title: Low dose organochlorine pesticides and polychlorinated biphenyls predict obesity, dyslipidemia, and insulin resistance among people free of diabetes.
abstract: BACKGROUND
  There is emerging evidence that background exposure to persistent organic pollutants (POPs) are important in the development of conditions predisposing to diabetes as well as of type 2 diabetes itself. We recently reported that low dose POPs predicted incident type 2 diabetes in a nested case-control study. The current study examined if low dose POPs predicted future adiposity, dyslipidemia, and insulin resistance among controls without diabetes in that study.
  
  
  RESULTS
  The 90 controls were diabetes-free during 20 years follow-up. They were a stratified random sample, enriched with overweight and obese persons. POPs measured in 1987-88 (year 2) sera included 8 organochlorine (OC) pesticides, 22 polychlorinated biphenyls (PCBs), and 1 polybrominated biphenyl (PBB). Body mass index (BMI), triglycerides, HDL-cholesterol, LDL-cholesterol, and homeostasis model assessment value for insulin resistance (HOMA-IR) were study outcomes at 2005-06 (year 20). The evolution of study outcomes during 18 years by categories of serum concentrations of POPs at year 2 was evaluated by adjusting for the baseline values of outcomes plus potential confounders. Parallel to prediction of type 2 diabetes, many statistically significant associations of POPs with dysmetabolic conditions appeared at low dose, forming inverted U-shaped dose-response relations. Among OC pesticides, p,p'-DDE most consistently predicted higher BMI, triglycerides, and HOMA-IR and lower HDL-cholesterol at year 20 after adjusting for baseline values. Oxychlordane, trans-nonachlor, and hexachlorobenzene also significantly predicted higher triglycerides. Persistent PCBs with ≥7 chlorides predicted higher BMI, triglycerides, and HOMA-IR and lower HDL-cholesterol at year 20 with similar dose-response curves.
  
  
  CONCLUSIONS
  Simultaneous exposure to various POPs in the general population may contribute to development of obesity, dyslipidemia, and insulin resistance, common precursors of type 2 diabetes and cardiovascular diseases. Although obesity is a primary cause of these metabolic abnormalities, POPs exposure may contribute to excess adiposity and other features of dysmetabolism.
authors.affiliation: Department of Preventative Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
authors.forename: Duk-Hee
authors.initials: DH
authors.lastname: Lee
authors.forename: Michael W
authors.initials: MW
authors.lastname: Steffes
authors.forename: Andreas
authors.initials: A
authors.lastname: Sjödin
authors.forename: Richard S
authors.initials: RS
authors.lastname: Jones
authors.forename: Larry L
authors.initials: LL
authors.lastname: Needham
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2; D050171:Dyslipidemias / Q000209:etiology*; D004781:Environmental Exposure / Q000009:adverse effects*; D004785:Environmental Pollutants / Q000097:blood* / Q000633:toxicity; D005260:Female; D006801:Humans; D006843:Hydrocarbons, Chlorinated / Q000633:toxicity; D007333:Insulin Resistance; D008297:Male; D009765:Obesity / Q000209:etiology*; D010575:Pesticides / Q000097:blood / Q000633:toxicity*; D011078:Polychlorinated Biphenyls / Q000097:blood / Q000633:toxicity*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D004785:Environmental Pollutants; D006843:Hydrocarbons, Chlorinated; D010575:Pesticides; D011078:Polychlorinated Biphenyls