Polychlorinated Biphenyls,Glycaemia and Diabetes in a Population Living in a Highly Polychlorinated Biphenyls-Polluted Area in Northern Italy: A Cross-Sectional and Cohort Study

Abstract

Background

Polychlorinated biphenyls (PCBs) have been found to be associated with diabetes in some, but not all, studies performed so far. The aim of this study was to assess the association between PCB serum levels and glycaemia and diabetes in people living in Brescia, a highly industrialised PCB-polluted town in Northern Italy.

Design and Methods

527 subjects were enrolled in a cross-sectional population-based study: they were interviewed face-to-face in 2003 and also provided a blood sample under fasting conditions. The concentration of 24 PCB congeners was determined using gas-chromatography (GC/MS). Subsequently, all subjects were included in a follow-up (cohort) study. According to the Local Health Authority health-care database, subjects were considered to be diabetic if they had diabetes at interview time (prevalent cases) or during a 7-year follow-up (incident cases).

Results

A total of 53 subjects (10.0%) were diabetics: 28 had diabetes at enrolment and other 25 developed the disease subsequently. Diabetes frequency increased according to the serum concentrations of total PCBs and single PCB congeners, but no association was found when estimates were adjusted for education, body mass index, age and gender by logistic regression analysis. Accordingly, glycaemia increased with PCB serum levels, but no association was observed when multiple regression analysis, including confounding factors, was performed.

Conclusions

This study does not support the hypothesis that PCB environmental exposure is strictly associated with diabetes or glycaemia.

Keywords

polychlorinated biphenyls diabetes glycaemia

References

Faroon

, Keith

, Jones

, De Rosa C. Carcinogenic effects of polychlorinated biphenyls. Toxicol Ind Health 2001;17:41–62.

Faroon

, Keith

, Jones

, De

Rosa C.

Effects of polychlorinated biphenyls on development and reproduction. Toxicol Ind Health 2001;17:63–93.

Carpenter

DO.

Environmental contaminants as risk factors for developing diabetes. Environ Health 2008;23:59–74.

Longnecker

, Klebanoff

, Brock

, . Polychlorinated biphenyl serum levels in pregnant subjects with diabetes. Diabetes Care 2001;24:1099–101.

Rignell-Hydbom

, Rylander

, Hagmar

Exposure to persistent organochlorine pollutants and type 2 diabetes mellitus. Hum Exp Toxicol 2007;26:447–52.

Fierens

, Mairesse

, Heilier

, . Dioxin/polychlorinated biphenyl body burden, diabetes and endometriosis: findings in a population-based study in Belgium. Biomarkers 2003;8:529–34.

Rylander

, Rignell-Hydbom

, Hagmar

A cross-sectional study of the association between persistent organochlorine pollutants and diabetes. Environ Health 2005;4:28–33.

Lee

, Lee

, Song

, . A strong dose-response relation between serum concentrations of persistent organic pollutants and diabetes: results from the National Health and Examination Survey 1999-2002. Diabetes Care 2006;29:1638–44.

Everett

, Frithsen

, Diaz

, . Association of a polychlorinated dibenzo-p-dioxin, a polychlorinated biphenyl, and DDT with diabetes in the 1999-2002 National Health and Nutrition Examination Survey. Environ Res 2007;103:413–8.

10.

Airaksinen

, Rantakokko

, Eriksson

, . Association between type 2 diabetes and exposure to persistent organic pollutants. Diabetes Care 2011;34:1972–9.

11.

Turyk

, Anderson

, Knobeloch

, . Prevalence of diabetes and body burdens of polychlorinated biphenyls, polybrominated-diphenyl ethers, and p, p'-diphenyldichloroethene in Great Lakes sport fish consumers. Chemosphere 2009;75:674–9.

12.

Turyk

, Anderson

, Knobeloch

, . Organochlorine exposure and incidence of diabetes in a cohort of Great Lakes sport fish consumers. Environ Health Perspect 2009;117:1076–82.

13.

Codru

, Schymura

, Negoita

, . Diabetes in relation to serum levels of polychlorinated biphenyls and chlorinated pesticides in adult Native Americans. Environ Health Perspect 2007;115:1442–7.

14.

Glynn

, Granath

, Aune

, . Organochlorines in Swedish women: determinants of serum concentrations. Environ Health Perspect 2003;111:349–55.

15.

Apostoli

, Magoni

, Bergonzi

, . Assessment of reference values for polychlorinated biphenyl concentration in human blood. Chemosphere 2005;61:413–21.

16.

Donato

, Magoni

, Bergonzi

, . Exposure to polychlorinated biphenyls in residents near a chemical factory in Italy: the food chain as main source of contamination. Chemosphere 2006;64:1562–72.

17.

Turrio-Baldassarri

, Abate

, Alivernini

, . A study on PCB, PCDD/PCDF industrial contamination in a mixed urban-agricultural area significantly affecting the food chain and the human exposure. part I: soil and feed. Chemosphere 2007;67:1822–30.

18.

Turrio-Baldassarri

, Abate

, Battistelli

, . PCDD/F and PCB in human serum of differently exposed population groups of an Italian city. Chemosphere 2008;73:S228–34.

19.

WHO. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. 1995. Technical Report Series No. 854. Available from: http://whqlibdoc.who.int/trs/WHO_TRS_854.pdf.

20.

Lonati

, Scarcella

, Indelicato

, . [Brescia Local Health Authority Population Database: a method based on current data for monitoring chronic diseases and management]. Epidemiol Prev 2008; 32:137–144. [Article in Italian].

21.

Ballschmiter

, Zell

Analysis of polychlorinated biphenyls (PCB) by glass capillary gas chromatography. Fresenius Z Anal Chem 1980;302:20–31.

22.

Van den Berg

, Birnbaum

, Denison

, . The 2005 World Health Organization reevaluation of human and Mammalian toxic equivalency factors for dioxins and dioxin-like compounds. Toxicol Sci 2006;93:223–41.

23.

Phillips

, Pirkle

, Burse

, . Chlorinated hydrocarbon levels in human serum: effects of fasting and feeding. Arch Environ Contam Toxicol 1989;18:495–500.

24.

Hansen

LG.

Stepping backward to improve assessment of PCB congener toxicities. Environ Health Perspect 1998;106:171–89.

25.

Wolff

, Camann

, Gammon

, . Proposed PCB congener groupings for epidemiological studies. Environ Health Perspect 1997;105:13–4.

26.

Cocco

, Brennan

, Ibba

, . Plasma polychlorobiphenyl and organochlorine pesticide level and risk of major lymphoma subtypes. Occup Environ Med 2008;65:132–40.

27.

Ukropec

, Radikova

, Huckova

, . High prevalence of prediabetes and diabetes in a population exposed to high levels of an organochlorine cocktail. Diabetologia 2010;53:899–906.

28.

Silverstone

, Rosenbaum

, Weinstock

, . Polychlorinated Biphenyl (PCB) exposure and diabetes: results from the Anniston Community Health Survey. Environ Health Perspect 2012;120:727–32.

29.

Lee

, Lee

, Jin

, . 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. Diabetes Care 2007;30:622–8.

30.

Lee

, Steffes

, Sjödin

, . Low dose of some persistent organic pollutants predicts type 2 diabetes: a nested case-control study. Environ Health Perspect 2010;118:1235–42.

31.

Philibert

, Schwartz

, Mergler

An exploratory study of diabetes in a First Nation community with respect to serum concentrations of p, p'-DDE and PCBs and fish consumption. Int J Environ Res Public Health 2009;6:3179–89.

32.

Grandjean

, Henriksen

, Choi

, . Marine food pollutants as a risk factor for hypoinsulinemia and type 2 diabetes. Epidemiology 2011;22:410–7.

33.

Persky

, Piorkowski

, Turyk

, . Associations of polychlorinated biphenyl exposure and endogenous hormones with diabetes in post-menopausal women previously employed at a capacitor manufacturing plant. Environ Res 2011;111:817–24.

34.

Uemura

, Arisawa

, Hiyoshi

, . Associations of environmental exposure to dioxins with prevalent diabetes among general inhabitants in Japan. Environ Res 2008;108:63–8.

35.

Lee

, Steffes

, Sjödin

, . Low dose organochlorine pesticides and polychlorinated biphenyls predict obesity, dyslipidemia, and insulin resistance among people free of diabetes. PLoS One 2011;6:e15977.

36.

Jørgensen

, Borch-Johnsen

, Bjerregaard

A cross-sectional study of the association between persistent organic pollutants and glucose intolerance among Greenland Inuit. Diabetologia 2008;51:1416–22.

37.

Vasiliu

, Cameron

, Gardiner

, . Polybrominated biphenyls, polychlorinated biphenyls, body weight, and incidence of adult-onset diabetes mellitus. Epidemiology 2006;17:352–9.

38.

Wang

, Tsai

, Yang

, . Increased risk of diabetes and polychlorinated biphenyls and dioxins: a 24-year follow-up study of the Yucheng cohort. Diabetes Care 2008;31:1574–9.

39.

Thayer

, Heindel

, Bucher

, Gallo

MA.

Role of environmental chemicals in diabetes and obesity: a National Toxicology Program workshop review. Environ Health Perspect 2012;120:779–89.

40.

Fujiyoshi

, Michalek

, Matsumura

Molecular epidemiologic evidence for diabetogenic effects of dioxin exposure in U.S. Air force veterans of the Vietnam war. Environ Health Perspect 2006;114:1677–83.

41.

Remillard

, Bunce

NJ.

Linking dioxins to diabetes: epidemiology and biologic plausibility. Environ Health Perspect 2002;110:853–8.

42.

Dirinck

, Jorens

, Covaci

, . Obesity and persistent organic pollutants: possible obesogenic effect of organochlorine pesticides and polychlorinated biphenyls. Obesity 2011;19:709–14.

43.

Hennig

, Meerarani

, Slim

, . Proinflammatory properties of coplanar PCBs: in vitro and in vivo evidence. Toxicol Appl Pharmacol 2002;181:174–83.

44.

Swedenborg

, Pongratz

AhR and ARNT modulate ER signaling. Toxicology 2010;268:132–8.

45.

SIVR Società Italiana Valori di Riferimento. Available from: http://www.valoridiriferimento.com/lista.htm. Accessed on: June 25, 2012.

46.

Il progetto cuore, Istituto Superiore di Sanità [in Italian]. Available from: http://www.cuore.iss.it/fattori/glicemia.asp. Accessed on: June 25, 2012.