Medscape Medical News
Environmental Toxins Associated With Diabetes, Obesity
Lara C. Pullen, PhD
June 24, 2014
Persistent organic pollutants (POPs) resist biodegradation and are ubiquitous in the environment and food chain. New data reveal that levels of POPs in human serum and adipose tissue are significantly correlated with glucose levels determined during an oral glucose tolerance test. The results suggest that environmental levels of POPs may be diabetogenic.
Eveline L. Dirinck, MD, from the Department of Endocrinology, Diabetology, and Metabolism in Antwerp University Hospital in Belgium, and colleagues publish the results of their cross-sectional study of 151 obese and 44 normal-weight individuals in the July issue of Diabetes Care. The investigators evaluated a wide range of ubiquitously present POPs, including 28 types of polychlorinated biphenyls (PCBs) and pesticide p,p'- dichlorodiphenyldichloroethylene (p,p'-DDE). They found that individuals who were obese had higher levels of POPs than normal-weight individuals.
The investigators then performed a logistic regression analysis using a model that included age, sex, family history of diabetes, body mass index, abdominal computed tomography, and visceral adipose tissue, smoking behavior, physical activity level score, and POP level. Serum levels of PCB153, the sum of PCBs, and p,p'-DDE were all significant predictors of abnormal glucose tolerance (odds ratio, 4.6, 4.8, and 3.4, respectively; P < .05). Adipose tissue levels of p,p'-DDE were also a significant predictor of abnormal glucose tolerance (odds ratio, 81.6; P < .05).
"Our analyses indicate indeed a positive correlation between fasting glucose, 2 h post load and [area under the curve] glucose levels on the one hand and serum and total body levels of all POPs on the other hand. Total body levels of all POPs were also significantly related to HbA1c.We did not detect a relationship with fasting insulin, thus failing to identify a compensatory rise in insulin secretion," the authors conclude.
The results build on a previous study in Sweden that found that elevated levels of POPs predicted the development of type 2 diabetes.
There is a strong correlation among central adiposity, cardiovascular disease, and type 2 diabetes mellitus. The authors suggest that exposure to endocrine-disrupting POPs may be contributing to the pandemic of both type 2 diabetes mellitus and obesity.
The authors have disclosed no relevant financial relationships.
Diabetes Care. 2014;37:1951-1958.