A strong dose-response relation between serum concentrations of persistent organic pollutants and diabetes: results from the National Health and Examination Survey 1999-2002.
OBJECTIVE
Low-level exposure to some persistent organic pollutants (POPs) has recently become a focus because of their possible link with the risk of diabetes.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Lee
Duk-Hee
DH
Department of Preventive Medicine, School of Medicine, Kyungpook University, 101 Dongin-dong, Jung-gu, Daegu, Korea 700-422. lee_dh@knu.ac.kr
Lee
In-Kyu
IK
Song
Kyungeun
K
Steffes
Michael
M
Toscano
William
W
Baker
Beth A
BA
Jacobs
David R
DR
D000328:Adult; D000368:Aged; D044383:Black People; D015992:Body Mass Index; D002706:Chlordan / Q000031:analogs & derivatives / Q000097:blood; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D003633:Dichlorodiphenyl Dichloroethylene / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004781:Environmental Exposure; D004785:Environmental Pollutants / Q000097:blood*; D005260:Female; D006801:Humans; D006843:Hydrocarbons, Chlorinated / Q000097:blood; D008297:Male; D017058:Mexican Americans; D008875:Middle Aged; D011078:Polychlorinated Biphenyls / Q000097:blood*; D000072317:Polychlorinated Dibenzodioxins / Q000031:analogs & derivatives / Q000097:blood; D014481:United States / Q000453:epidemiology; D044465:White People; D001741:Black or African American
D004785:Environmental Pollutants; D006843:Hydrocarbons, Chlorinated; D000072317:Polychlorinated Dibenzodioxins; D002706:Chlordan; C008743:oxychlordane; C001870:nonachlor; D003633:Dichlorodiphenyl Dichloroethylene; D011078:Polychlorinated Biphenyls; C046839:1,2,3,4,6,7,8-heptachlorodibenzodioxin; C018117:octachlorodibenzo-4-dioxin