Abstract
Positive associations have been reported between persistent organic pollutants (POPs) and type 2 diabetes mellitus (T2DM); however, causality has not been established. Over the last decades, environmental exposure to legacy POPs has decreased, complicating epidemiological studies. In addition, physiological risk factors for T2DM may also influence POP concentrations, contributing to a complex network of factors that could impact associations with T2DM. Longitudinal studies on this topic are lacking, and few have assessed prospective and cross-sectional associations between repeated POP measurements and T2DM in the same individuals, which may shed light on causality. To compare longitudinal trends in concentrations of polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) in T2DM cases and controls, and to examine prospective and cross-sectional associations between PCBs, OCPs and T2DM at different time-points before and after T2DM diagnosis in cases. We conducted a longitudinal, nested case-control study (1986-2016) of 116 T2DM cases and 139 controls from the Tromsø Study. All participants had three blood samples collected before T2DM diagnosis in cases, and up to two samples thereafter. We used linear mixed-effect models to assess temporal changes of POPs within and between T2DM cases and controls, and logistic regression models to investigate the associations between different POPs and T2DM at different time-points. PCBs, trans-nonachlor, cis-nonachlor, oxychlordane, cis-heptachlor epoxide, p,p'-DDE, and p,p'-DDT declined more slowly in cases than controls, whereas β-HCH and HCB declined similarly in both groups. Most POPs showed positive associations between both pre- and post-diagnostic concentrations and T2DM, though effect estimates were imprecise. These associations were most consistent for cis-heptachlor epoxide. The observed positive associations between certain POPs and T2DM may be because of higher POP concentrations within prospective T2DM cases, due to slower temporal declines as compared to controls.
Highlights
Type 2 diabetes mellitus (T2DM) is a global health challenge, affecting nearly 463 million people worldwide in 2019 (Saeedi et al, 2019)
Recent research has focused on other risk factors, like persistent organic pollutants (POPs), and has established positive associations between type 2 diabetes mellitus (T2DM) and several polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs)
We have presented all results from the logistic regression models as odds ratios (ORs) per 1-standard deviations (SD) increase in POP measure in controls along with 95% confidence intervals (CIs)
Summary
Type 2 diabetes mellitus (T2DM) is a global health challenge, affecting nearly 463 million people worldwide (prevalence: 9.3%) in 2019 (Saeedi et al, 2019). Recent research has focused on other risk factors, like persistent organic pollutants (POPs), and has established positive associations between T2DM and several polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) (Magliano et al, 2014; Taylor et al., 2013), causality has not been established. Physiological risk factors for T2DM may influence POP concentrations, contributing to a complex network of factors that could impact associations with T2DM. Longitudinal studies on this topic are lacking, and few have assessed prospective and cross-sectional associations between repeated POP measurements and T2DM in the same individuals, which may shed light on causality. Discussion: The observed positive associations between certain POPs and T2DM may be because of higher POP concentrations within prospective T2DM cases, due to slower temporal declines as compared to controls
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