title: Associations of organochlorine pesticides and polychlorinated biphenyls with total, cardiovascular, and cancer mortality in elders with differing fat mass.
abstract: BACKGROUND
  We investigated if certain persistent organic pollutants (POPs), namely polychlorinated biphenyls (PCBs) and organochlorine (OC) pesticides, predicted total, cardiovascular disease (CVD), and cancer mortality among the elderly, with the hypothesis that associations differ by the amount of fat mass.
  
  
  METHODS
  We studied serum concentrations of 11 PCBs in 633 elders (age≥70 years) and of 5 OC pesticides in 675 elders within the National Health and Nutrition Examination Survey (NHANES) 1999-2004. Mean follow-up was 4.1-years.
  
  
  RESULTS
  Neither PCBs nor OC pesticides were associated with total mortality when fat mass was not considered in analyses. However, associations of PCBs and OC pesticides with total mortality depended on fat mass (Pinteraction<0.01 and 0.06, respectively). PCBs associated inversely with total mortality for high fat mass, but not for lower fat mass. On the contrary, OC pesticides associated positively with total mortality for low fat mass and this association weakened at higher fat mass. The interaction was also observed with CVD mortality. In elders with low fat mass, higher PCBs associated with 2-3 fold higher risk of CVD mortality, while this association was absent in elders with more fat mass (Pinteraction=0.03). The positive association between OC pesticides and CVD mortality was also observed only among elderly with low fat mass (Pinteraction=0.03).
  
  
  CONCLUSIONS
  The possibility of interaction between POPs and the amount of fat mass on risk of mortality from chronic diseases is clinically important in modern societies with an obesity epidemic and requires confirmation in other studies with larger sample size.
authors: Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea; Department of Biomedical Science, Kyungpook National University, Daegu, Republic of Korea; BK21 Plus KNU Biomedical Convergence Program, Department of Biomedical Science, Kyungpook National University, Republic of Korea.
authors: Se-A
authors: SA
authors: Kim
authors: Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
authors: Ki-Su
authors: KS
authors: Kim
authors: Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
authors: Yu-Mi
authors: YM
authors: Lee
authors: Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
authors: David R
authors: DR
authors: Jacobs
authors: Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea; Department of Biomedical Science, Kyungpook National University, Daegu, Republic of Korea; BK21 Plus KNU Biomedical Convergence Program, Department of Biomedical Science, Kyungpook National University, Republic of Korea. Electronic address: lee_dh@knu.ac.kr.
authors: Duk-Hee
authors: DH
authors: Lee
mesh_terms: D015502:Absorptiometry, Photon; D050154:Adiposity; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000401:mortality*; D004781:Environmental Exposure; D004785:Environmental Pollutants / Q000097:blood; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D006843:Hydrocarbons, Chlorinated / Q000097:blood*; D008297:Male; D009369:Neoplasms / Q000139:chemically induced / Q000401:mortality*; D009749:Nutrition Surveys; D010575:Pesticides / Q000097:blood*; D011078:Polychlorinated Biphenyls / Q000097:blood*; D016016:Proportional Hazards Models; D014481:United States / Q000453:epidemiology
chemical_list: D004785:Environmental Pollutants; D006843:Hydrocarbons, Chlorinated; D010575:Pesticides; D011078:Polychlorinated Biphenyls
keywords: Cancer mortality; Cardiovascular mortality; Fat mass; Obesity; Organochlorine pesticides; Persistent organic pollutants; Polychlorinated biphenyls