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Persistent organic pollutants and type 2 diabetes: a prospective analysis in the nurses' health study and meta-analysis.

Wu H, Bertrand KA, Choi AL, Hu FB, Laden F, Grandjean P, Sun Q - Environ. Health Perspect. (2012)

Bottom Line: We used a fixed-effects model to summarize results.After multivariable adjustment, plasma HCB concentration was positively associated with incident T2D [pooled odds ratio (OR) 3.59 (95% CI: 1.49, 8.64, ptrend = 0.003) comparing extreme tertiles].Other POPs were not significantly associated with diabetes.

View Article: PubMed Central - PubMed

Affiliation: Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USA.

ABSTRACT

Background: Prospective data regarding persistent organic pollutants (POPs) and risk of type 2 diabetes (T2D) are limited, and the results for individual POPs are not entirely consistent across studies.

Objectives: We prospectively examined plasma POP concentrations in relation to incident T2D and summarized existing evidence in a meta-analysis.

Methods: Plasma polychlorinated biphenyls (PCBs), dichlorodiphenyltrichloroethane (DDT), dichlorodiphenyldichloroethylene (DDE), and hexachlorobenzene (HCB) concentrations were measured in 1,095 women who were free of diabetes at blood draw in 1989-1990 and participated in two case-control studies in the Nurses' Health Study. We identified 48 incident T2D cases through 30 June 2008. We conducted a literature search in PubMed and EMBASE through December 2011 to identify prospective studies on POPs in relation to diabetes. We used a fixed-effects model to summarize results.

Results: After multivariable adjustment, plasma HCB concentration was positively associated with incident T2D [pooled odds ratio (OR) 3.59 (95% CI: 1.49, 8.64, ptrend = 0.003) comparing extreme tertiles]. Other POPs were not significantly associated with diabetes. After pooling our results with those of six published prospective studies that included 842 diabetes cases in total, we found that HCB and total PCBs both were associated with diabetes: the pooled ORs were 2.00 (95% CI: 1.13, 3.53; I2 = 21.4%, pheterogeneity = 0.28) and 1.70 (95% CI: 1.28, 2.27; I2 = 16.3%, pheterogeneity = 0.30) for HCB and total PCBs, respectively.

Conclusions: These findings support an association between POP exposure and the risk of T2D.

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Literature search and study selection.
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f1: Literature search and study selection.

Mentions: Meta-analysis. Study selection. We searched the National Institutes of Health U.S. National Library of Medicine’s PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) and Elsevier’s EMBASE (http://www.embase.com/) databases for articles regarding POP exposures and diabetes risk that were published through 2 December 2011. [For a list of the search terms used, see Supplemental Material, p. 2 (http://dx.doi.org/10.1289/ehp.1205248).] We applied the following study inclusion criteria: a) a prospective study design, and b) that point estimates of relative risk (RR) of diabetes with 95% CI or SEs were available or could be derived. We excluded animal studies, clinical trials, cross-sectional studies, reviews, commentaries, letters, and studies that examined irrelevant exposures or outcomes. Two investigators (H.W. and K.A.B.) independently screened all studies by title or abstract, and then by a full text evaluation. Any discrepancy between the two authors was solved by discussion with the senior investigator (Q.S.). Of 589 unique publications identified in the literature search, we identified six prospective studies (Lee et al. 2010, 2011; Rignell-Hydbom et al. 2009; Turyk et al. 2009; Vasiliu et al. 2006; Wang et al. 2008) that explicitly evaluated the association between circulating POP concentrations and incident T2D (Figure 1).


Persistent organic pollutants and type 2 diabetes: a prospective analysis in the nurses' health study and meta-analysis.

Wu H, Bertrand KA, Choi AL, Hu FB, Laden F, Grandjean P, Sun Q - Environ. Health Perspect. (2012)

Literature search and study selection.
© Copyright Policy - public-domain
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3569682&req=5

f1: Literature search and study selection.
Mentions: Meta-analysis. Study selection. We searched the National Institutes of Health U.S. National Library of Medicine’s PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) and Elsevier’s EMBASE (http://www.embase.com/) databases for articles regarding POP exposures and diabetes risk that were published through 2 December 2011. [For a list of the search terms used, see Supplemental Material, p. 2 (http://dx.doi.org/10.1289/ehp.1205248).] We applied the following study inclusion criteria: a) a prospective study design, and b) that point estimates of relative risk (RR) of diabetes with 95% CI or SEs were available or could be derived. We excluded animal studies, clinical trials, cross-sectional studies, reviews, commentaries, letters, and studies that examined irrelevant exposures or outcomes. Two investigators (H.W. and K.A.B.) independently screened all studies by title or abstract, and then by a full text evaluation. Any discrepancy between the two authors was solved by discussion with the senior investigator (Q.S.). Of 589 unique publications identified in the literature search, we identified six prospective studies (Lee et al. 2010, 2011; Rignell-Hydbom et al. 2009; Turyk et al. 2009; Vasiliu et al. 2006; Wang et al. 2008) that explicitly evaluated the association between circulating POP concentrations and incident T2D (Figure 1).

Bottom Line: We used a fixed-effects model to summarize results.After multivariable adjustment, plasma HCB concentration was positively associated with incident T2D [pooled odds ratio (OR) 3.59 (95% CI: 1.49, 8.64, ptrend = 0.003) comparing extreme tertiles].Other POPs were not significantly associated with diabetes.

View Article: PubMed Central - PubMed

Affiliation: Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USA.

ABSTRACT

Background: Prospective data regarding persistent organic pollutants (POPs) and risk of type 2 diabetes (T2D) are limited, and the results for individual POPs are not entirely consistent across studies.

Objectives: We prospectively examined plasma POP concentrations in relation to incident T2D and summarized existing evidence in a meta-analysis.

Methods: Plasma polychlorinated biphenyls (PCBs), dichlorodiphenyltrichloroethane (DDT), dichlorodiphenyldichloroethylene (DDE), and hexachlorobenzene (HCB) concentrations were measured in 1,095 women who were free of diabetes at blood draw in 1989-1990 and participated in two case-control studies in the Nurses' Health Study. We identified 48 incident T2D cases through 30 June 2008. We conducted a literature search in PubMed and EMBASE through December 2011 to identify prospective studies on POPs in relation to diabetes. We used a fixed-effects model to summarize results.

Results: After multivariable adjustment, plasma HCB concentration was positively associated with incident T2D [pooled odds ratio (OR) 3.59 (95% CI: 1.49, 8.64, ptrend = 0.003) comparing extreme tertiles]. Other POPs were not significantly associated with diabetes. After pooling our results with those of six published prospective studies that included 842 diabetes cases in total, we found that HCB and total PCBs both were associated with diabetes: the pooled ORs were 2.00 (95% CI: 1.13, 3.53; I2 = 21.4%, pheterogeneity = 0.28) and 1.70 (95% CI: 1.28, 2.27; I2 = 16.3%, pheterogeneity = 0.30) for HCB and total PCBs, respectively.

Conclusions: These findings support an association between POP exposure and the risk of T2D.

Show MeSH
Related in: MedlinePlus