Associations between plasma persistent organic pollutants and type II diabetes in Canadians: a nationally-representative, cross-sectional study.

Abstract

Background: There is increasing evidence from epidemiological and toxicological studies that persistent organic pollutants (POPs) contribute to the pathogenesis of type II diabetes. Aims: To quantify the associations between plasma POPs and diabetes in cycle 1 (2007-2009) of the Canadian Health Measures Survey, a cross-sectional multistage sample representing 96% of Canadians. Methods: Our sample included 1669 participants aged 20 to 79. We used logistic regression with bootstrap resampling to analyze 19 POPs detectable in at least 60% of plasma samples. Diabetes was defined as any of self-reported doctor diagnosis, use of diabetic medication, fasting HbA1C >=6.5% or fasting glucose >=7.0 mmol/L. Results: The relative odds of diabetes (OR, 95% CI) for interquartile increases in log-transformed and lipid-normalized POPs after adjustment for BMI, waist-to-hip ratio (WHR), BMI-WHR interaction, daily leisure energy expenditure and age (sex was not a confounder) were 2.0 (1.2-3.3) for Arochlor 1260; 1.7 (1.1-2.9) for PCB 138; 2.1 (1.2-3.5) for PCB 153; 1.9 (1.0-3.4) for PCB 163; 1.9 (1.2-3.0) for PCB 170; 1.8 (1.2-2.8) for PCB 180; 1.7 (1.0-2.9) for PCB 187; 1.5 (1.1-2.1) for betahexachlorohexane; 1.4 (1.0-1.8) for hexachlorobenzene and 2.1 (1.0-4.6) for oxychlordane. Adjusted interquartile ORs with 2-sided p value >0.05 were 1.6 (0.9-2.7) for PCB 118; 1.6 (1.0-2.6) for PCB 146; 1.6 (0.9-2.7) for PCB 156; 1.3 (0.9-1.9) for PCB 194; 1.4 (0.9-2.1) for PCB 201; 1.3 (0.9-1.9) for PCB 203; 1.5 (0.9-2.3) for pp-DDE; 1.9 (0.7-4.8) for transnonachlor; and 1.1 (0.8-1.5) for PBDE 47. Conclusions: Most POPs were positively associated with the odds of diabetes in this sample although some estimates had insufficient precision. Our results add to the weight of evidence that POPs contribute to the pathogenesis of type II diabetes.