Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Servicio de Oncología Radioterápica. Hospital Universitario Virgen de las Nieves, Granada, Spain.
Environ Int. 2021 Oct;155:106607. doi: 10.1016/j.envint.2021.106607. Epub 2021 May 7.
Continuous exposure to low doses of persistent organic pollutant (POPs), such as those occurring in the general population, might contribute to the burden of type 2 diabetes mellitus (T2DM). However, evidences from longitudinal studies are scarce. We aimed to explore the associations of accumulated POP exposure with the development of T2DM by means of 1) longitudinal associations with the 16-year incidence of the disease, and 2) complementary cross-sectional analyses with markers of glucose homeostasis at recruitment. Organochlorine pesticide and polychlorinated biphenyl (PCB) concentrations were analyzed in adipose tissue samples and incident T2DM cases were retrieved from clinical records. Homeostatic model assessment values of insulin sensitivity/resistance and β-cell function at recruitment were calculated. Linear and Cox-regression models were performed. In individuals with normal weight/overweight (n = 293), we observed positive dose-response relationships between the studied POPs and T2DM risk, particularly for hexachlorobenzene (HCB) [hazard ratio (HR): 3.96 for 4th quartile versus 1st quartile (Q1); confidence interval (CI) 95%: 0.79, 19.71]. PCB-180 showed a positive but seemingly non-linear association with T2DM risk [HR of 3 quartile (Q3) versus Q1: 6.48; CI 95%: 0.82, 51.29]. Unadjustment for body mass index considerably increased the magnitude of the associations. In the cross-sectional study (n = 180), HCB and PCB-180 were inversely associated with insulin sensitivity and positively associated with insulin resistance parameters. Our results suggest that a higher burden of specific POPs in adipose tissue may disrupt glucose homeostasis, possibly contributing to increase T2DM risk, especially in non-obese adults.
持续暴露于低剂量的持久性有机污染物（POPs），如一般人群中存在的污染物，可能会导致 2 型糖尿病（T2DM）的负担加重。然而，纵向研究的证据很少。我们旨在通过以下两种方法探讨累积 POP 暴露与 T2DM 发展之间的关联：1）纵向关联与疾病的 16 年发病率，2）在招募时使用葡萄糖稳态标志物进行补充性横断面分析。分析脂肪组织样本中的有机氯农药和多氯联苯（PCB）浓度，并从临床记录中检索到 T2DM 病例。在招募时计算胰岛素敏感性/抵抗和β细胞功能的稳态模型评估值。进行线性和 Cox 回归模型分析。在体重正常/超重的个体（n=293）中，我们观察到研究中的 POPs 与 T2DM 风险之间存在正剂量反应关系，尤其是六氯苯（HCB）[第 4 四分位数与第 1 四分位数（Q1）的危险比（HR）：3.96；95%置信区间（CI）：0.79，19.71]。PCB-180 与 T2DM 风险呈正相关，但似乎呈非线性关系[HR Q3 与 Q1：6.48；95%CI：0.82，51.29]。不调整体重指数会大大增加关联的幅度。在横断面研究（n=180）中，HCB 和 PCB-180 与胰岛素敏感性呈负相关，与胰岛素抵抗参数呈正相关。我们的研究结果表明，脂肪组织中特定 POPs 的负担增加可能会破坏葡萄糖稳态，从而可能导致 T2DM 风险增加，尤其是在非肥胖成年人中。
