title: Persistent organic pollutants and diabetes among Inuit in the Canadian Arctic.
abstract: Type 2 diabetes is a chronic metabolic disease that is of increasing concern in Inuit communities. Behavioural factors such as physical inactivity and poor diet are well-known risk factors. Exposure to persistent organic pollutants (POPs) has emerged as an additional factor in the pathogenesis of diabetes. In this study, association between polychlorinated biphenyls (PCBs) and p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) with diabetes in Canadian Inuit was examined. Data from the Adult Inuit Health Survey (2007-2008) of Inuit participants from the Canadian Arctic were analyzed. Self-reported diabetes (excluding gestational diabetes) and clinical measurement of fasting glucose were examined as outcomes. Association with individual PCB congeners, sum of dioxin-like PCBs (∑DL-PCB), non-dioxin-like PCBs (∑NDL-PCB), total PCBs (∑PCB), and p,p'-DDE were investigated using multiple regression models adjusted for confounding factors. Using different methods to incorporate serum lipids, highest vs. lowest quartile exposures to PCB-105, PCB-118, PCB-153, PCB-156, PCB-170, PCB-180, PCB-183, ∑PCB, and p,p'-DDE were associated with increased risk of diabetes. For these PCBs, odds ratios (ORs) ranged from 1.9-3.5 (lower 95% CI: 0.8-1.4, upper 95% CI: 4.4-9.0) and for p,p'-DDE the OR was 2.5 (lower 95% CI: 1.1-1.2, upper 95% CI: 5.9-6.0). The highest vs. lowest quartile exposure to most PCBs and p,p'-DDE were associated with an increase of fasting glucose by 3-7%. PCBs and p,p'-DDE were associated with increased risk of diabetes and higher fasting glucose level in a cross-sectional survey of Canadian Inuit. Cause-effect relationships of PCBs and p,p'-DDE with diabetes and diabetes-related outcomes need to be further investigated in a cohort study.
authors.affiliation: Department of Biology, University of Ottawa, Ontario K1N 6N5, Canada. Electronic address: ksing075@uottawa.ca.
authors.forename: Kavita
authors.initials: K
authors.lastname: Singh
authors.affiliation: Department of Biology, University of Ottawa, Ontario K1N 6N5, Canada. Electronic address: laurie.chan@uottawa.ca.
authors.forename: Hing Man
authors.initials: HM
authors.lastname: Chan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001110:Arctic Regions; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control; D003633:Dichlorodiphenyl Dichloroethylene / Q000032:analysis* / Q000097:blood; D004781:Environmental Exposure / Q000009:adverse effects; D004785:Environmental Pollutants / Q000032:analysis* / Q000097:blood; D005260:Female; D006801:Humans; D004930:Inuit; D008297:Male; D008875:Middle Aged; D011078:Polychlorinated Biphenyls / Q000032:analysis* / Q000097:blood; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D004785:Environmental Pollutants; D003633:Dichlorodiphenyl Dichloroethylene; D011078:Polychlorinated Biphenyls
keywords: Canada; Diabetes; Inuit; Persistent organic pollutants