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Can Low Dose Persistent Organic Pollutants Explain the Current Epidemic of Type 2 Diabetes?

Lee, Duk-Hee1; Jacobs, David2

doi: 10.1097/01.ede.0000392125.80481.54
Abstracts: ISEE 22nd Annual Conference, Seoul, Korea, 28 August–1 September 2010: Persistent Organic Pollutants: New Risk Factors For Chronic Diseases

1Kyungpook National University, Daegu, Republic of Korea; and 2University of Minnesota, Minneapolis, MN.

Abstracts published in Epidemiology have been reviewed by the societies at whose meetings the abstracts have been accepted for presentation. These abstracts have not undergone review by the Editorial Board of Epidemiology.


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A current paradigm for type 2 diabetes rests on a sequence of events. Obesity occurs due to energy imbalance between energy input and output, insulin resistance is due to obesity, and exhaustion of pancreatic beta cells is due to overproduction of insulin to compensate for insulin resistance, ultimately progressing to type 2 diabetes. However, there is emerging evidence that the background exposure to persistent organic pollutants (POPs), a group of chemicals that mainly accumulates in adipose tissue, may be critically involved in the pathogenesis of type 2 diabetes.

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It has been recently reported that serum concentrations of POPs were strongly associated with the prevalence of type 2 diabetes in the US general population.

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After adjusting for known risk factors for diabetes, compared to people with very low concentrations of POPs, the prevalence of type 2 diabetes among those with detectable concentrations of POPs increased by 15–40 fold. Also, the associations were more strongly observed among obese than nonobese persons. Although dioxins have been widely studied as the most toxic chemical among POPs, organochlorine pesticides and polychlorinated biphenyl congeners were strongly associated with type-2 diabetes. In particular, it was striking that when POPs concentrations were very low, prevalent type 2 diabetes was very rare even among the obese with BMI ≥30 kg/m2. Serum concentrations of these POPs were also associated with insulin resistance and adverse lipid profiles among those without diabetes. Recent findings from prospective studies and experimental studies support these cross-sectional associations.

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Adverse metabolic effects may occur at the low and persistent exposures to POPs currently observed in the general population even as there is a decreasing trend of chlorinated POPs during recent decades. These low levels of POPs may contribute to the epidemic of type 2 diabetes.

© 2011 Lippincott Williams & Wilkins, Inc.