Abstract Background Polychlorinated biphenyls (PCBs) were associated with cardiovascular disease (CVD) in the general population. However, it is unclear whether PCBs exposure increases the additional risk of CVD among type 2 diabetes (T2D) cases. This study aims to investigate the associations between serum concentrations of PCBs and incident CVD among T2D cases. Methods The study population was derived from Dongfeng-Tongji cohort in 2008 and followed up until December 31, 2018, with a total of 2,806 participants with type 2 diabetes included and 1180 of them developed CVD during the follow-up. Cox proportional hazard regression models and quantile g-computation method were conducted for the associations of serum PCB levels with incident CVD risk. Results Compared with the first quartile, the risk of incident CVD was increased by 25%, 30%, and 28% in the fourth quartile of serum concentrations of PCB28, PCB52, and PCB101, respectively. Similar results were obtained for lower-chlorinated PCBs (PCB28 + PCB52 + PCB101) with HR (95% CI) of 1.257 (1.063, 1.486), and 1.346 (1.139, 1.589) in the third and fourth quartiles, respectively (P trend = 0.001). Quantile g-computation indicated that mixed exposure to PCBs increased the risk of CVD and the top three weights of PCB congeners were PCB101, PCB52, and PCB28. Conclusions Serum PCB independently increased the risk of incident CVD among T2D cases, in which lower-chlorinated PCBs played a dominant role.
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