title: Evaluation of the association between persistent organic pollutants (POPs) and diabetes in epidemiological studies: a national toxicology program workshop review.
abstract: BACKGROUND
  Diabetes is a major threat to public health in the United States and worldwide. Understanding the role of environmental chemicals in the development or progression of diabetes is an emerging issue in environmental health.
  
  
  OBJECTIVE
  We assessed the epidemiologic literature for evidence of associations between persistent organic pollutants (POPs) and type 2 diabetes.
  
  
  METHODS
  Using a PubMed search and reference lists from relevant studies or review articles, we identified 72 epidemiological studies that investigated associations of persistent organic pollutants (POPs) with diabetes. We evaluated these studies for consistency, strengths and weaknesses of study design (including power and statistical methods), clinical diagnosis, exposure assessment, study population characteristics, and identification of data gaps and areas for future research.
  
  
  CONCLUSIONS
  Heterogeneity of the studies precluded conducting a meta-analysis, but the overall evidence is sufficient for a positive association of some organochlorine POPs with type 2 diabetes. Collectively, these data are not sufficient to establish causality. Initial data mining revealed that the strongest positive correlation of diabetes with POPs occurred with organochlorine compounds, such as trans-nonachlor, dichlorodiphenyldichloroethylene (DDE), polychlorinated biphenyls (PCBs), and dioxins and dioxin-like chemicals. There is less indication of an association between other nonorganochlorine POPs, such as perfluoroalkyl acids and brominated compounds, and type 2 diabetes. Experimental data are needed to confirm the causality of these POPs, which will shed new light on the pathogenesis of diabetes. This new information should be considered by governmental bodies involved in the regulation of environmental contaminants.
authors: Office of Health Assessment and Translation, Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina 27709 , USA. taylorkw@niehs.nih.gov
authors: Kyla W
authors: KW
authors: Taylor
authors: Raymond F
authors: RF
authors: Novak
authors: Henry A
authors: HA
authors: Anderson
authors: Linda S
authors: LS
authors: Birnbaum
authors: Chad
authors: C
authors: Blystone
authors: Michael
authors: M
authors: Devito
authors: David
authors: D
authors: Jacobs
authors: Josef
authors: J
authors: Köhrle
authors: Duk-Hee
authors: DH
authors: Lee
authors: Lars
authors: L
authors: Rylander
authors: Anna
authors: A
authors: Rignell-Hydbom
authors: Rogelio
authors: R
authors: Tornero-Velez
authors: Mary E
authors: ME
authors: Turyk
authors: Abee L
authors: AL
authors: Boyles
authors: Kristina A
authors: KA
authors: Thayer
authors: Lars
authors: L
authors: Lind
mesh_terms: D000818:Animals; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced / Q000453:epidemiology*; D004781:Environmental Exposure; D004785:Environmental Pollutants / Q000032:analysis / Q000633:toxicity*; D006801:Humans; D006843:Hydrocarbons, Chlorinated / Q000032:analysis / Q000633:toxicity; D051379:Mice; D009765:Obesity / Q000139:chemically induced / Q000453:epidemiology; D051381:Rats
chemical_list: D004785:Environmental Pollutants; D006843:Hydrocarbons, Chlorinated
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