Polychlorinated Biphenyls and Organochlorine Pesticides in Plasma Predict Development of Type 2 Diabetes in the Elderly

OBJECTIVE Persistent organic pollutants (POPs), lipophilic chemicals that accumulate mainly in adipose tissue, have recently been linked to type 2 diabetes. However, evidence from prospective studies is sparse. This study was performed to evaluate prospective associations of type 2 diabetes with selected POPs among the elderly. RESEARCH DESIGN AND METHODS Nineteen POPs (14 polychlorinated biphenyl [PCB] congeners, 3 organochlorine pesticides, 1 brominated diphenyl ether, and 1 dioxin) were measured in plasma collected at baseline in 725 participants, aged 70 years, of the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS). RESULTS After adjusting for known type 2 diabetes risk factors, including obesity, odds ratios (ORs) (95% CIs) for type 2 diabetes at age 75 years (n = 36) according to the quintiles of a summary measure of concentrations of PCBs (vs. the lowest quintile) were 4.5, 5.1, 8.8 (1.8–42.7), and 7.5 (1.4–38.8) (Ptrend <0.01). Among organochlorine pesticides, adjusted ORs across concentrations of trans-nonachlor showed that Ptrend = 0.03. Adjusted ORs (95% CIs) across quintiles of the sum of three organochlorine pesticides were 1.1, 1.6, 1.5, and 3.4 (1.0–11.7) (Ptrend = 0.03). Neither brominated diphenyl ether 47 nor dioxin was significantly associated with incident diabetes. The sum of PCBs improved reclassification significantly when added to traditional risk factors for diabetes. CONCLUSIONS Despite the small number of incident cases, this study found that environmental exposure to some POPs substantially increased risk of future type 2 diabetes in an elderly population.

[1]  D. Mozaffarian,et al.  Association Between Adiposity in Midlife and Older Age and Risk of Diabetes in Older Adults , 2010 .

[2]  D. Mozaffarian,et al.  Association between adiposity in midlife and older age and risk of diabetes in older adults. , 2010, JAMA.

[3]  Stuart Harrad,et al.  Persistent Organic Pollutants , 2010 .

[4]  D. Jacobs,et al.  Low Dose of Some Persistent Organic Pollutants Predicts Type 2 Diabetes: A Nested Case–Control Study , 2010, Environmental health perspectives.

[5]  K. Kristiansen,et al.  Persistent Organic Pollutant Exposure Leads to Insulin Resistance Syndrome , 2009, Environmental health perspectives.

[6]  V. Koshkin,et al.  Molecular and Metabolic Evidence for Mitochondrial Defects Associated With β-Cell Dysfunction in a Mouse Model of Type 2 Diabetes , 2009, Diabetes.

[7]  C. Agardh,et al.  Exposure to p,p′-DDE: A Risk Factor for Type 2 Diabetes , 2009, PloS one.

[8]  D. Sharp.  Environmental toxins, a potential risk factor for diabetes among canadian aborginals , 2009, International journal of circumpolar health.

[9]  H. Anderson,et al.  Organochlorine Exposure and Incidence of Diabetes in a Cohort of Great Lakes Sport Fish Consumers , 2009, Environmental health perspectives.

[10]  J. Adam,et al.  Isolated post-challenge hyperglycemia: concept and clinical significance. , 2008, Acta medica Indonesiana.

[11]  M. Pencina,et al.  Evaluating the added predictive ability of a new marker: From area under the ROC curve to reclassification and beyond , 2008, Statistics in medicine.

[12]  D. Jacobs,et al.  Relationship between serum concentrations of persistent organic pollutants and the prevalence of metabolic syndrome among non-diabetic adults: results from the National Health and Nutrition Examination Survey 1999–2002 , 2007, Diabetologia.

[13]  D. Jacobs,et al.  Could low-level background exposure to persistent organic pollutants contribute to the social burden of type 2 diabetes? , 2006, Journal of Epidemiology and Community Health.

[14]  D. Jacobs,et al.  A Strong Dose-Response Relation Between Serum Concentrations of Persistent Organic Pollutants and Diabetes , 2006, Diabetes Care.

[15]  L. Hagmar,et al.  A cross-sectional study of the association between persistent organochlorine pollutants and diabetes , 2005, Environmental health : a global access science source.

[16]  T. Louis,et al.  Lipid Adjustment in the Analysis of Environmental Contaminants and Human Health Risks , 2005, Environmental health perspectives.

[17]  Kristina A Thayer,et al.  Large effects from small exposures. I. Mechanisms for endocrine-disrupting chemicals with estrogenic activity. , 2003, Environmental health perspectives.

[18]  T. Harris.  Invited commentary: body composition in studies of aging: new opportunities to better understand health risks associated with weight. , 2002, American journal of epidemiology.

[19]  E. Weir,et al.  Identifying and managing adverse environmental health effects: 5. Persistent organic pollutants. , 2002, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[20]  R. Tisch,et al.  The role of environmental factors in insulin-dependent diabetes mellitus: an unresolved issue. , 1999, Environmental health perspectives.

[21]  B. Howard.  Insulin resistance and lipid metabolism. , 1999, The American journal of cardiology.

[22]  K. Steenland,et al.  Cancer, heart disease, and diabetes in workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin. , 1999, Journal of the National Cancer Institute.

[23]  M Matsuo,et al.  [Oxidative stress and aging]. , 1997, Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics.

[24]  H. Obana,et al.  The effects of "yusho" type PCB on triglyceride lipase and fatty acid composition. , 1987, Environmental research.

[25]  E. Mazzaferri,et al.  Age and the endocrine system. , 1985, Clinics in geriatric medicine.

[26]  Dana B Barr,et al.  Comprehensive solid-phase extraction method for persistent organic pollutants. Validation and application to the analysis of persistent chlorinated pesticides. , 2003, Analytical chemistry.

[27]  M. Longnecker,et al.  Serum dioxin level in relation to diabetes mellitus among Air Force veterans with background levels of exposure. , 2000, Epidemiology.