title: High prevalence of prediabetes and diabetes in a population exposed to high levels of an organochlorine cocktail.
abstract: OBJECTIVE
  A heavily polluted area of Eastern Slovakia was targeted by the PCBRISK cross-sectional survey to search for possible links between environmental pollution and both prediabetes and diabetes.
  
  
  METHODS
  Associations of serum levels of five persistent organic pollutants (POPs), namely polychlorinated biphenyls (PCBs), 2,2'-bis(4-chlorophenyl)-1,1-dichloroethylene (p,p'-DDE), 2,2'-bis(4-chlorophenyl)-1,1,1-trichloro-ethane (p,p'-DDT), hexachlorobenzene (HCB) and beta-hexachlorocyclohexane (beta-HCH), with prediabetes and diabetes were investigated in 2,047 adults. Diabetes and prediabetes were diagnosed by fasting plasma glucose in all participants and by OGTT in 1,220 compliant participants.
  
  
  RESULTS
  Our population was stratified in terms of individual POPs quintiles and associations between environmental pollution, prediabetes and diabetes were investigated. Prevalence of prediabetes and diabetes increased in a dose-dependent manner, with individuals in upper quintiles of individual POPs showing striking increases in prevalence of prediabetes as shown by OR and 95% CI for PCBs (2.74; 1.92-3.90), DDE (1.86; 1.17-2.95), DDT (2.48; 1.77-3.48), HCB (1.86; 1.7-2.95) and beta-HCH (1.97; 1.28-3.04). Interestingly, unlike PCBs, DDT and DDE, increased levels of HCB and beta-HCH seemed not to be associated with increased prevalence of diabetes. Nevertheless, individuals in the 5th quintile of the variable expressing the cumulative effect of all five POPs (sum of orders) had a more than tripled prevalence of prediabetes and more than six times higher prevalence of diabetes when compared with the 1st referent quintile.
  
  
  CONCLUSIONS
  Increasing serum concentrations of individual POPs considerably increased prevalence of prediabetes and diabetes in a dose-dependent manner. Interaction of industrial and agricultural pollutants in increasing prevalence of prediabetes or diabetes is likely.
authors.affiliation: Diabetes Laboratory, Institute of Experimental Endocrinology (an EU Centre of Excellence) Slovak Academy of Sciences, Vlarska 3, 83306 Bratislava, Slovak Republic.
authors.forename: J
authors.initials: J
authors.lastname: Ukropec
authors.forename: Z
authors.initials: Z
authors.lastname: Radikova
authors.forename: M
authors.initials: M
authors.lastname: Huckova
authors.forename: J
authors.initials: J
authors.lastname: Koska
authors.forename: A
authors.initials: A
authors.lastname: Kocan
authors.forename: E
authors.initials: E
authors.lastname: Sebokova
authors.forename: B
authors.initials: B
authors.lastname: Drobna
authors.forename: T
authors.initials: T
authors.lastname: Trnovec
authors.forename: K
authors.initials: K
authors.lastname: Susienkova
authors.forename: V
authors.initials: V
authors.lastname: Labudova
authors.forename: D
authors.initials: D
authors.lastname: Gasperikova
authors.forename: P
authors.initials: P
authors.lastname: Langer
authors.forename: I
authors.initials: I
authors.lastname: Klimes
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology*; D004305:Dose-Response Relationship, Drug; D004785:Environmental Pollutants / Q000097:blood*; D004787:Environmental Pollution; D005163:Factor Analysis, Statistical; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006843:Hydrocarbons, Chlorinated / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood / Q000453:epidemiology*; D015995:Prevalence; D018154:Slovakia / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D004785:Environmental Pollutants; D006843:Hydrocarbons, Chlorinated