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DOI: 10.2337/dc06-2190
© 2007 by the American Diabetes Association
Pathophysiology/Complications |
Association Between Serum Concentrations of Persistent Organic Pollutants and Insulin Resistance Among Nondiabetic Adults
Results from the National Health and Nutrition Examination Survey 1999–2002
1 Department of Preventive Medicine and Health Promotion Research Center, School of Medicine, Kyungpook National University, Daegu, Korea
2 Department of Endocrinology, School of Medicine, Kyungpook National University, Daegu, Korea
3 Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
4 Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota
5 Department of Nutrition, University of Oslo, Oslo, Norway
Address correspondence and reprint requests to Duk-Hee Lee, MD, PhD, Department of Preventive Medicine, School of Medicine, Kyungpook University, 101 Dongin-dong, Jung-gu, Daegu, Korea 700-422. E-mail: lee_dh{at}knu.ac.kr
OBJECTIVE—We reported strong relations between serum concentrations of persistent organic pollutants (POPs), especially organochlorine (OC) pesticides or nondioxin-like polychlorinated biphenyls (PCBs), and prevalence of diabetes in a U.S population with background exposure to POPs. Here, we investigated POPs and insulin resistance, a frequent pathogenic precursor of type 2 diabetes.
RESEARCH DESIGN AND METHODS—Serum POPs and homeostasis model assessment of insulin resistance (HOMA-IR) were investigated cross-sectionally in 749 nondiabetic participants aged 
20 years. Nineteen POPs in five subclasses were selected, detectable in 60% of participants.
RESULTS—Among subclasses, OC pesticides were most strongly associated with HOMA-IR. Adjusted geometric means of HOMA were 3.27, 3.36, 3.48, and 3.85 (P for trend <0.01) across quartiles of OC pesticides. The relationship strengthened with increasing HOMA-IR percentile: adjusted odds ratios comparing the highest versus lowest POPs quartile were 1.8 for being 50th percentile of HOMA-IR, 4.4 for being 75th percentile, and 7.5 for being 90th percentile. Associations with elevated HOMA-IR appeared to be specific to oxychlordane and trans-nonachlor but also were found for two nondioxin-like PCBs. No HOMA-IR associations were seen in the other three POP subclasses. The association between OC pesticides and HOMA-IR tended to strengthen as waist circumference increased, with no apparent association in the lowest quartile of OC pesticide concentrations.
CONCLUSIONS—These findings, coupled with those concerning diabetes prevalence, suggest that OC pesticides and nondioxin-like PCBs may be associated with type 2 diabetes risk by increasing insulin resistance, and POPs may interact with obesity to increase the risk of type 2 diabetes.
Abbreviations: HOMA-IR, homeostasis model assessment of insulin resistance • LOD, limit of detection • NHANES, National Health and Nutrition Examination Survey • OC, organochlorine • PCB, polychlorinated biphenyl • PCDD, polychlorinated dibenzo-p-dioxin • PCDF, polychlorinated dibenzofurans • POP, persistant organic pollutant
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