title: Diabetes, metabolic syndrome, and obesity in relation to serum dioxin concentrations: the Seveso women's health study.
abstract: BACKGROUND
  In animal studies, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) alters glucose transport and increases serum lipid levels and blood pressure. Epidemiologic evidence suggests an association between TCDD and metabolic disease.
  
  
  OBJECTIVE
  On 10 July 1976, a chemical explosion in Seveso, Italy, resulted in the highest known residential exposure to TCDD. Using data from the Seveso Women's Health Study (SWHS), a cohort study of the health of the women, we examined the relation of serum TCDD to diabetes, metabolic syndrome, and obesity > 30 years later.
  
  
  METHODS
  In 1996, we enrolled 981 women who were newborn to 40 years of age in 1976 and resided in the most contaminated areas. Individual TCDD concentration was measured in archived serum that had been collected soon after the explosion. In 2008, 833 women participated in a follow-up study. Diabetes was classified based on self-report or fasting serum glucose and glycated hemoglobin levels. Metabolic syndrome was defined by International Diabetes Federation criteria. Obesity was defined as body mass index ≥ 30 kg/m2.
  
  
  RESULTS
  A 10-fold increase in serum TCDD (log10TCDD) was not associated with diabetes (adjusted hazard ratio = 0.76; 95% CI: 0.45, 1.28) or obesity [adjusted odds ratio (OR) = 0.80; 95% CI: 0.58, 1.10]. Log10TCDD was associated with metabolic syndrome, but only among women who were ≤ 12 years of age at the time of the explosion (adjusted OR = 2.03; 95% CI: 1.25, 3.29; pinteraction = 0.01).
  
  
  CONCLUSIONS
  We found an increased prevalence of metabolic syndrome associated with TCDD, but only among women who were the youngest at the time of the explosion. Continued follow-up of the SWHS cohort will be informative.
authors.affiliation: Center for Environmental Research and Children's Health, School of Public Health, University of California, Berkeley, Berkeley, CA 94720, USA. mwarner@berkeley.edu
authors.forename: Marcella
authors.initials: M
authors.lastname: Warner
authors.forename: Paolo
authors.initials: P
authors.lastname: Mocarelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Brambilla
authors.forename: Amelia
authors.initials: A
authors.lastname: Wesselink
authors.forename: Steven
authors.initials: S
authors.lastname: Samuels
authors.forename: Stefano
authors.initials: S
authors.lastname: Signorini
authors.forename: Brenda
authors.initials: B
authors.lastname: Eskenazi
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000139:chemically induced / Q000453:epidemiology*; D004781:Environmental Exposure; D004784:Environmental Monitoring; D004785:Environmental Pollutants / Q000097:blood / Q000633:toxicity*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D024821:Metabolic Syndrome / Q000139:chemically induced / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000139:chemically induced / Q000453:epidemiology*; D016017:Odds Ratio; D000072317:Polychlorinated Dibenzodioxins / Q000097:blood / Q000633:toxicity*; D015995:Prevalence; D011446:Prospective Studies; D016387:Women's Health; D055815:Young Adult
chemical_list: D004785:Environmental Pollutants; D000072317:Polychlorinated Dibenzodioxins