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)
- author
- 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
- organization
- publishing date
- 2019
- 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
-
- pmid:31029940
- 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
- 2024-05-14 06:48:26
@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 < 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.</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}},
keywords = {{Biomonitoring; Longitudinal data; Polychlorinated biphenyl congeners; POPs; Type 2 diabetes}},
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}},
}