Abstract
We have studied rates of diabetes in 601 members of the Mohawk Nation at Akwesasne, ages 18–84 years, in relation to serum concentrations of 101 polychlorinated biphenyl (PCB) congeners and three chlorinated pesticides [dichlorodiphenyldichloroethylene (DDE), hexachlorobenzene (HCB) and mirex]. Diabetes was determined from either a diagnosis by a physician or by having a fasting glucose concentration of >125 mg/dL. Rates of diabetes are high in this community. Three models were used. In the first model rate ratios (RR) were determined for quartiles of total PCBs after adjustment for age, sex, body mass index (BMI) and total serum lipids. For total PCBs RR=2.21 (1.2–4.2), while for total pesticides RR=3.75 (1.3–10.7). When the total PCB results were also adjusted for total pesticides and the total pesticide results were also adjusted for total PCBs (Model 2) the RRs were somewhat reduced. In Model 3 we considered subgroups of PCBs based on numbers of chlorines on the molecule (tri-/tetra, penta-/hexa, hepta plus) and numbers of ortho chlorines (non-/mono; di-, tri-/tetra-), and considered each of the pesticides individually after adjustment for all other contaminants as well as age, sex, BMI and serum lipids. We found a highly significant association between diabetes and PCBs with only three or four chlorines (RR=5.02), but no significant association with those with greater chlorination. When evaluating PCBs based on numbers of ortho chlorines only, those with no or one ortho chlorine showed significant associations. As mono-ortho PCBs include some with dioxin-like activity, we compared those with and without a TEF, and found that the association with diabetes was exclusively with the non-dioxin-like congeners. Of the pesticides only hexachlorobenzene showed a small but significant association with diabetes. Because lower chlorinated PCBs are more volatile and do not greatly accumulate in fish, these results suggest that inhalation is the major route of exposure to those PCBs that increase risk of diabetes.
References
1. Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet 2011;378:31–40.10.1016/S0140-6736(11)60679-XSearch in Google Scholar
2. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes. Diabetes Res Clin Pract 2010;87:4–14.10.1016/j.diabres.2009.10.007Search in Google Scholar
3. Kriska AM, Saremi A, Hanson RL, Bennet PH, Kobes S, et al. Physical activity, obesity, and the incidence of type 2 diabetes in a high-risk population. Am J Epidemiol 2003;15:669–75.10.1093/aje/kwg191Search in Google Scholar
4. Biggs ML, Mukamal KJ, Luchsinger JA, Ix JH, Carnethon MR, et al. Association between adiposity in midlife and older age and risk of diabetes in older adults. J Am Med Assoc 2010;303:2504–12.10.1001/jama.2010.843Search in Google Scholar
5. Centers for Disease Control and Prevention (CDC). Diabetes prevalence among American Indians and Alaska Natives and the overall population – United States, 1994–2002. Morbid Mortal Week Report 2003;52:702.Search in Google Scholar
6. Del Razo LM, García-Vargas GG, Valenzuela OL, Castellanos EH, Sánchez-Peña LC, et al. Exposure to arsenic in drinking water is associated with increased prevalence of diabetes: a cross-sectional study in the Zimapán and Lagunera regions in Mexico. Environ Health 2011;10:73. http://www.ehjournal.net/content/10/1/73.10.1186/1476-069X-10-73Search in Google Scholar
7. Rignell-Hydbom A, Lidfeldt J, Kiviranta H, Rantakokko P, Samsioe G, et al. Exposure to p,p′-DDE: a risk factor for type 2 diabetes. PLoS ONE 2009;4:e7503.10.1371/journal.pone.0007503Search in Google Scholar
8. Turyk M, Anderson H, Knobeloch L, Imm P, Persky V. Organochlorine exposure and incidence of diabetes in a cohort of Great Lakes sport fish consumers. Environ Health Perspect 2009;117:1076–82.10.1289/ehp.0800281Search in Google Scholar
9. Lee D-H, Steffes MW, Sjödin A, Jones RS, Needham LL, et al. Low dose of some persistent organic pollutants predicts type 2 diabetes: a nested case-control study. Environ Health Perspect 2010;118:1235–42.10.1289/ehp.0901480Search in Google Scholar
10. Ruzzin J, Petersen R, Meugnier E, Madsen L, Lock EJ, et al. Persistent organic pollutant exposure leads to insulin resistance syndrome. Environ Health Perspect 2010;118:465–71.10.1289/ehp.0901321Search in Google Scholar
11. Hwang S-A. Fitzgerald EF, Bush B, Cook KSE. Exposure to PCBs from hazardous waste among Mohawk women and infants at akwesasne. J Franklin Inst 1996;333A:17–23.Search in Google Scholar
12. Fitzgerald EF, Hwang S-A, Langguth K, Cayo M, Yang B-Z, et al. Fish consumption and other environmental exposures and their associations with serum PCB concentrations among Mohawk women at Akwesasne. Environ Res 2004;94:160–70.10.1016/S0013-9351(03)00133-6Search in Google Scholar
13. DeCaprio AP, Johnson GW, Tarbell AM, Carpenter DO, Chiarenzelli JR, et al. Polychlorinated biphenyl (PCB) exposure assessment by multivariate statistical analysis of serum congener profiles in an adult native American population. Environ Res 2005;98:284–302.10.1016/j.envres.2004.09.004Search in Google Scholar PubMed
14. Matthews HB, Anderson MW. Effect of chlorination on the distribution and excretion of polychlorinated biphenyls. Drug Metab Dispos 1975;3:371–80.Search in Google Scholar
15. Codru N, Schymura MJ, Negoita S, The Akwesasne Task Force on the Environment, Rej R, et al. Diabetes in relation to serum levels of polychlorinated biphenyls and chlorinated pesticides in adult Native Americans. Environ Health Perspect 2007;115:1442–7.10.1289/ehp.10315Search in Google Scholar PubMed PubMed Central
16. Aminov Z, Haase RF, Pavuk M, Carpenter DO, Anniston Environmental Health Research Consortium. Anaylsis of the effects of exposure to polychlorinated biphenyls and chlorinated pesticides on serum lipid levels in residents of Anniston, Alabama. Environ Health 2013;12:108. http://www.ehjournal.net/content/12/1/108.10.1186/1476-069X-12-108Search in Google Scholar PubMed PubMed Central
17. Goncharov A, Haase RF, Santiago-Rivera A, Morse G, Akwesasne Task Force on the Environment, et al. High serum PCBs are associated with elevation of serum lipids and cardiovascular disease in a Native American population. Environ Red 2008;106:226–39.10.1016/j.envres.2007.10.006Search in Google Scholar PubMed PubMed Central
18. DeCaprio AP, Tarbell AM, Bott A, Wagemaker DL, Williams RL, et al. Routine analysis of 101 polychlorinated biphenyl congeners in human serum by parallel dual-column gas chromatography with electron capture detection. J Analytic Toxicol 2000;24:403–20.10.1093/jat/24.6.403Search in Google Scholar PubMed
19. Robertson LW, Ludewig G. Polychlorinated biphenyl (PCB) carcinogenicity with special emphasis on airborne PCBs. Gefahrst Reinhalt Luft 2011;71:25–32.Search in Google Scholar
20. Carpenter DO. Exposure to and health effects of volatile PCBs. Rev Environ Health 2015;30:81–92.10.1515/reveh-2014-0074Search in Google Scholar PubMed
21. Ampleman MD, Martinez A, DeWall J, Rawn DFK, Hornbuckle KC, et al. Inhalation and dietary exposure to PCBs in urban and rural cohorts via congener-specific measurements. Environ Sci Technol 2015;49:1156–64.10.1021/es5048039Search in Google Scholar PubMed PubMed Central
22. Kouznetsova M, Huang X, Ma J, Lessner L, Carpenter DO. Increased rate of hospitalization for diabetes and residential proximity of hazardous waste sites. Environ Health Perspect 2007;115:75–9.10.1289/ehp.9223Search in Google Scholar PubMed PubMed Central
23. Borlaglu JT, Walker CH. Comparative aspects of congener specific PCB metabolism. Eur J Drug Metab PH 1989;14: 127–31.10.1007/BF03190852Search in Google Scholar PubMed
24. Öberg M, Sjodin A, Casabona H, Nordgre I, Klasson-Wehler E, et al. Tissue distribution and half-lives of individual polychlorinated biphenyls and serum levels of 4-hydroxy-2,3,3′, 4,5-pentachlorobiphenyl in the rat. Toxicol Sci 2002;70:171–82.10.1093/toxsci/70.2.171Search in Google Scholar PubMed
©2016 by De Gruyter
