Exposure to p,p'-DDE: a risk factor for type 2 diabetes.
BACKGROUND
Persistent organic pollutants (POPs), such as PCBs, DDT and dioxins have in several cross-sectional studies shown strong associations with type 2 diabetes mellitus. Reversed causality can however not be excluded. The aim of this case-control study was to evaluate whether POPs concentration is a risk factor for type 2 diabetes.


RESULTS
A case-control study was performed within a well-defined cohort of women, age 50-59 years, from the Southern part of Sweden. Biomarkers for POP exposure, 2,2',4,4',5,5'-hexachlorobiphenyl (CB-153) and 1,1-dichloro-2,2-bis (p-chlorophenyl)-ethylene (p,p'-DDE) were analyzed in stored serum samples, which were collected at the baseline examination when the cohort was established. For 107 out of the 371 cases, serum samples were stored at least three years before their type 2 diabetes was diagnosed. In this data set, CB-153 and p,p'-DDE were not associated with an increased risk to develop type 2 diabetes. However, when only the cases (n = 39) that were diagnosed more than six years after the baseline examination and their controls were studied, the women in the highest exposed quartile showed an increased risk to develop type 2 diabetes (OR of 1.6 [95% 0.61, 4.0] for CB-153 and 5.5 [95% CI 1.2, 25] for p,p'-DDE).


CONCLUSIONS
The results from the present case-control study, including a follow-up design, confirms that p,p'-DDE exposure can be a risk factor for type 2 diabetes.
Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, University Hospital, Lund, Sweden. anna.rignell-hydbom@med.lu.se
Anna
A
Rignell-Hydbom
Jonas
J
Lidfeldt
Hannu
H
Kiviranta
Panu
P
Rantakokko
Göran
G
Samsioe
Carl-David
CD
Agardh
Lars
L
Rylander
D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000139:chemically induced*; D003633:Dichlorodiphenyl Dichloroethylene / Q000097:blood / Q000633:toxicity*; D004781:Environmental Exposure; D004785:Environmental Pollutants / Q000097:blood / Q000633:toxicity*; D005260:Female; D008040:Genetic Linkage; D006801:Humans; D007306:Insecticides / Q000097:blood / Q000633:toxicity*; D008875:Middle Aged; D016017:Odds Ratio; D011078:Polychlorinated Biphenyls / Q000494:pharmacology; D012307:Risk Factors
D015415:Biomarkers; D004785:Environmental Pollutants; D007306:Insecticides; D003633:Dichlorodiphenyl Dichloroethylene; D011078:Polychlorinated Biphenyls; C014024:2,4,5,2',4',5'-hexachlorobiphenyl