Advanced

Chlorinated persistent organic pollutants and type 2 diabetes - A population-based study with pre- and post- diagnostic plasma samples

Tornevi, Andreas ; Sommar, Johan ; Rantakokko, Panu ; Åkesson, Agneta ; Donat-Vargas, Carolina ; Kiviranta, Hannu ; Rolandsson, Olov ; Rylander, Lars LU ; Wennberg, Maria and Bergdahl, Ingvar A. LU (2019) In Environmental Research 174. p.35-45
Abstract

Background: Persistent organic pollutants (POPs) have been associated with type 2 diabetes (T2D), but causality is uncertain. Objective: Within longitudinal population-based data from northern Sweden, we assessed how POPs associated with T2D prospectively and cross-sectionally, and further investigated factors related to individual changes in POP concentrations. Methods: For 129 case-controls pairs matched by age, sex and date of sampling, plasma concentrations of hexachlorobenzene (HCB), dichlorodiphenyl-dichloroethylene (p,p'-DDE), dioxin-like (DL) polychlorinated biphenyl congeners (PCB-118 and PCB-156), and non-dioxin like (NDL-PCB: PCB-74, -99, -138 -153, −170, −180, −183 and PCB-187) were analyzed twice (baseline and follow-up,... (More)

Background: Persistent organic pollutants (POPs) have been associated with type 2 diabetes (T2D), but causality is uncertain. Objective: Within longitudinal population-based data from northern Sweden, we assessed how POPs associated with T2D prospectively and cross-sectionally, and further investigated factors related to individual changes in POP concentrations. Methods: For 129 case-controls pairs matched by age, sex and date of sampling, plasma concentrations of hexachlorobenzene (HCB), dichlorodiphenyl-dichloroethylene (p,p'-DDE), dioxin-like (DL) polychlorinated biphenyl congeners (PCB-118 and PCB-156), and non-dioxin like (NDL-PCB: PCB-74, -99, -138 -153, −170, −180, −183 and PCB-187) were analyzed twice (baseline and follow-up, 9–20 years apart). The cases received their T2D diagnose between baseline and follow-up. Prospective (using baseline data) and cross-sectional (using follow-up data) odds ratios (ORs) for T2D on lipid standardized POPs (HCB, p,p'-DDE, ∑DL-PCBs, ∑NDL-PCBs) were estimated using conditional logistic regression, adjusting for body mass index (BMI) and plasma lipids. The influence of BMI, weight-change, and plasma lipids on longitudinal changes in POP concentrations were evaluated among non-diabetic individuals (n = 306). Results: POPs were associated with T2D in both the prospective and cross-sectional assessments. Of a standard deviation increase in POPs, prospective ORs ranged 1.42 (95% CI: 0.99, 2.06) for ∑NDL-PCBs to 1.55 (95% CI: 1.01, 2.38) for HCB (p < 0.05 only for HCB), and cross-sectional ORs ranged 1.62 (95% CI: 1.13; 2.32) for p,p'-DDE to 2.06 (95% CI: 1.29, 3.28) for ∑DL-PCBs (p < 0.05 for all POPs). In analyses of non-diabetic individuals, higher baseline BMI, decreased weight and decreased plasma lipid concentrations were associated with a slower decrease of POPs. Cases had, besides a higher BMI, reduced cholesterol and weight gain at follow-up compared to controls, which can explain the higher ORs in the cross-sectional assessments. Discussion: The association between POPs and T2D was confirmed, but an indication that individuals body fat history might influence POP-T2D associations weakens the epidemiological support for a causal association. It also warrants studies based on other exposure metrics than biomonitoring. In addition, we note that a cross-sectional design overestimates the ORs if T2D cases have successfully intervened on weight and/or blood lipids, as changes in these factors cause changes in POPs.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Biomonitoring, Longitudinal data, Polychlorinated biphenyl congeners, POPs, Type 2 diabetes
in
Environmental Research
volume
174
pages
11 pages
publisher
Elsevier
external identifiers
  • scopus:85064677945
ISSN
0013-9351
DOI
10.1016/j.envres.2019.04.017
language
English
LU publication?
yes
id
3492ed5f-0ac0-47e5-baeb-d56a83676cf5
date added to LUP
2019-05-03 08:56:31
date last changed
2019-05-28 03:57:19
@article{3492ed5f-0ac0-47e5-baeb-d56a83676cf5,
  abstract     = {<p>Background: Persistent organic pollutants (POPs) have been associated with type 2 diabetes (T2D), but causality is uncertain. Objective: Within longitudinal population-based data from northern Sweden, we assessed how POPs associated with T2D prospectively and cross-sectionally, and further investigated factors related to individual changes in POP concentrations. Methods: For 129 case-controls pairs matched by age, sex and date of sampling, plasma concentrations of hexachlorobenzene (HCB), dichlorodiphenyl-dichloroethylene (p,p'-DDE), dioxin-like (DL) polychlorinated biphenyl congeners (PCB-118 and PCB-156), and non-dioxin like (NDL-PCB: PCB-74, -99, -138 -153, −170, −180, −183 and PCB-187) were analyzed twice (baseline and follow-up, 9–20 years apart). The cases received their T2D diagnose between baseline and follow-up. Prospective (using baseline data) and cross-sectional (using follow-up data) odds ratios (ORs) for T2D on lipid standardized POPs (HCB, p,p'-DDE, ∑DL-PCBs, ∑NDL-PCBs) were estimated using conditional logistic regression, adjusting for body mass index (BMI) and plasma lipids. The influence of BMI, weight-change, and plasma lipids on longitudinal changes in POP concentrations were evaluated among non-diabetic individuals (n = 306). Results: POPs were associated with T2D in both the prospective and cross-sectional assessments. Of a standard deviation increase in POPs, prospective ORs ranged 1.42 (95% CI: 0.99, 2.06) for ∑NDL-PCBs to 1.55 (95% CI: 1.01, 2.38) for HCB (p &lt; 0.05 only for HCB), and cross-sectional ORs ranged 1.62 (95% CI: 1.13; 2.32) for p,p'-DDE to 2.06 (95% CI: 1.29, 3.28) for ∑DL-PCBs (p &lt; 0.05 for all POPs). In analyses of non-diabetic individuals, higher baseline BMI, decreased weight and decreased plasma lipid concentrations were associated with a slower decrease of POPs. Cases had, besides a higher BMI, reduced cholesterol and weight gain at follow-up compared to controls, which can explain the higher ORs in the cross-sectional assessments. Discussion: The association between POPs and T2D was confirmed, but an indication that individuals body fat history might influence POP-T2D associations weakens the epidemiological support for a causal association. It also warrants studies based on other exposure metrics than biomonitoring. In addition, we note that a cross-sectional design overestimates the ORs if T2D cases have successfully intervened on weight and/or blood lipids, as changes in these factors cause changes in POPs.</p>},
  author       = {Tornevi, Andreas and Sommar, Johan and Rantakokko, Panu and Åkesson, Agneta and Donat-Vargas, Carolina and Kiviranta, Hannu and Rolandsson, Olov and Rylander, Lars and Wennberg, Maria and Bergdahl, Ingvar A.},
  issn         = {0013-9351},
  language     = {eng},
  pages        = {35--45},
  publisher    = {Elsevier},
  series       = {Environmental Research},
  title        = {Chlorinated persistent organic pollutants and type 2 diabetes - A population-based study with pre- and post- diagnostic plasma samples},
  url          = {http://dx.doi.org/10.1016/j.envres.2019.04.017},
  doi          = {10.1016/j.envres.2019.04.017},
  volume       = {174},
  year         = {2019},
}