A Strong Dose-Response Relation Between Serum Concentrations of Persistent Organic Pollutants and Diabetes Results from the National Health and Examination Survey 1999–2002

University of Oslo, Kristiania (historical), Oslo, Norway
Diabetes Care (Impact Factor: 8.42). 08/2006; 29(7):1638-44. DOI: 10.2337/dc06-0543
Source: PubMed


Low-level exposure to some persistent organic pollutants (POPs) has recently become a focus because of their possible link with the risk of diabetes.
Cross-sectional associations of the serum concentrations of POPs with diabetes prevalence were investigated in 2,016 adult participants in the National Health and Nutrition Examination Survey 1999-2002. Six POPs (2,2',4,4',5,5'-hexachlorobiphenyl, 1,2,3,4,6,7,8-heptachlorodibenzo-p-dioxin, 1,2,3,4,6,7,8,9-octachlorodibenzo-p-dioxin, oxychlordane, p,p'-dichlorodiphenyltrichloroethane, and trans-nonachlor) were selected, because they were detectable in >or=80% of participants.
Compared with subjects with serum concentrations below the limit of detection, after adjustment for age, sex, race and ethnicity, poverty income ratio, BMI, and waist circumference, diabetes prevalence was strongly positively associated with lipid-adjusted serum concentrations of all six POPs. When the participants were classified according to the sum of category numbers of the six POPs, adjusted odds ratios were 1.0, 14.0, 14.7, 38.3, and 37.7 (P for trend < 0.001). The association was consistent in stratified analyses and stronger in younger participants, Mexican Americans, and obese individuals.
There were striking dose-response relations between serum concentrations of six selected POPs and the prevalence of diabetes. The strong graded association could offer a compelling challenge to future epidemiologic and toxicological research.

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Available from: In-kyu Lee, Oct 05, 2015
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    • "Overall, 8–18% of cancer patients have diabetes [1]. Epidemiological studies of Lee et al. [2] [3] have revealed that the incidence of diabetes has increased due to exposure to pollutants. "
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    • "The IARC has recently classified PCB as a human carcinogen (class 1) (Lauby-Secretan et al., 2013). There are numerous epidemiological studies that showed neurological, immunological or endocrine effects of PCB-exposure on humans (Harper et al., 1995; Heilmann et al., 2010; Grandjean et al., 2001; Lee et al., 2006; Winneke et al., 1998). For human biomonitoring, the blood levels of 6 " indicator " congeners are usually quantified, three of them showed especially long biological half-lives (PCB 138, PCB 153 and PCB 180). "
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    ABSTRACT: Despite their long-term ban, persistent organochlorine compounds like hexachlorobenzene (HCB), p,p′-dichlorodiphenylethylene (DDE) as well as polychlorinated biphenyls (PCBs) are still of environmental concern. For the evaluation of potential occupational or environmental exposures to these substances, it is essential to know the current background burden of the general population. As representative and up-to-date information is missing for Germany, we have analysed a large dataset generated in studies on potential exposure to lower chlorinated PCBs to fill this gap for the levels of HCB, DDE as well as PCB 138, PCB 153 and PCB 180.
    International Journal of Hygiene and Environmental Health 03/2015; DOI:10.1016/j.ijheh.2015.02.006 · 3.83 Impact Factor
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    • "Interestingly, there were interactions between persistent organic pollutants (POPs), lipophilic chemical mixtures stored in adipose tissue and continuously released to circulation, and obesity in relation to the risk of T2D [25-27], parallel to the findings of serum GGT and obesity; the relationship between obesity and T2D became stronger as the serum concentrations of POPs increased. In particular, obesity was not associated with T2D among persons with very low serum concentrations of POPs in one human study [27]. Based on the physiological mechanism of the induction of cellular GGT and the empirical findings on the interactions between POPs and obesity, the claim of serum GGT as an indicator for various environmental chemicals seems to be the most plausible, and the interactions between serum GGT and obesity suggest that the presence of low dose chemical mixtures like POPs is necessary for T2D to develop, particularly in obese persons. "
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    ABSTRACT: Background Despite the consistent relationship between serum γ-glutamyltransferase (GGT) and type 2 diabetes (T2D), one unsolved issue is the role of serum GGT in the well-known association between obesity and T2D. This study was performed to investigate whether the association between body mass index (BMI) and impaired fasting glucose (IFG) differed depending on serum GGT levels within the normal range. Methods Study subjects were 2,424 men and 3,652 women aged ≥ 40, participating in the Fifth Korean National Health and Nutrition Examination Survey. Serum GGT levels within the normal range were classified into gender-specific tertiles. Results Among men and women belonging to the lowest tertile of serum GGT, BMI showed statistically non-significant weak associations with the risk of IFG. However, among persons in the highest tertile of serum GGT, the risk of IFG was 3 − 4 times higher among persons with BMI ≥ 25 kg/m2 than those with BMI < 23 kg/m2 (Pinteraction = 0.032 in men and 0.059 in women). Conclusions The well-known strong association between BMI and IFG was observed mainly among persons with elevation of serum GGT to certain physiological levels, suggesting a critical role of serum GGT in the pathogenesis of IFG. This finding has an important clinical implication because serum GGT can be used to detect high-risk obese persons.
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