Circulating levels of persistent organic pollutants (POPs) and carotid atherosclerosis in the elderly.
OBJECTIVE
Increased circulating levels of persistent organic pollutants (POPs) have been associated with myocardial infarction. Because myocardial infarction is an atherosclerotic disease, we investigated, in a cross-sectional study, whether POP levels are related to atherosclerosis.


METHODS
In the population-based Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study (n = 1,016 participants 70 years of age), the prevalence of carotid artery plaques was determined by ultrasound. The number of carotid arteries with plaques (0, 1, or 2) was recorded. Also, the intima-media thickness (IMT) and gray scale median of the intima-media complex (IM-GSM) were measured. Twenty-three POPs, comprising 16 polychlorinated biphenyls (PCBs), 5 pesticides, 1 dioxin, and 1 brominated compound (brominated diphenyl ether congener BDE-47), were analyzed by high-resolution chromatography coupled to high-resolution mass spectrometry.


RESULTS
Seven of the POPs (PCB congeners 153, 156, 157, 170, 180, 206, and 209) were significantly associated with the number of carotid arteries with plaques even after adjusting for multiple risk factors (sex, waist circumference, body mass index, fasting blood glucose, systolic and diastolic blood pressure, high-density lipoprotein and low-density lipoprotein cholesterol, serum triglycerides, smoking, antihypertensive treatment, and statin use; p = 0.002-0.0001). Highly chlorinated PCBs (congeners 194, 206, and 209) were associated with an echolucent IM-GSM (p < 0.0001 after adjustment), whereas associations between POPs and IMT were modest.


CONCLUSIONS
Circulating levels of PCBs were associated with atherosclerotic plaques and echogenicity of the intima-media complex independent of cardiovascular risk factors, including lipids. This suggests that POPs may be a risk factor for myocardial infarction, but associations need to be confirmed in prospective studies.
Occupational and Environmental Medicine, Department of Medicine, Uppsala University, Uppsala, Sweden. monica.lind@medsci.uu.se
P Monica
PM
Lind
Bert
B
van Bavel
Samira
S
Salihovic
Lars
L
Lind
D000368:Aged; D050197:Atherosclerosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004147:Dioxins / Q000097:blood; D004785:Environmental Pollutants / Q000097:blood*; D055768:Halogenated Diphenyl Ethers / Q000097:blood; D006801:Humans; D009203:Myocardial Infarction / Q000097:blood; D010575:Pesticides / Q000097:blood; D011078:Polychlorinated Biphenyls / Q000097:blood; D015995:Prevalence; D012307:Risk Factors; D014463:Ultrasonography
D004147:Dioxins; D004785:Environmental Pollutants; D055768:Halogenated Diphenyl Ethers; D010575:Pesticides; D011078:Polychlorinated Biphenyls