title: Persistent organic pollutants in young adults and changes in glucose related metabolism over a 23-year follow-up.
abstract: OBJECTIVE
  Substantial evidence associates persistent organic pollutants (POP) with metabolic disturbances related to diabetes, but longitudinal studies with repeated measures are scarce. We aimed to characterize the association between background exposures to POPs with repeated measures of glucose homeostasis over 23-years.
  
  
  METHODS
  Within the Coronary Artery Risk Development in Young Adults study (year 0 ages: 18-30 years), we measured POPs in serum obtained in 1987-88 (follow-up year 2) in 90 non-diabetic controls and 90 cases diabetes-free at year 2 who became diabetic by year 20. We analyzed 32 POPs detectable in ≥75% of participants and created summary scores for 32 POPs, 23 polychlorinated biphenyls (PCB), and 8 organochlorine pesticides (OCP). Dependent variables were measures of glucose homeostasis at years 0-25 (up to 8 examinations). We explored associations using repeated measures regression adjusted for race, sex, concurrent body mass index (BMI), examination center and period, separately for cases and controls.
  
  
  RESULTS
  The associations between the three summary scores and measures of glucose homeostasis were present for observations at ages 40-55 years, and particularly between 48-55 years: the 23 PCB summary was associated with HbA1c (never-diabetics: slope [value per unit of summary score], β=0.008, p=0.02; diabetics: β=0.03, p=0.07), fasting glucose (never-diabetics: β=0.24, p=0.003; diabetics: β=1.10, p=0.03), and insulin sensitivity% (never-diabetics: β=-2.82, p<0.001, diabetics: β=-0.31, p=0.30). No associations were observed at younger ages.
  
  
  CONCLUSIONS
  Glucose homeostasis may worsen after decades of exposure to PCBs and OCPs at background environmental levels, independent of BMI and after participants reached the 5th decade of life.
authors.affiliation: Department of Family and Preventive Medicine, University of California, San Diego, 9500 Gilman Drive #0725, La Jolla, CA 92093-0725, USA. Electronic address: jrsuarez@ucsd.edu.
authors.forename: Jose R
authors.initials: JR
authors.lastname: Suarez-Lopez
authors.affiliation: Department of Preventive Medicine, School of Medicine, Kyungpook National University, 101 Dongin-dong, Jung-gu, Daegu 700-422, Korea. Electronic address: lee_dh@knu.ac.kr.
authors.forename: Duk-Hee
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Hospital del Mar Institute of Medical Research (IMIM), School of Medicine, Universitat Autonoma de Barcelona, and CIBERESP, Carrer del Dr. Aiguader, 88, E-08003 Barcelona, Catalonia, Spain. Electronic address: mporta@imim.es.
authors.forename: Miquel
authors.initials: M
authors.lastname: Porta
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Minnesota, MMC 609 Mayo 420 Delaware, Minneapolis, MN 55455, USA. Electronic address: steff001@umn.edu.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Steffes
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, 1800S, 2nd street, Suite 300, Minneapolis, MN 55454, USA. Electronic address: jacob004@umn.edu.
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology* / Q000209:etiology; D004781:Environmental Exposure; D004785:Environmental Pollutants / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D006843:Hydrocarbons, Chlorinated / Q000633:toxicity*; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D004785:Environmental Pollutants; D006843:Hydrocarbons, Chlorinated; D005947:Glucose
keywords: Glucose; HbA1c; Organochlorine; PCB; POPs