Abstract
ObjectiveSeveral risk factors for type 2 diabetes mellitus (T2DM) are also associated with blood concentrations of persistent organic pollutants (POPs), and factors related to the disease may affect POP concentrations, and subsequent associations between POPs and T2DM. The purpose of this pilot study was to investigate the change in concentrations of lipids, hormones and POPs pre- and post-diagnosis in T2DM cases compared to healthy controls and their associations with T2DM. MethodsWe measured POPs, lipids, and thyroid and steroid hormones in plasma from 44 female cases collected prior to (pre-diagnostic) and following (post-diagnostic) T2DM diagnosis, and in 44 healthy female age-matched controls. We compared cross-sectional differences and longitudinal changes within and between matched cases and controls with t-tests and multivariable linear regression models. Associations between POP concentrations and T2DM were investigated using conditional logistic regression. ResultsBetween the pre- and post-diagnostic measurement, cases developed more favorable lipid profiles and the longitudinal changes in lipid-normalized concentrations of non-dioxin-like polychlorinated biphenyls (PCBs), dioxin-like PCBs, beta-hexachlorocyclohexane (HCH), HCB, and 1,1,1-trichloro-2,2-bis(4-chlorophenyl) ethane (p,p'-DDE) differed significantly between cases and controls. The longitudinal changes in POPs were mainly driven by changes in bodyweight, total lipids and T2DM status. Cases had significantly higher pre-diagnostic concentrations of POPs and triglycerides, and lower concentrations of high-density lipoprotein cholesterol and free thyroxin than controls. Pre-diagnostic POP concentrations were not significantly associated with incident T2DM, whereas several post-diagnostic POP concentrations were significantly positively associated with prevalent T2DM. ConclusionsThis pilot study suggests that factors related to T2DM affect blood concentrations of POPs and may partly explain the positive associations between POPs and T2DM.
Highlights
Chlorinated persistent organic pollutants (POPs) have received extensive attention due to their lipophilicity, persistency, and chronic toxicity in living organisms
A number of physiological conditions asso ciated with type 2 diabetes mellitus (T2DM) are associated with elevated POP concentrations and becomes a challenge when investigating the association between POPs and T2DM
Several post-diagnostic POP concentrations were positively and significantly associated with prevalent T2DM. These results suggest that factors related to lifestyle changes after T2DM diagnosis, for instance changes in weight and lipid profiles may affect POP concentrations and subsequent associations between POPs and prevalent T2DM
Summary
Chlorinated persistent organic pollutants (POPs) have received extensive attention due to their lipophilicity, persistency, and chronic toxicity in living organisms. Individuals with T2DM often suffer from dyslipidemia, a condition that causes elevated lipid concentrations in the blood, which may affect circulating POP concentrations (Jansen et al, 2017). Studies have reported that individuals who develop T2DM have elevated concentrations of blood lipids and higher BMI, years before being diagnosed with T2DM (Hulsegge et al, 2017; Vazquez et al, 2007). In order to disentangle these complex relationships, longitudinal studies of POPs and T2DM with repeated measurements from the same individuals are needed (Lee et al, 2014). Such studies are costly and require large collections of prospective samples. The intention is to use the lessons learnt from this study in the design of larger, future, longitudinal studies of POPs and T2DM
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