title: Association between serum concentrations of persistent organic pollutants and insulin resistance among nondiabetic adults: results from the National Health and Nutrition Examination Survey 1999-2002.
abstract: OBJECTIVE
  We reported strong relations between serum concentrations of persistent organic pollutants (POPs), especially organochlorine (OC) pesticides or nondioxin-like polychlorinated biphenyls (PCBs), and prevalence of diabetes in a U.S population with background exposure to POPs. Here, we investigated POPs and insulin resistance, a frequent pathogenic precursor of type 2 diabetes.
  
  
  METHODS
  Serum POPs and homeostasis model assessment of insulin resistance (HOMA-IR) were investigated cross-sectionally in 749 nondiabetic participants aged > or = 20 years. Nineteen POPs in five subclasses were selected, detectable in > or = 60% of participants.
  
  
  RESULTS
  Among subclasses, OC pesticides were most strongly associated with HOMA-IR. Adjusted geometric means of HOMA were 3.27, 3.36, 3.48, and 3.85 (P for trend <0.01) across quartiles of OC pesticides. The relationship strengthened with increasing HOMA-IR percentile: adjusted odds ratios comparing the highest versus lowest POPs quartile were 1.8 for being > or = 50th percentile of HOMA-IR, 4.4 for being > or = 75th percentile, and 7.5 for being > or = 90th percentile. Associations with elevated HOMA-IR appeared to be specific to oxychlordane and trans-nonachlor but also were found for two nondioxin-like PCBs. No HOMA-IR associations were seen in the other three POP subclasses. The association between OC pesticides and HOMA-IR tended to strengthen as waist circumference increased, with no apparent association in the lowest quartile of OC pesticide concentrations.
  
  
  CONCLUSIONS
  These findings, coupled with those concerning diabetes prevalence, suggest that OC pesticides and nondioxin-like PCBs may be associated with type 2 diabetes risk by increasing insulin resistance, and POPs may interact with obesity to increase the risk of type 2 diabetes.
authors.affiliation: Department of Preventive Medicine, School of Medicine, Kyungpook National University, 101 Dongin-dong, Jung-gu, Daegu, Korea 700-422. lee_dh@knu.ac.kr
authors.forename: Duk-Hee
authors.initials: DH
authors.lastname: Lee
authors.forename: In-Kyu
authors.initials: IK
authors.lastname: Lee
authors.forename: Soo-Hee
authors.initials: SH
authors.lastname: Jin
authors.forename: Michael
authors.initials: M
authors.lastname: Steffes
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
mesh_terms: D002487:Centers for Disease Control and Prevention, U.S.; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D004785:Environmental Pollutants / Q000097:blood*; D006306:Health Surveys; D006801:Humans; D006843:Hydrocarbons, Chlorinated / Q000097:blood*; D007333:Insulin Resistance; D009749:Nutrition Surveys; D016017:Odds Ratio; D011078:Polychlorinated Biphenyls / Q000097:blood*; D014481:United States
chemical_list: D004785:Environmental Pollutants; D006843:Hydrocarbons, Chlorinated; D011078:Polychlorinated Biphenyls