformin Based On Urban Wastewater

Diabetes is one of the global public health problems facing the 21st century.In 2017,the prevalence of diabetes in China was 10.9%,and about 144 million adults had diabetes.The number of patients and deaths is increasing every year.And understanding the spatial distribution of diabetes has always been the focus and difficulty of medical and health departments.Metformin is the main oral drug for anti-diabetes,and its space consumption pattern can well reflect the treatment information of diabetes.This study analyzed metformin concentration in wastewater,used sewage epidemiological methods to study metformin space consumption patterns in major cities in China,analyzed factors affecting metformin use,and predicted the prevalence of diabetes.First,a partial study was conducted by collecting water samples from 21 sewage plants in 19 cities in northeast China,which has a high prevalence rate.Metformin was analyzed by GC-MS with solid phase extraction and N-methyl-bis(trifluoroacetamide)derivatization.Based on inverse calculations,the results showed that per capita consumption of metformin in the Northeast region was 0.66 to 15.6 mg/d/capita(mean 5.54 mg/d/capita).The prevalence of metformin ranges from 0.09%to 2.10%(mean 0.74%).There are significant spatial differences in the consumption and prevalence of metformin.Monte Carlo simulation was used for uncertainty analysis,and the simulation results showed good agreement with the actual measured values.The space consumption law of metformin was studied from two aspects of addictive substances and economic factors.The results showed that caffeine and metformin had different space consumption patterns.Tobacco and metformin consumption have a strong positive correlation,that is,tobacco may increase the risk of diabetes;economically,the consumption of metformin decreases as the per capita disposable income of urban residents increases.Secondly,macro-research was conducted by collecting 40 representative cities in 20 provinces across the country.The calculation results show that metformin consumption ranges from 0.11 to 15.6 mg/d/capita(mean 3.25 mg/d/capita),and the prevalence rate among the population.The range is 0.02%to 2.10%(mean 0.44%).Consumption is significantly different between different administrative regions and different levels of cities.Consumption trends are high between the north and the south,and between east and west,and between the economic regions,which is consistent with the prevalence of diabetes in China.Using metformin as a biomarker to build a diabetes prevalence model,the national diabetes prevalence prediction result is 9.53%,which is basically equivalent to the traditional survey's 10.9%prevalence.Utilizing the real-time and rapid characteristics of wastewater-based epidemiological methods and the spatial differences reflected in this research can provide some ideas for related research on diabetes.Predicting the prevalence of diabetes through metformin consumption can further assess public health issues in different regions and take different measures to address them.