title: Simultaneous exposure of non-diabetics to high levels of dioxins and mercury increases their risk of insulin resistance.
abstract: Insulin resistance and the defective function of pancreatic β-cells can occur several years before the development of type 2 diabetes. It is necessary to investigate and clarify the integrated effects of moderate-to-high exposure to dioxins and mercury on the pancreatic endocrine function. This cross-sectional study investigated 1449 non-diabetic residents near a deserted pentachlorophenol and chloralkali factory. Metabolic syndrome related factors were measured to examine associations with serum dioxin and blood mercury. We also investigated associations between insulin resistance (HOMA-IR > 75th percentile), defective pancreatic β-cells function (HOMA β-cell > 75th percentile), serum dioxins and blood mercury. After adjusting for confounding factors, we found that insulin resistance increased with serum dioxins (b = 0.13, P < 0.001) and blood mercury (b = 0.01, P < 0.001). Moreover, participants with higher serum dioxins or blood mercury were at a significantly increasing risk for insulin resistance (P(trend) < 0.001). The joint highest tertile of serum dioxins and blood mercury was associated with elevated HOMA-IR at 11 times the odds of the joint lowest tertile (AOR 11.00, 95% CI: 4.87, 26.63). We hypothesize that simultaneous exposure to dioxins and mercury heightens the risk of insulin resistance more than does individual exposure.
authors.affiliation: Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.
authors.forename: Jung-Wei
authors.initials: JW
authors.lastname: Chang
authors.forename: Hsiu-Ling
authors.initials: HL
authors.lastname: Chen
authors.forename: Huey-Jen
authors.initials: HJ
authors.lastname: Su
authors.forename: Po-Chi
authors.initials: PC
authors.lastname: Liao
authors.forename: How-Ran
authors.initials: HR
authors.lastname: Guo
authors.forename: Ching-Chang
authors.initials: CC
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004147:Dioxins / Q000097:blood / Q000633:toxicity*; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D007515:Islets of Langerhans / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008628:Mercury / Q000097:blood / Q000633:toxicity*; D008875:Middle Aged
chemical_list: D004147:Dioxins; D008628:Mercury