Dioxins, furans and dioxin-like PCBs in human blood: causes or consequences of diabetic nephropathy?
Nephropathy, or kidney disease, is a major, potential complication of diabetes. We assessed the association of 6 chlorinated dibenzo-p-dioxins, 9 chlorinated dibenzofurans and 8 polychlorinated biphenyls (PCBs) in blood with diabetic nephropathy in the 1999-2004 National Health and Nutrition Examination Survey (unweighted N=2588, population estimate=117,658,357). Diabetes was defined as diagnosed or undiagnosed (glycohemoglobin ≥ 6.5%) and nephropathy defined as urinary albumin to creatinine ratio >30 mg/g, representing microalbuminuria or macroalbuminuria. For the 8 chemicals analyzed separately, values above the 75th percentile were considered elevated, whereas for the other 15 compounds values above the maximum limit of detection were considered elevated. Seven of 8 dioxins and dioxin-like compounds, analyzed separately, were found to be associated with diabetic nephropathy. The chemicals associated with diabetic nephropathy were: 1,2,3,6,7,8-Hexachlorodibenzo-p-dioxin; 1,2,3,4,6,7,8,9-Octachlorodibenzo-p-dioxin; 2,3,4,7,8-Pentachlorodibenzofuran; PCB 126; PCB 169; PCB 118; and PCB 156. Three of the 8 dioxins and dioxin-like compounds; 1,2,3,4,6,7,8,9-Octachlorodibenzo-p-dioxin; 2,3,4,7,8-Pentachlorodibenzofuran and PCB 118; expressed as log-transformed continuous variables; were associated with diabetes without nephropathy. When 4 or more of the 23 chemicals were elevated the odds ratios were 7.00 (95% CI=1.80-27.20) for diabetic nephropathy and 2.13 (95% CI=0.95-4.78) for diabetes without nephropathy. Log-transformed toxic equivalency (TEQ) was associated with both diabetic nephropathy, and diabetes without nephropathy, the odds ratios were 2.35 (95% CI=1.57-3.52) for diabetic nephropathy, and 1.44 (95% CI=1.11-1.87) for diabetes without nephropathy. As the kidneys function to remove waste products from the blood, diabetic nephropathy could be either the cause or the consequence (or both) of exposure to dioxins, furans and dioxin-like PCBs.
Master of Environmental Studies Program, College of Charleston, Charleston, SC, USA. Electronic address: everettc@cofc.edu.
Charles J
CJ
Everett
Public Health Program, Department of Health and Human Performance, School of Education, Health and Human Performance, College of Charleston, Charleston, SC, USA.
Olivia M
OM
Thompson
D000328:Adult; D003928:Diabetic Nephropathies / Q000097:blood* / Q000139:chemically induced; D004147:Dioxins / Q000097:blood* / Q000633:toxicity; D005663:Furans / Q000097:blood* / Q000633:toxicity; D006801:Humans; D009749:Nutrition Surveys; D011078:Polychlorinated Biphenyls / Q000097:blood* / Q000633:toxicity
D004147:Dioxins; D005663:Furans; D011078:Polychlorinated Biphenyls
Diabetic nephropathy; Dioxins; Furans; Kidney disease; Polychlorinated biphenyls