A cross-sectional study of the association between persistent organochlorine pollutants and diabetes.
BACKGROUND
Experimental evidence supports the hypothesis that persistent organochlorine pollutants (POPs) may cause type 2 diabetes mellitus, whereas there is no fully convincing epidemiological evidence for such an association. In Sweden the most important source of POP exposure is fatty fish. We have assessed the association between serum levels of POPs and prevalence of diabetes in Swedish fishermen and their wives, with high consumption of fatty fish from the Baltic Sea.


METHODS
In 196 men (median age 60 years) and 184 women (median age 64 years), we analyzed 2,2',4,4',5,5'-hexachlorobiphenyl (CB-153) and 1,1-dichloro-2,2-bis(p-chlorophenyl)-ethylene (p,p'-DDE) in serum using gas chromatography-mass spectrometry. The participants were asked if they had diabetes and, if so, since which year and about medication and diet. The Odds Ratios (OR) for diabetes with respect to continuous exposure variables were analyzed with logistic regression, adjusting for potential confounders. Moreover trends of diabetes prevalence with respect to trichotomized exposure variables were tested with Jonckheere-Terpstra's test.


RESULTS
Six percent of the men and 5% of the women had diabetes. After confounder adjustment CB-153 was significantly associated with diabetes prevalence using both categorized and continuous exposure data (an increase of 100 ng/g lipid corresponded to an OR of 1.16, 95% confidence interval [CI] 1.03, 1.32, p = 0.03). Similar associations were observed for p,p'-DDE (an increase of 100 ng/g lipid corresponded to an OR of 1.05, 95% CI 1.01, 1.09, p = 0.006). Gender stratified analyses showed among men consistent positive associations with CB-153, but a more ambiguous pattern with respect to DDE. In contrast, among the women the associations with p,p'-DDE were stronger than with CB-153.


CONCLUSIONS
The study provides support that POP exposure might contribute to type 2 diabetes mellitus.
Rylander
Lars
L
Division of Occupational and Environmental Medicine and Psychiatric Epidemiology, Department of Laboratory Medicine, University Hospital, SE-221 85 Lund, Sweden. lars.rylander@med.lu.se
Rignell-Hydbom
Anna
A
Hagmar
Lars
L
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced / Q000453:epidemiology*; D003633:Dichlorodiphenyl Dichloroethylene / Q000097:blood / Q000633:toxicity; D004785:Environmental Pollutants / Q000097:blood / Q000633:toxicity*; D005260:Female; D005398:Fisheries; D020387:Food Chain; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D006843:Hydrocarbons, Chlorinated / Q000097:blood / Q000633:toxicity*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011078:Polychlorinated Biphenyls / Q000097:blood / Q000633:toxicity; D015995:Prevalence; D017747:Seafood; D013548:Sweden / Q000453:epidemiology
D004785:Environmental Pollutants; D006843:Hydrocarbons, Chlorinated; D003633:Dichlorodiphenyl Dichloroethylene; D011078:Polychlorinated Biphenyls