Department of Physical and Environmental Sciences, University of Toronto Scarborough, Toronto, ON, Canada.
School of Nursing, Faculty of Health Sciences, Queen's University, 92 Barrie Street, Kingston, ON, K7L 3N6, Canada.
Sci Rep. 2021 Dec 15;11(1):24050. doi: 10.1038/s41598-021-03065-6.
Indigenous populations are disproportionately affected by type 2 diabetes (T2DM) compared to non-Indigenous people. Of importance, the prevalence of T2DM is greater amongst females than males in First Nations communities, in contrast to higher male prevalence reported in non-Indigenous Canadians. Therefore, in this study we extend our previously published work with respect to females, and the potential association between environmental exposures to organochlorine pesticides, such as dichlorodiphenyltrichloroethane (DDT), and dichlorodiphenyldichloroethylene (DDE) to explain the greater prevalence of T2DM among Indigenous females compared to males. Using data from the Multi-Community Environment-and-Health Study, Principal Component Analysis (PCA), examined 9-polychlorinated biphenyl congeners, 7-organic pesticides, and 4-metal/metalloids. Modified Poisson regression with robust error variance estimated adjusted prevalence ratios (PR) and corresponding 95% confidence intervals (95% CI), regressing prevalent T2DM on the newly derived principal components (PC), adjusting for a priori covariates, including parity. We further examined the relationship between high detection concentrations of DDT and tertials of categorized DDE exposures on T2DM among Indigenous Cree women. Among 419 female participants, 23% (n = 95) had physician-diagnosed T2DM. PCA analysis show that DDT and Lead (Pb) loaded highly on the second axis (PC-2), although in opposite directions, indicating the different exposure sources. As previously published, T2DM was significantly associated with PC-2 across adjusted models, however, after further adjusting for parity in this analysis, T2DM was no longer significantly associated with increasing PC-2 scores (PR = 0.88, 95% 0.76, 1.03). Furthermore, we found that the highest detectable levels of DDT, and tertiles of DDE were significantly associated with prevalent T2DM in the fully adjusted model (PR = 1.93, 1.17, 3.19), and (PR = 3.58, 1.10, 11.70), respectively. This cross-sectional analysis suggests organochlorines, specifically, detectable high exposure concentrations of DDT and DDE are associated with prevalent type 2 diabetes, signifying a possible important link between parity and environmental organochlorines pesticides among Indigenous Cree women.
与非原住民相比，土著人群患 2 型糖尿病（T2DM）的比例不成比例。值得注意的是，在第一民族社区中，女性患 T2DM 的比例高于男性，而在非原住民加拿大人中，男性的患病率更高。因此，在这项研究中，我们扩展了之前关于女性的研究工作，并探讨了环境暴露于有机氯农药（如滴滴涕（DDT）和滴滴涕（DDE））与 T2DM 之间的潜在关联，以解释与男性相比，土著女性 T2DM 的患病率更高。使用来自多社区环境与健康研究的数据，主成分分析（PCA）检查了 9 种多氯联苯同系物、7 种有机农药和 4 种金属/类金属。使用修正泊松回归和稳健误差方差估计调整后的患病率比（PR）和相应的 95%置信区间（95%CI），将普遍存在的 T2DM 回归到新得出的主成分（PC）上，调整了先验协变量，包括生育次数。我们还进一步研究了滴滴涕高检出浓度与分类 DDE 暴露 tertials 与土著克里妇女 T2DM 之间的关系。在 419 名女性参与者中，23%（n=95）有医生诊断的 T2DM。PCA 分析表明，滴滴涕和铅（Pb）在第二轴（PC-2）上高度加载，尽管方向相反，表明不同的暴露源。如前所述，T2DM 在调整后的模型中与 PC-2 显著相关，但在本分析中进一步调整生育次数后，T2DM 与 PC-2 评分的增加不再显著相关（PR=0.88，95%0.76，1.03）。此外，我们发现滴滴涕的最高检出水平和 DDE 的 tertiles 在完全调整模型中与普遍存在的 T2DM 显著相关（PR=1.93，1.17，3.19）和（PR=3.58，1.10，11.70）。这项横断面分析表明，有机氯化合物，特别是滴滴涕和 DDE 的高检出浓度与 2 型糖尿病的普遍存在有关，这表明在土著克里妇女中，生育次数和环境有机氯农药之间可能存在重要联系。
