Exposure to pesticides and diabetes: A systematic review and meta-analysis

Organochlorine pesticides: occurrence, spatial distribution of residues, toxicity, and toxic mechanisms

Organochlorine pesticides (OCPs) are a class of synthetic, broad-spectrum insecticides that have been widely used for plant pest control over the last century. OCPs are persistent organic pollutants (POPs) with mutagenic, teratogenic, and carcinogenic properties. Although most OCPs are banned to use now, they are ubiquitous in the environment and food, and identified in the serum and urine of humans. Exposure to OCPs could affect the human nervous system, auditory system, and endocrine system, leading to neurodegenerative diseases, hearing loss, cancer, and other diseases. Further, the toxic mechanisms of OCPs are explored from oxidative stress, DNA damage, and inflammatory response. Overall, this review offers a comprehensive insight into the occurrence, spatial distribution of residues, toxicity, and toxic mechanisms of OCPs.

Insomnia and its risk factors in patients with type 2 diabetes: A cross-sectional study

AIMS

Insomnia is notably prevalent among individuals with type 2 diabetes and adversely affects both glycemic control and overall quality-of-life. The objective of this study was to evaluate the possible risk factors for insomnia in patients diagnosed with type 2 diabetes and co-morbid insomnia.

METHODS

This is a baseline study analyzing cross-sectional data at baseline timepoint collected in a randomized controlled trial study. A total of 227 participants with type 2 diabetes and insomnia were recruited. The diagnosis of insomnia was based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and the total score of Insomnia Severity Index. Multiple linear regression model was used to analyze the possible biomedical and mental health risk factors for insomnia severity, total sleep time, sleep efficiency and sleep onset latency.

RESULTS

Factors significantly associated with insomnia severity included fasting blood glucose and depression. Blood magnesium level was related to total sleep time. Sleep efficiency was associated with blood phosphorus. Factors related to sleep onset latency were depression and fatigue.

CONCLUSION

Factors related to high insomnia severity and poor sleep quality in type 2 diabetes patients with insomnia included fasting blood glucose, blood magnesium, blood phosphorus, depression and fatigue.

Introducing internal allocation factors for assessing aggregate pesticide exposure across multiple pathways and routes

In the health risk assessment of pesticides, methods for external exposure assessment have been well developed. However, quantifying the contribution of various exposure pathways or routes to internal dose remains challenging. This study introduced the internal allocation factor (IAF) for 319 pesticides to investigate the impact of different exposure pathways and routes on chemical distribution within the human body. The IAFs can be calculated from various exposure sources (or pathways), routes, and biological samples. Analysis of different exposure sources revealed that crop exposure generally had the lowest IAF in organs and tissues, indicating a high contribution to the internal dose. The median IAF values for crop exposure in blood, liver, lung, kidney, fat, and muscle were all around 1.05. For three exposure routes of soil pesticide, the results found that IAF values for oral and dermal exposure routes were significantly lower than those for inhalation exposure. When the pesticide concentrations in biological samples are known, IAF can be utilized to back-calculate the pesticide levels in other organs and tissues. The results show that under a single exposure route, the concentration factor varies greatly between organs or tissues due to differences in compositions of human tissues (e.g., water and lipid contents) and pesticide properties (e.g., hydrophilicity and lipophilicity).

Development and Psychometric Properties of Scale for Safe Pesticide Use Behaviors Assessment Based on the Health Belief Model

OBJECTIVES

This study aimed to develop and validate a measurement tool that provides a model-based assessment of health beliefs affecting individuals' safe pesticide use behaviors.

METHODS

This study employed a methodological design. The study sample consisted of 701 agricultural workers engaged in pesticide-related work in a district in southern Türkiye. Data were collected using a sociodemographic form and the 42-item draft version of the Health Belief Model Scale for Safe Pesticide Use Behaviors (HeBSaPUB). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to determine construct validity. Cronbach's alpha internal consistency and test-retest correlation coefficients were calculated for reliability.

RESULTS

The 39-item HeBSaPUB scale showed good psychometric properties in terms of reliability, content validity, and construct validity. In the EFA, a six-factor structure emerged, explaining 61.36% of the total variance in the measured variables: perceived susceptibility, perceived barriers, perceived severity, perceived benefits, cues to action, and self-efficacy. This structure was confirmed by CFA using a cross-validation approach. Cronbach's alpha coefficient was 0.90 for the whole scale and ranged from 0.81 to 0.92 for the sub-dimensions. The test-retest reliability coefficient values of the scale were between 0.763 and 0.927. The items on the scale were not additive, and each sub-dimension was evaluated independently. An increase in the scores of perceived susceptibility, perceived benefit, perceived severity, cues to action, and self-efficacy, along with a decrease in the scores of perceived barriers, indicated positive health beliefs.

CONCLUSION

The results of the study demonstrated that the HeBSaPUB scale is a valid and reliable instrument for measuring attitudes and beliefs toward safe behaviors in preventing the risk of pesticide exposure. The HeBSaPUB scale can contribute to identifying needs for health professionals.

Concentrations of DDT metabolites in different food items and public health risk in Africa regions: systematic review and metal analysis

Background

DDT (Dichlorodiphenyltrichloroethane) is a synthetic organochlorine pesticide used in agriculture and mosquito control but later banned due to its harmful effects on humans. It persists in the environment, biomagnified through the food chain, and poses serious health risks, including reproductive defect, cancer, and nervous system disorders. DDT has a long half-life and potential of long-range transport and continuing to contaminate long after use and remains to pose a global environmental and health concern. Therefore, this review was designed to assess the concentration of DDT metabolites (p,p'-DDT, p,p'-DDD, and p,p'-DDE) in various food items and evaluate the health risk to consumers in the African.

Methods

The preferred reporting item for systematic reviews and meta-analysis (PRISMA) protocol was used to conduct this work. SCOPUS, PubMed, Web of Science, Google Scholar, DOAJ, national repository, and MedNar were used to retrieve articles from October 1, 2023, to January 20, 2024. Meta-analysis data visualized using a forest plot. A random-effects model was applied when heterogeneity existed in overall mean concentration of DDT metabolites. The subgroup analysis, meta-regression, and sensitivity analysis was conducted and the Joanna Briggs Institute Critical Assessment tool to assess the quality of the studies.

Results

The overall mean concentrations of p,p'-DDT, p,p'-DDD and p,p'-DDE, regardless of the types of food items, were 0.188, 0.22, and 0.0878 mg/kg, respectively. Based on the type of food items, The current study found that residue levels of DDT metabolites in vegetables, milk, and cereals exceeded the Maximum Residue Limits (MRLs) set by FAO/WHO/EU (0.05, 0.02, and 0.05 mg/kg, respectively), while residue levels in meat, khat, and fruit were below the MRLs (5, 0.5, and 0.05 mg/kg, respectively). The findings of the health risk assessment revealed that consumers are prone to both carcinogenic and non-carcinogenic risks from DDT metabolites. The persistence and bioaccumulation of these metabolites, along with multiple exposure routes and improper handling, may increase long-term health risks, even at low doses. DDT metabolite levels in most food categories exceed recommended limits, posing significant health risks to consumers. To reduce reliance on DDT, effective and cost-efficient alternative insecticides and vector-control strategies must be developed. Promoting environmental management, improving housing, and implementing farm-to-fork risk-based actions, such as Hazard Analysis and Critical Control Points (HACCP), across the food chain are crucial to mitigating the adverse effects of DDT exposure in the African region.

Consensus on the key characteristics of metabolism disruptors

Metabolism-disrupting agents (MDAs) are chemical, infectious or physical agents that increase the risk of metabolic disorders. Examples include pharmaceuticals, such as antidepressants, and environmental agents, such as bisphenol A. Various types of studies can provide evidence to identify MDAs, yet a systematic method is needed to integrate these data to help to identify such hazards. Inspired by work to improve hazard identification of carcinogens using key characteristics (KCs), we developed 12 KCs of MDAs based on our knowledge of processes underlying metabolic diseases and the effects of their causal agents: (1) alters function of the endocrine pancreas; (2) impairs function of adipose tissue; (3) alters nervous system control of metabolic function; (4) promotes insulin resistance; (5) disrupts metabolic signalling pathways; (6) alters development and fate of metabolic cell types; (7) alters energy homeostasis; (8) causes inappropriate nutrient handling and partitioning; (9) promotes chronic inflammation and immune dysregulation in metabolic tissues; (10) disrupts gastrointestinal tract function; (11) induces cellular stress pathways; and (12) disrupts circadian rhythms. In this Consensus Statement, we present the logic that revealed the KCs of MDAs and highlight evidence that supports the identification of KCs. We use chemical, infectious and physical agents as examples to illustrate how the KCs can be used to organize and use mechanistic data to help to identify MDAs.

The herbicide 2,4-dichlorophenoxyacetic acid induces pancreatic β-cell death via oxidative stress-activated AMPKα signal downstream-regulated apoptotic pathway

2,4-Dichlorophenoxyacetic acid (2,4-D) is one of commonly and widely used organic herbicides in agriculture. It has been reported that 2,4-D can induce adverse effects in mammalian cells. Epidemiological and animal studies have indicated that exposure to 2,4-D is associated with poorer glycemic control and impaired pancreatic β-cell function. However, limited information is available on 2,4-D-induced toxicological effects in β-cells, with the underlying toxicological mechanisms remains unclear. Herein, our results showed that 2,4-D exposure (30-500 μg/mL) significantly reduced cell viability, induced mitochondria dysfunction (including the mitochondrial membrane potential (MMP) loss, the increase in cytosolic cytochrome c release, and the change in Bcl-2 and Bax protein expression), and triggered apoptotic events (including the increased population of apoptotic cells, caspase-3 activity, and caspase-3/-7 and PAPR activation) in RIN-m5F β-cells, accompanied with insulin secretion inhibition. Exposure of cells to 2,4-D could also evoke JNK, ERK1/2, p38, and AMP-activated protein kinase (AMPK)α activation as well as reactive oxygen species (ROS) generation. Pretreatment of cells with compound C (an AMPK inhibitor) and the antioxidantN-acetylcysteine (NAC), but not that SP600125/PD98059/SB203580 (the inhibitors of JNK/ERK/p38, respectively), obviously attenuated the 2,4-D-triggered AMPKα phosphorylation, MMP loss, apoptotic events, and insulin secretion dysfunction,as similar effects with the transfection with AMPKα1-specific siRNA. Of note, buffering the ROS production with NAC obviously prevented the 2,4-D-induced ROS generation as well as AMPKα activation, but the either compound C and AMPKα1-specific siRNA transfection could not effectively reduce 2,4-D-induced ROS generation. Collectively, these findings indicate that the induction of oxidative stress-activated AMPKα signaling is a crucial mechanism underlying 2,4-D-triggered mitochondria-dependent apoptosis, ultimately leading to β-cell death.

DNA methylation in the association between pesticide exposures and type 2 diabetes

BACKGROUND

Numerous epidemiological studies have found that pesticide exposure is associated with the incidence of type 2 diabetes (T2D); however, the underlying mechanisms remain unknown. DNA methylation may play a role in this process.

AIM

To identify the genes associated with pesticide exposure and T2D by reviewing the current literature.

METHODS

We systematically searched PubMed and Embase for relevant studies that examined the association between pesticide exposure and DNA methylation, and studies on DNA methylation and T2D through January 15, 2024.

RESULTS

We identified six genes (Alu, CABLES1, CDH1, PDX1, PTEN, PTPRN2) related to pesticide exposure and T2D. We also suggested future research directions to better define the role of DNA methylation in the association between pesticide exposure and T2D.

CONCLUSION

DNA methylation of specific genes may play a vital role in the association between pesticide exposure and T2D.

Impact of pesticides exposure and type 2 diabetes risk: a systematic review and meta-analysis

OBJECTIVE

We conducted a systematic review and meta-analysis of observational studies that assessed the relationship between pesticides exposure and type 2 diabetes. We also examined the presence of heterogeneity and biases across the available studies.

METHODS

We conducted a comprehensive literature search of peer-reviewed studies published from 2011 to 2023, without language limitations. A random-effects model was employed to calculate the overall odds ratio (OR) and its corresponding 95% confidence interval (CI).

RESULTS

We included 19 studies (n = 12 case-control and n = 7 cross-sectional) for a total of 45,813 participants in our analysis. Our findings revealed a notable correlation between pesticide exposure and type 2 diabetes (non-specific definition) when not limiting pesticide types (OR: 1.19, 95% CI: 1.11-1.28). Subgroup analysis identified associations between pyrethroid (OR: 1.17, 95% CI: 1.05-1.30) and type 2 diabetes, as well as between organochlorine (OR: 1.26, 95% CI: 1.11-1.43) and type 2 diabetes. However, no statistically significant association was observed between herbicide exposure and the onset of type 2 diabetes (OR: 1.26, 95% CI: 0.91-1.75). In the elderly group, pesticide exposure significantly heightened the risk of type 2 diabetes (OR: 1.25, 95% CI: 1.14-1.38), with no statistically significant heterogeneity among studies (I2 = 14.2%, p = 0.323).

CONCLUSIONS

Pesticide (organochlorine and pyrethroid) exposure constitutes a risk factor for type 2 diabetes.

Multiple pesticide exposure and impaired glucose regulation in U.S. non-diabetic population

Prediabetes is a serious metabolic disorder that is often overlooked and 70% of individuals with prediabetes would eventually develop type 2 diabetes. The diabetogenic effects of pesticides have been reported in toxicological studies but their association with prediabetes is rarely investigated. We aimed to evaluate the association between pesticide exposure and impaired glucose regulation (IGR), including prediabetes (defined as impaired fasting glucose [IFG] and/or impaired glucose tolerance [IGT]) and insulin resistance, in a general U.S. non-diabetic population. Three classes of urinary pesticides, including organophosphorus pesticides (OPs), pyrethroid, and herbicides were measured. Generalized linear regression, restricted cubic spline, and Bayesian kernel machine regression (BKMR) models were combined to evaluate their associations. 3,5,6-trichloropyridinol (TCPY) was positively associated with prediabetes and IGT (highest vs lowest TCPY quartile: prediabetes: OR: 1.97, 95% CI: 1.18, 3.31; IGT: OR: 2.03, 95% CI: 1.14, 3.66) in a linear dose-response manner (P for nonlinear<0.05). Another two metabolites of OPs, malathion dicarboxylic acid (MDCA) diacid and para-nitrophenol (PNP), were found to increase the odds ratio of insulin resistance (PNP: OR: 1.22, 95% CI: 1.05, 1.42; MDCA: OR: 1.36, 95% CI: 1.08, 1.70) with linear dose-response curves (P for nonlinear<0.05). Considering mutual exposure to multiple pesticides, TCPY, MDCA, and PNP made the most contributions in the mixture exposure and IGR. No obvious interactions among pesticides were found in the multiple exposure settings. The odds ratio of TCPY exposure and prediabetes was increased with advancing age but not related to body mass index (BMI). The results remained robust in sensitivity analysis with restricted participants without abnormal urinary creatinine and unsteady glucose or insulin levels. Our findings suggested the close relationship between OPs and impaired glucose regulation, especially in older adults, which provides insights into the prevention of diabetes at the earlier stage.

Pentachlorophenol increases diabetes risk by damaging β-cell secretion and disrupting gut microbial-related amino acids and fatty acids biosynthesis

Pentachlorophenol (PCP), a ubiquitous environmental pollutant, has been reported as a possible contributor to diabetes. However, evidence for general population is scarce while related mechanisms are largely unknown. Using a representative population-based case-control study in Beijing (n = 1796), we found a positive association between PCP exposure and diabetes risk with the odds ratio reaching 1.68 (95 % confidence interval: 1.30 to 2.18). A further rat experiment revealed that low-dose PCP mimicking real-world human exposure can significantly impair glycemic homeostasis by inducing pancreatic β-cell dysfunction, with non-linear dose-response relationships. Subsequent multi-omics analysis suggested that low-dose PCP led to notable gut microbiota dysbiosis (especially the species from genus Prevotella, such as intermedia, dentalis, ruminicola, denticola, melaninogenica, and oris), decreased serum amino acids (L-phenylalanine, L-tyrosine, and L-tryptophan) and increased serum fatty acids (oleic and palmitic acid) in rats, while strong correlations were observed among alterations of gut microbes, serum metabolites and glycemic-related biomarkers (e.g., fasting blood glucose and insulin). Collectively, these results imply PCP may increase diabetes risk by disrupting gut microbial-related amino acids and fatty acids biosynthesis. This will help guide future in-depth studies on the roles of PCP in the development of human diabetes.

Pesticide Exposures during Pregnancy and Health Outcomes in Latin America and the Caribbean: A Scoping Review of Human Observational Studies

Background

Latin America and the Caribbean (LAC) are regions with intense pesticide use. Numerous studies have demonstrated the adverse health effects associated with pesticide exposure. The embryonic and fetal periods are particularly susceptible to xenobiotics, with pesticides exhibiting potentially teratogenic effects.

Objectives

The objective was to review the scientific literature on outcomes associated with prenatal pesticide exposure, identifying challenges and gaps in this field.

Methods

We conducted a scoping review using terms related to pesticides, LAC, and pregnancy across six databases. The final search was conducted on 5 March 2024. The inclusion criteria for the studies were as follows: a) being human observational studies involving pregnant women of any age or gestational age duration, newborns from these pregnancies, or both; b) reporting any exposure to pesticide and any adverse outcome; c) having been conducted in any country of LAC; d) having been published between 1 January 2000 and 5 March 2024; e) having the full text available in English, Spanish, or Portuguese; and f) presenting original results. Nonoriginal research papers, such as qualitative studies, reviews, critical analyses, and opinion papers, were excluded. The included studies were categorized and presented based on the outcomes they evaluated.

Results

We included 80 studies conducted in 13 countries; the included studies encompassed obstetric outcomes, anthropometric parameters, congenital anomalies, neurodevelopment, respiratory infections, and childhood leukemia, as well as molecular effects. Organochlorines were the primary type of exposure investigated among the included studies. Many studies relied on indirect measures of pesticide exposure.

Discussion

Adverse outcomes associated with prenatal pesticide exposure have been observed in Latin American and Caribbean populations, consistent with the global literature. Significant knowledge gaps remain, especially regarding groups of pesticides other than organochlorines. Less than half of the countries in LAC have conducted any study on the potential effects of prenatal exposure. Ongoing research into the risks of prenatal exposure is imperative. It is essential to consider the region's unique characteristics, particularly when investigating the risks associated with pesticides authorized exclusively in this region. https://doi.org/10.1289/JHP1043.

Residential proximity to agricultural pesticide use and cardiovascular disease risk factors among adult Latina women in California's Salinas Valley

Cardiovascular disease is a leading cause of death worldwide. There is limited evidence that exposure to current-use pesticides may contribute to cardiovascular disease risk. We examined the association between residential proximity to the application of agricultural pesticides and cardiovascular risk factors among 484 adult women in the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) Study, a cohort based in an agricultural region of California. Outcome assessment was completed between 2010 and 2013. Using participant residential addresses and California's Pesticide Use Reporting database, we estimated agricultural pesticide use within 1 km of residences during the 2-year period preceding outcome assessment. We used Bayesian hierarchical modeling to evaluate associations between exposure to 14 agricultural pesticides and continuous measures of waist circumference, body mass index, and blood pressure. Each 10-fold increase in paraquat application around homes was associated with increased diastolic blood pressure (β = 2.60 mm Hg; 95% credible interval [CrI], 0.27-4.89) and each 10-fold increase in glyphosate application was associated with increased pulse pressure (β = 2.26 mm Hg; 95% CrI, 0.09-4.41). No meaningful associations were observed for the other pesticides examined. Our results suggest that paraquat and glyphosate pesticides may affect cardiovascular disease development in women with chronic environmental exposure. This article is part of a Special Collection on Environmental Epidemiology.

Removal of acephate and methamidophos from water: Coagulation and adsorptive treatment approaches

Pesticides has transformed the agricultural industry, primarily by enhancing productivity. However, the indiscriminate use of such compounds can adversely affect human health and disrupt ecosystem balance. Limited knowledge exists regarding the removal of these compounds from water, particularly for organophosphate pesticides when employing conventional treatment technologies. Therefore, this study aimed to assess the removal of acephate (ACE) and methamidophos (MET) - considered priority pesticides in Brazil - from waters with high and low turbidity during the clarification process carried out with aluminum sulfate (AS) and ferric chloride (FC), either alone or combined with powdered activated carbon (PAC) adsorption. All water samples were submitted to solid phase extraction (SPE C18 cartridges) prior to acephate and methamidophos analysis by HPLC MS/MS. The clarification process with either AS or FC coagulant did not efficiently remove acephate or methamidophos and maximum average removal (27 %) was observed with waters of high turbidity when using ferric chloride as coagulant. Addition of mineral PAC was also ineffective for removing both pesticides. However, the use of vegetable PAC (10 mg/L) resulted in better removal percentages, up to 80%, but only for methamidophos. The limited removal rates were attributed to the high hydrophilicity of acephate and methamidophos, along with their neutral charge at coagulation pH. These factors hinder the interaction of such organophosphorus pesticides with the flocs formed during coagulation as well as with PAC surface.

New findings on the risk of hypertension from organophosphorus exposure under different glycemic statuses: The key role of lipids?

BACKGROUND AND OBJECTIVE

Considering the widespread use of organophosphorus pesticides (OPs) and the global prevalence of hypertension (HTN), as well as studies indicating that different glycemic statuses may respond differently to the biological effects of OPs. Therefore, this study, based on the Henan rural cohort, aims to investigate the association between OPs exposure and HTN, and further explores whether lipids mediate these associations.

METHODS

We measured the plasma levels of OPs in 2730 participants under different glycemic statuses using gas chromatography-triple quadrupole mass spectrometry (GC-MS/MS). A generalized linear model, Quantile g-computation (QGC), adaptive elastic net (AENET), and Bayesian kernel machine regression (BKMR) models were used to assess the impact of OPs exposure on HTN, with least absolute shrinkage and selection operator (LASSO) penalty regression identifying main OPs. Mediation models were used to evaluate the intermediary role of blood lipids in the OPs-HTN relationship.

RESULTS

The detection rates for all OPs were high, ranging from 76.35 % to 99.17 %. In the normal glucose tolerance (NGT) population, single exposure models indicated that malathion and phenthoate were associated with an increased incidence of HTN (P-FDR < 0.05), with corresponding odds ratios (ORs) and 95 % confidence intervals (CIs) of 1.624 (1.167,2.260) and 1.290 (1.072,1.553), respectively. QGC demonstrated a positive association between OP mixtures and HTN, with malathion and phenthoate being the primary contributors. Additionally, the AENET model's Exposure Response Score (ERS) suggested that the risk of HTN increases with higher ERS (P < 0.001). Furthermore, BKMR revealed that co-exposure to OPs increases HTN risk, with phenthoate having a significant impact. Furthermore, triglycerides (TG) mediated 6.55 % of the association between phenthoate and HTN. However, no association was observed in the impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM) populations.

CONCLUSIONS

Our findings suggest that in the NGT population, OPs may significantly contribute to the development of HTN, proposing TG as a potential novel target for HTN prevention.

Association of green tea consumption with prediabetes, diabetes and markers of glucose metabolism in rural Vietnam: a cross-sectional study

The literature on green tea consumption and glucose metabolism has reported conflicting findings. This cross-sectional study examined the association of green tea consumption with abnormal glucose metabolism among 3000 rural residents aged 40-60 years in Khánh Hòa province in Vietnam. Multinomial logistic regression analysis was conducted to examine the association of green tea consumption (0, < 200, 200-< 400, 400-< 600 or ≥ 600 ml/d) with prediabetes and diabetes (based on the American Diabetes Association criteria). Linear regression analysis was performed to examine the association between green tea consumption and the log-transformed homeostatic model assessment of insulin resistance (HOMA-IR) (a marker of insulin resistance) and the log-transformed homeostatic model assessment of β-cell function (HOMA-β) (a marker of insulin secretion). The OR for prediabetes and diabetes among participants who consumed ≥ 600 ml/d v. those who did not consume green tea were 1·61 (95 % CI = 1·07, 2·42) and 2·04 (95 % CI = 1·07, 3·89), respectively. Higher green tea consumption was associated with a higher level of log-transformed HOMA-IR (Pfor trend = 0·04) but not with a lower level of log-transformed HOMA-β (Pfor trend = 0·75). Higher green tea consumption was positively associated with the prevalence of prediabetes, diabetes and insulin resistance in rural Vietnam. The findings of this study indicated prompting the need for further research considering context in understanding the link between green tea consumption and glucose metabolism, especially in rural settings in low- and middle-income countries.

Diabetes mellitus and serum organochlorine pesticides mixtures in Mexican women

BACKGROUND

Very recently, it has been reported that exposure to different mixtures of organochlorine pesticides (OCP) is associated with the development of diabetes mellitus (DM). In Mexico, DM is a public health problem that might be related to the historical intense use of OCP. We aimed to evaluate, the association between DM and serum concentrations of OCP mixtures, and identify the main contributors within them.

METHODS

We conducted a secondary cross-sectional analysis on the control group from a breast cancer population-based case-control study conducted from 2007 to 2011 in Northern Mexico. We identified 214 self-reported diabetic women and 694 non-diabetics. We obtained direct information about sociodemographic, lifestyle and reproductive characteristics. We determined 24 OCP and metabolites in serum by gas chromatography using an electron capture micro detector. We used Weighted Quantile Sum regression to assess the association of DM and exposure to multiple OCP, and the contribution of each compound within the mixture.

RESULTS

We found a positive adjusted association between DM and an OCP mixture (OR: 2.63, 95%CI: 1.85, 3.74), whose primary contribution arose from p, p'-DDE (mean weight 23.3%), HCB (mean weight 17.3%), trans nonachlor (mean weight 15.4%), o, p'-DDE (mean weight 7.3%), heptachlor epoxide (mean weight 5.9%), oxychlordane (mean weight 4.7%), and heptachlor (mean weight 4.5%). In addition, these OCP along with p, p'-DDT and cis chlordane, were of concern and remained associated when excluding hypertensive women from the analysis (OR 2.55; 95% CI 1.56, 4.18).

CONCLUSIONS

Our results indicate, for the first time in a Latin-American population, that the concomitant exposure to multiple OCP is associated with DM. Further research is needed since the composition of OCP mixtures may vary according to regional pesticides use patterns.

Carcinogenic, non-carcinogenic risk, and attributable cases to organochlorine pesticide exposure in women from Northern Mexico

This study aimed to estimate the carcinogenic and non-carcinogenic risk as well as the attributable cases due to exposure to organochlorine pesticides (OCPs): hexachlorobenzene (HCB), dichlorophenyltrichloroethane (DDT), hexachlorocyclohexane (HCH), heptachlor, and chlordane. From serum concentrations of pesticides of interest in a sample of 908 women from Northern Mexico, the risk for both cancer and non-cancer health effects was evaluated. The population attributable fraction (PAF) was also calculated based on summary association estimates between exposure to OCPs and different health events. Findings revealed that due to their OCP exposure slightly less than half of the women in the sample were at increased risk of developing non-cancerous diseases. Moreover, approximately 25% and 75% of participants were at risk of develop some type of cancer associated with their HCB and DDE concentrations, respectively. In addition, it was estimated that 40.5% of type 2 diabetes, 18.7% of endometriosis, and 23.1% of non-Hodgkin's lymphoma cases could have been prevented if women had not been exposed to these OCPs. Results suggest that the use of OCPs may have contributed to the disease burden in the study area and, based on the time required for these substances to be eliminated from the body, there are probably some women who are still at elevated risk of developing diseases associated to OCPs.

Hair-Derived Exposome Exploration of Cardiometabolic Health: Piloting a Bayesian Multitrait Variable Selection Approach

Cardiometabolic health is complex and characterized by an ensemble of correlated and/or co-occurring conditions including obesity, dyslipidemia, hypertension, and diabetes mellitus. It is affected by social, lifestyle, and environmental factors, which in-turn exhibit complex correlation patterns. To account for the complexity of (i) exposure profiles and (ii) health outcomes, we propose to use a multitrait Bayesian variable selection approach and identify a sparse set of exposures jointly explanatory of the complex cardiometabolic health status. Using data from a subset (N = 941 participants) of the nutrition, environment, and cardiovascular health (NESCAV) study, we evaluated the link between measurements of the cumulative exposure to (N = 33) pollutants derived from hair and cardiometabolic health as proxied by up to nine measured traits. Our multitrait analysis showed increased statistical power, compared to single-trait analyses, to detect subtle contributions of exposures to a set of clinical phenotypes, while providing parsimonious results with improved interpretability. We identified six exposures that were jointly explanatory of cardiometabolic health as modeled by six complementary traits, of which, we identified strong associations between hexachlorobenzene and trifluralin exposure and adverse cardiometabolic health, including traits of obesity, dyslipidemia, and hypertension. This supports the use of this type of approach for the joint modeling, in an exposome context, of correlated exposures in relation to complex and multifaceted outcomes.

Associations of chronic exposure to a mixture of pesticides and type 2 diabetes mellitus in a Chinese elderly population

Epidemiological studies have related exposure to pesticides to increased risk of diabetes. However, few studies have evaluated the health effects of mixed pesticides exposure, especially in an elderly population. Here, we utilized gas chromatography-tandem mass spectrometry to quantify the levels of 39 pesticides in 4 categories in a Chinese elderly population. Then we used general linear models to explore the association between individual pesticide exposure and type 2 diabetes mellitus (T2DM). Restricted cubic spline (RCS) models were fitted to identify potential non-linearities between those associations. Furthermore, stratified analysis by gender was conducted to explore the gender-specific associations. Finally, we used weighted quantile sum (WQS) regression, quantile-based g computation (qgcomp), and Bayesian kernel machine regression (BKMR) to evaluate the effects of mixed exposure to 39 pesticides. The results showed that exposure to pesticides was associated with high risk of T2DM, with β-Hexachlorocyclohexane (β-BHC) and oxadiazon being the most significant independent contributors, which was pronounced among elderly women. Moreover, the association of β-BHC and oxadiazon with T2DM was linear. These indicated that it is an urgent need to take practical measures to control these harmful pesticides.

Influence of pesticide mixture on their heterogeneous atmospheric degradation by ozone and OH radicals

Pesticides in the atmosphere can exist in both gaseous and particulate phases due to their semi-volatile properties. They can undergo degradation when exposed to atmospheric oxidants like ozone and hydroxyl radicals. The majority of studies on the atmospheric reactivity of pesticides study them in combination, without considering potential mixture effects that could induce uncertainties in the results. Therefore, this study aims to address this gap, through laboratory studies using a flow reactor, and by evaluating the degradation kinetics of pendimethalin mixed with folpet, tebuconazole, and S-metolachlor, which were simultaneously adsorbed on hydrophobic silica particles that mimic atmospheric aerosols. The comparison with other mixtures, including pendimethalin, from the literature has shown similar reactivity with ozone and hydroxyl radicals, indicating that the degradation kinetics of pesticides is independent of the mixture. Moreover, the degradation rates of the four pesticides under study indicate that they are not or slightly degraded by ozone, with half-lives ranging from 29 days to over 800 days. In contrast, when exposed to hydroxyl radicals, tebuconazole exhibited the fastest reactivity, with a half-life of 4 days, while pendimethalin had a half-life of 17 days.

Association between dietary pesticide exposure profiles and body weight change in French adults: Results from the NutriNet-Santé cohort

BACKGROUND

Pesticides cause a wide range of deleterious health effects, including metabolic disorders. Little is known about the effects of dietary pesticide exposure on body weight (BW) change in the general population. We aimed to investigate the role of dietary pesticide exposure in BW change among NutriNet-Santé participants, focusing on potential sexual dimorphism.

METHODS

Participants completed a Food Frequency Questionnaire (2014), assessing conventional and organic food consumption. Dietary exposure from plant foods of 25 commonly used pesticides was estimated using a residue database, accounting for agricultural practices (conventional and organic). Exposure profiles based on dietary patterns were computed using Non-negative Matrix Factorization (NMF). Mixed models were used to estimate the associations between BW change and exposure to pesticide mixtures, overall and after stratification by sex and menopausal status.

RESULTS

The final sample included 32,062 participants (8,211 men, 10,637 premenopausal, and 13,214 postmenopausal women). The median (IQR) follow-up was 7.0 (4.4; 8.0) years. Four pesticides profiles were inferred. Overall, men and postmenopausal women lost BW during follow-up, whereas premenopausal women gained BW. Higher exposure to NMF3, reflecting a lower exposure to synthetic pesticides, was associated with a lower BW gain, especially in premenopausal women (β(95 %CI) = -0.04 (-0.07; 0) kg/year, p = 0.04). Higher exposure to NMF2, highly positively correlated with a mixture of synthetic pesticides (azoxystrobin, boscalid, chlorpropham, cyprodinil, difenoconazole, fenhexamid, iprodione, tebuconazole, and lamda-cyhalothrin), was associated with a higher BW loss in men (β(95 %CI) = -0.05 (-0.08; -0.03) kg/year, p < 0.0001). No associations were observed for NMF1 and 4.

CONCLUSIONS

This study suggests a role of pesticide exposure, inferred from dietary patterns, on BW change, with sexually dimorphic actions, including a potential role of a lower exposure to synthetic pesticides on BW change in women. In men, exposure to a specific pesticide mixture was associated with higher BW loss. The underlying mechanisms need further elucidation.

Association of hair polychlorinated biphenyls and multiclass pesticides with obesity, diabetes, hypertension and dyslipidemia in NESCAV study

Obesity, diabetes, hypertension and dyslipidemia are well-established risk factors for cardiovascular diseases (CVDs), and have been associated with exposure to persistent organic pollutants. However, studies have been lacking as regards effects of non-persistent pesticides on CVD risk factors. Here, we investigated whether background chronic exposure to polychlorinated biphenyls (PCBs) and multiclass pesticides were associated with the prevalence of these CVD risk factors in 502 Belgian and 487 Luxembourgish adults aged 18-69 years from the Nutrition, environment and cardiovascular health (NESCAV) study 2007-2013. We used hair analysis to evaluate the chronic internal exposure to three PCBs, seven organochlorine pesticides (OCs) and 18 non-persistent pesticides. We found positive associations of obesity with hexachlorobenzene (HCB), β-hexachlorocyclohexane (β-HCH) and chlorpyrifos, diabetes with pentachlorophenol (PCP), fipronil and fipronil sulfone, hypertension with PCB180 and chlorpyrifos, and dyslipidemia with diflufenican and oxadiazon, among others. However, we also found some inverse associations, such as obesity with PCP, diabetes with γ-HCH, hypertension with diflufenican, and dyslipidemia with chlorpyrifos. These results add to the existing evidence that OC exposure may contribute to the development of CVDs. Additionally, the present study revealed associations between CVD risk factors and chronic environmental exposure to currently used pesticides such as organophosphorus and pyrethroid pesticides.

American Diabetes Association Professional Practice Committee, ElSayed NA, Aleppo G, Bannuru RR, Bruemmer D, Collins BS, Ekhlaspour L, Hilliard ME, Johnson EL, Khunti K, Lingvay I, Matfin G, McCoy RG, Perry ML, Pilla SJ, Polsky S, Prahalad P, Pratley RE, Segal AR, Seley JJ, Stanton RC, Gabbay RA. 1. Improving Care and Promoting Health in Populations: Standards of Care in Diabetes-2024

The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at https://professional.diabetes.org/SOC.

Pesticides vs. Biopesticides: From Pest Management to Toxicity and Impacts on the Environment and Human Health

The environmental pollution that occurs in direct response to the widespread use of man-made/conventional pesticides results from many chemicals that require a long period of time, often decades, to degrade. The synthetic nature of pesticides also harms animals, beneficial insects, microorganisms, and plants, as well as humans. Fortunately, however, there are many natural pesticides, the so-called biopesticides, that are also effective against pests and more importantly, do not interfere with the well-being of ecosystems. Consequently, most biopesticides are safer for use around people and pets than man-made pesticides because, for example, they can be easily washed away from fruits and vegetables. The natural habitat is a rich resource with a wide selection of plants, many of which are also used to treat diseases in humans, animals, and plants. Out of concern for public health, environmental safety, and the stringent regulation of pesticide residues in agricultural commodities, the use of biopesticides is becoming increasingly important, but questions regarding potential pest resistance to these products may arise, just as is the case with conventional pesticides. Therefore, the performance and potential role of biopesticides in the management of plant pests should be prioritized due to their sustainability and importance to human and environmental welfare. In this review, we propose to highlight a scenario in which we discuss in detail the main constraints posed by the use of pesticides compared to biopesticides, starting with issues regarding their definition and continuing on to issues related to their toxicity and their impact on the environment and human health.

POPs in long-finned pilot whales mass stranded in Iceland as a proxy for their physiological condition

Long-finned pilot whales (Globicephala melas) are the most frequently stranded cetaceans in the world; however, the predominant drivers of these events are poorly understood. In this study the levels of persistent organic pollutants from pilot whales stranded in North-east Iceland were quantified and compared to historical data and physical parameters to investigate whether contaminant load may have influenced the physiological state of stranded individuals, how these loads fluctuate with sex and age group, and if this is consistent with the literature. Historical comparison was also carried out to discern how pollutant contamination has changed throughout the past few decades. DDE, transnonachlor and PCB-153 were the top three pollutants respectively. The accumulation of POPs was greater on average in immature individuals than adults, whilst among adults, males had higher concentration than females. Moreover, despite an indication of decreasing POP loads throughout the years, knowledge of harmful thresholds remains exceedingly limited.

Association of glyphosate exposure with multiple adverse outcomes and potential mediators

Glyphosate (GLY) is a widely used herbicide with potential adverse effects on public health. However, the current epidemiological evidence is limited. This study aimed to investigate the potential associations between exposure to GLY and multiple health outcomes. The data on urine GLY concentration and nine health outcomes, including type 2 diabetes mellitus (T2DM), hypertension, cardiovascular disease (CVD), obesity, chronic kidney disease (CKD), hepatic steatosis, cancers, chronic obstructive pulmonary disease (COPD), and neurodegenerative diseases (NGDs), were extracted from NHANES (2013-2016). The associations between GLY exposure and each health outcome were estimated using reverse-scale Cox regression and logistic regression. Furthermore, mediation analysis was conducted to identify potential mediators in the significant associations. The dose-response relationships between GLY exposure with health outcomes and potential mediators were analyzed using restricted cubic spline (RCS) regression. The findings of the study revealed that individuals with higher urinary concentrations of GLY had a higher likelihood of having T2DM, hypertension, CVD and obesity (p < 0.001, p = 0.005, p < 0.001 and p = 0.005, respectively). In the reverse-scale Cox regression, a notable association was solely discerned between exposure to GLY and the risk of T2DM (adjusted HR = 1.22, 95% CI: 1.10, 1.36). Consistent outcomes were also obtained via logistic regression analysis, wherein the adjusted OR and 95% CI for T2DM were determined to be 1.30 (1.12, 1.52). Moreover, the present investigation identified serum high-density lipoprotein cholesterol (HDL) as a mediator in this association, with a mediating effect of 7.14% (p = 0.040). This mediating effect was further substantiated by RCS regression, wherein significant dose-response associations were observed between GLY exposure and an increased risk of T2DM (p = 0.002) and reduced levels of HDL (p = 0.001). Collectively, these findings imply an association between GLY exposure and an increased risk of T2DM in the general adult population.

Hormonal Injustice: Environmental Toxicants as Drivers of Endocrine Health Disparities

The toll of multiple endocrine disorders has increased substantially in recent decades, and marginalized populations bear a disproportionate burden of disease. Because of the significant individual and societal impact of these conditions, it is essential to identify and address all modifiable risk factors contributing to these disparities. Abundant evidence now links endocrine dysfunction with exposure to endocrine-disrupting chemicals (EDCs), with greater exposures to multiple EDCs occurring among vulnerable groups, such as racial/ethnic minorities, those with low incomes, and others with high endocrine disease burdens. Identifying and eliminating EDC exposures is an essential step in achieving endocrine health equity.

The Hidden Threat: Endocrine Disruptors and Their Impact on Insulin Resistance

The association between Insulin resistance, a global health issue, and endocrine disruptors (EDCs), chemicals interfering with the endocrine system, has sparked concern in the scientific community. This article provides a comprehensive review of the existing literature regarding the intricate relationship between EDCs and insulin resistance. Phthalates, commonly found in consumer products, are well-established EDCs with documented effects on insulin-signaling pathways and metabolic processes. Epidemiological studies have connected phthalate exposure to an increased risk of type 2 diabetes mellitus (T2DM). Perfluoroalkyl substances (PFAS), persistent synthetic compounds, have shown inconsistent associations with T2DM in epidemiological research. However, studies suggest that PFAS may influence insulin resistance and overall metabolic health, with varying effects depending on specific PFAS molecules and study populations. Bisphenol A (BPA), found in plastics and resins, has emerged as a concern for glucose regulation and insulin resistance. Research has linked BPA exposure to T2DM, altered insulin release, obesity, and changes in the mass and function of insulin-secreting β-cells. Triclosan, an antibacterial agent in personal care products, exhibits gender-specific associations with T2DM risk. It may impact gut microbiota, thyroid hormones, obesity, and inflammation, raising concerns about its effects on metabolic health. Furthermore, environmental EDCs like polycyclic aromatic hydrocarbons, pesticides, and heavy metals have demonstrated associations with T2DM, insulin resistance, hypertension, and obesity. Occupational exposure to specific pesticides and heavy metals has been linked to metabolic abnormalities.

Dichlorodiphenyltrichloroethane for Malaria and Agricultural Uses and Its Impacts on Human Health

Pesticides are widely used in agriculture and disease control, and dichlorodiphenyltrichloroethane (DDT) is one of the most used pesticides in human history. Besides its significant contributions in pest control in agriculture, DDT was credited as having saved millions of human lives for controlling malaria and other deadly insect-transmitted diseases. Even today, the use of DDT in some countries for malaria control cannot be replaced without endangering people who live there. The recent COVID-19 pandemic has changed our lives and reminded us of the challenges in dealing with infectious diseases, especially deadly ones including malaria. However, DDT and its metabolites are stable, persist long, are found in almost every corner of the world, and their persistent effects on humans, animals, and the environment must be seriously considered. This review will focus on the history of DDT use for agriculture and malaria control, the pathways for the spread of DDT, benefits and risks of DDT use, DDT exposure to animals, humans, and the environment, and the associated human health risks. These knowledge and findings of DDT will benefit the selection and management of pesticides worldwide.

The Associations between Organophosphate Pesticides (OPs) and Respiratory Disease, Diabetes Mellitus, and Cardiovascular Disease: A Review and Meta-Analysis of Observational Studies

Although some epidemiological studies have identified the associations between exposure to organophosphate pesticides (Ops) and respiratory diseases, diabetes mellitus (DM), and cardiovascular diseases (CVDs), controversial results still exist. In this review and meta-analysis, we aimed to investigate the overall pooled effect estimates and the possible mechanisms of the relationship between OP exposure and adverse health outcomes. In this study, Web of Science, PubMed, Embase, OVID, and the Cochrane Library were systematically searched until September 2022. Nineteen observational studies that focused on the general population or occupational populations examined the associations between OP exposure and respiratory diseases, DM, and CVD were included. Based on the overall pooled results, a significantly positive association was observed between OP exposure and respiratory diseases (OR: 1.12, 95% CI: 1.06-1.19). A significant link was also observed between various individual species of OP exposure and respiratory diseases, with an OR value of 1.11 (95% CI: 1.05-1.18). In particular, there was a significant association of OPs with wheezing and asthma, with OR values of 1.19 (95% CI: 1.08-1.31) and 1.13 (95% CI: 1.05-1.22), respectively. In addition, a significant association was also observed between OP exposure and DM (OR: 1.18, 95% CI: 1.07-1.29). However, no significant association was observed between OP exposure and CVD (OR: 1.00, 95% CI: 0.94-1.05). Exposure to OPs was associated with a significantly increased risk of respiratory diseases and DM, but there was no evidence of a significant association between OP exposure and CVD. Considering the moderate strength of the results, further evidence is needed to confirm these associations.

Associations of Prenatal Agricultural Farm Work with Fetal Overgrowth and Pregnancy Complications in State of Arizona Birth Records

OBJECTIVE

The purpose of this study is to examine fetal growth outcomes from agricultural worker households.

METHODS

Using Arizona 2006 to 2013 birth certificates with parental occupation, we identified N = 623,185 live births by agricultural household status. Logistic regression models estimated adjusted odds ratios (aORs) for macrosomia (>4000 g), postterm birth (>41 weeks), low birth weight (<2500 g), preterm birth (<37 weeks), large for GA, small for GA, and 5-minute APGAR (<7).

RESULTS

Newborns of agricultural households (n = 6371) had a higher risk of macrosomia (aOR, 1.15; 95% CI, 1.05-1.26), large for GA (aOR, 1.12; 95% CI, 1.03-1.22), postterm birth (aOR, 1.20; 95% CI, 1.09-1.33), and low 5-minute APGAR (aOR, 1.39; 95% CI, 1.07-1.81), whereas low birth weight (aOR, 0.85; 95% CI, 0.76-0.96) and preterm birth (aOR, 0.82; 95% CI, 0.74-0.92) were inversely related.

CONCLUSIONS

Having an agriculture working parent increased the likelihood of fetal overgrowth and low APGAR.

Mapping Potential Population-Level Pesticide Exposures in Ecuador Using a Modular and Scalable Geospatial Strategy

Human populations and ecosystems are extensively exposed to pesticides. Most nations lack the capacity to control pesticide contamination and have limited availability of pesticide use information. Ecuador is a country with intense pesticide use with high exposure risks to humans and the environment, although relative or combined risks are not well understood. Here, we analyzed the distribution of application rates in Ecuador and identified regions of concern because of high potential exposure. We used a geospatial analysis to identify grid cells (∼8 km × 8 km) where the highest pesticide application rates and density of human populations overlap. Furthermore, we identified other regions of concern based on the number of amphibian species as an indicator of ecosystem integrity and the location of natural protected areas. We found that 28% of Ecuador's population dwelled in areas with high pesticide application rate. We identified an area of ∼512 km2 in the Amazon region where high application rates, large human settlements, and a high number of amphibian species overlapped. Additionally, we distinguished clusters of pesticide application rates and human populations that intersected with natural protected areas. Ecuador exemplifies how pesticides are disproportionately applied in areas with the potential to affect human health and ecosystems' integrity. Global estimates of population dwelling, pesticide application rates, and environmental factors are key in prioritizing locations to conduct further exposure assessments. The modular and scalable nature of the geospatial tools we developed can be expanded and adapted to other regions of the world where data on pesticide use are limited.

Pregnancy pesticide exposure and child development in low- and middle-income countries: A prospective analysis of a birth cohort in rural Bangladesh and meta-analysis

BACKGROUND

Despite considerable evidence on a negative association between pregnancy pesticide exposure and child development in high-income countries, evidence from low- and middle-income countries (LMICs) is limited. Therefore, we assessed associations between pregnancy pesticide exposure and child development in rural Bangladesh and summarised existing literature in a systematic review and meta-analysis.

METHODS

We used data from 284 mother-child pairs participating in a birth cohort established in 2008. Eight urinary pesticide biomarkers were quantified in early pregnancy (mean gestational age 11.6±2.9 weeks) as an index of pesticide exposure. The Bayley Scales of Infant and Toddler Development, Third Edition were administered at 20-40 months of age. Associations between creatinine-adjusted urinary pesticide biomarker concentrations and child development scores were estimated using multivariable generalised linear models. We searched ten databases up to November 2021 to identify prospective studies on pregnancy pesticide exposure and child development conducted in LMICs. We used a random-effects model to pool similar studies, including our original analysis. The systematic review was pre-registered with PROSPERO: CRD42021292919.

RESULTS

In the Bangladesh cohort, pregnancy 2-isopropyl-4-methyl-6-hydroxypyrimidine (IMPY) concentrations were inversely associated with motor development (-0.66 points [95% CI -1.23, -0.09]). Pregnancy 3,5,6-trichloro-2-pyridinol (TCPY) concentrations were inversely associated with cognitive development, but the association was small: -0.02 points (-0.04, 0.01). We observed no associations between 4-nitrophenol and 3-phenoxybenzoic acid (3-PBA) concentrations and child development. The systematic review included 13 studies from four LMICs. After pooling our results with one other study, we found consistent evidence that pregnancy 3-PBA concentrations were not associated with cognitive, language, or motor development.

CONCLUSION

Evidence suggests that pregnancy exposure to some organophosphate pesticides is negatively associated with child development. Interventions to reduce in-utero pesticide exposure in LMICs may help protect child development.

Environmental Pollution and the Risk of Developing Metabolic Disorders: Obesity and Diabetes

To meet the increased need for food and energy because of the economic shift brought about by the Industrial Revolution in the 19th century, there has been an increase in persistent organic pollutants (POPs), atmospheric emissions and metals in the environment. Several studies have reported a relationship between these pollutants and obesity, and diabetes (type 1, type 2 and gestational). All of the major pollutants are considered to be endocrine disruptors because of their interactions with various transcription factors, receptors and tissues that result in alterations of metabolic function. POPs impact adipogenesis, thereby increasing the prevalence of obesity in exposed individuals. Metals impact glucose regulation by disrupting pancreatic β-cells, causing hyperglycemia and impaired insulin signaling. Additionally, a positive association has been observed between the concentration of endocrine disrupting chemicals (EDCs) in the 12 weeks prior to conception and fasting glucose levels. Here, we evaluate what is currently known regarding the link between environmental pollutants and metabolic disorders. In addition, we indicate where further research is required to improve our understanding of the specific effects of pollutants on these metabolic disorders which would enable implementation of changes to enable their prevention.

Association between Organochlorine Pesticides and Vitamin D in Female Subjects

In human population studies, organochlorine pesticides (OCPs) have been linked to vitamin D deficiency. Therefore, this study examined the association between OCPs, vitamin D₃ (cholecalciferol, 25(OH)D₃), and the active metabolite 1,25-dihydrovitamin D₃ (1,25(OH)₂D₃) in a cohort of non-obese women. The serum samples of 58 female participants (age-31.9 ± 4.6 years; body mass index (BMI)-25.7 ± 3.7 kg/m²) were screened for 10 indicator OCPs. 25(OH)D₃ and 1,25(OH)₂D₃ levels were determined via isotope dilution liquid chromatography tandem mass spectrometry. In this cohort, the 25(OH)D₃ and 1,25(OH)₂D₃ levels were 22.9 ± 11.2 ng/mL and 0.05 ± 0.02 ng/mL, respectively, with 28 participants classified as 25(OH)D₃-deficient (<50 nmol/L). In the study cohort, no correlations were found between individual or total OCPs (ƩOCPs) and 25(OH)D₃. p,p'-dichlorodiphenyldichloroethylene (DDE) and ƩOCPs correlated positively with 1,25(OH)₂D₃, with the latter being negatively correlated with estimated glomerular filtration rate (eGFR). In women with sufficient 25(OH)D₃ levels, p,p'-dichlorodiphenyltrichloroethan (DDT) was positively correlated with 1,25(OH)₂D₃, whilst in the deficient group, hexachlorobenzene (HCB) and p,p'-(DDE) were positively correlated with 1,25(OH)₂D₃, β-Hexachlorocyclohexane (HCH) was positively correlated with 25(OH)D₃, and none of the OCPs were associated with measures of renal function. Overall, OCPs and ƩOCPs were not associated with 25(OH)D₃, suggesting that they are unrelated to vitamin D deficiency, but p,p'-DDE and ƩOCPs correlated positively with active 1,25(OH)₂D₃, while ƩOCPs correlated negatively with eGFR, suggesting a possible renal effect. Analysis of vitamin D deficiency revealed an association between β-HCH and 25(OH)D₃, and between HCB and p,p'-DDE and 1,25(OH)₂D₃, suggesting that OCP effects may be enhanced in cases of vitamin D deficiency.

Habitual Tea Consumption Increases the Incidence of Metabolic Syndrome in Middle-Aged and Older Individuals

In middle-aged and elderly individuals, the relationship between tea consumption and incident metabolic syndrome (MetS) is still unclear. Therefore, this study intends to figure out the relationship between tea-drinking frequency and MetS in rural middle-aged and older Chinese residents. In the Northeast China Rural Cardiovascular Health Study, 3632 middle-aged or older individuals (mean age 57 ± 8, 55.2% men) without MetS were included at baseline during 2012–2013 and were followed up on between 2015–2017. Participants showing differential tea consumption frequency were divided into the following classes: non-habitual tea drinkers, occasional tea drinkers, 1–2 times/day drinkers, and ≥3 times/day drinkers. Data showed that non-habitual tea drinking was more common among women. The frequency of tea consumption was higher in ethnic groups other than Han and among singles, as well as in concurrent smokers and drinkers and individuals with primary or lower educational status. The increasing tea consumption was in line with baseline elevations in body mass index, systolic and diastolic blood pressure, high-density lipoprotein cholesterol (HDL-C), and AST/ALT ratio. Multivariate logistic regression analysis confirmed that occasional tea drinking increased the incidence of low HDL-C [OR (95% CI): 1.268 (1.015, 1.584)], high waist circumference [OR (95% CI): 1.336 (1.102, 1.621)], and MetS [OR (95% CI): 1.284 (1.050, 1.570)]. In addition, 1–2 times/day tea drinking increased the cumulative incidence of high TG [OR (95% CI): 1.296 (1.040, 1.616)], high waist circumference [OR (95% CI): 1.296 (1.044, 1.609)] and MetS [OR (95% CI): 1.376 (1.030, 1.760)]. We demonstrated that regular tea consumption is correlated with a greater incidence of metabolic disorders and MetS. Our findings may help clarify the contradictory association reported between tea drinking and MetS development in middle-aged and older residents of rural China.

Sauver JL, Rocca WA. Integrating Environmental Data with Medical Data in a Records-Linkage System to Explore Groundwater Nitrogen Levels and Child Health Outcomes

Background: The Rochester Epidemiology Project (REP) medical records-linkage system offers a unique opportunity to integrate medical and residency data with existing environmental data, to estimate individual-level exposures. Our primary aim was to provide an archetype of this integration. Our secondary aim was to explore the association between groundwater inorganic nitrogen concentration and adverse child and adolescent health outcomes. Methods: We conducted a nested case-control study in children, aged seven to eighteen, from six counties of southeastern Minnesota. Groundwater inorganic nitrogen concentration data were interpolated, to estimate exposure across our study region. Residency data were then overlaid, to estimate individual-level exposure for our entire study population (n = 29,270). Clinical classification software sets of diagnostic codes were used to determine the presence of 21 clinical conditions. Regression models were adjusted for age, sex, race, and rurality. Results: The analyses support further investigation of associations between nitrogen concentration and chronic obstructive pulmonary disease and bronchiectasis (OR: 2.38, CI: 1.64-3.46) among boys and girls, thyroid disorders (OR: 1.44, CI: 1.05-1.99) and suicide and intentional self-inflicted injury (OR: 1.37, CI: >1.00-1.87) among girls, and attention deficit conduct and disruptive behavior disorders (OR: 1.34, CI: 1.24-1.46) among boys. Conclusions: Investigators with environmental health research questions should leverage the well-enumerated population and residency data in the REP.

Can Sulfonylureas for Agricultural Use Cause Diabetes? A Report of Three Cases

Sulfonylureas (SUs) are commonly used as herbicides. Many farmers and other professionals use SUs for cereal, strawberry, and grape crops. This study examines the possible association between exposure to SUs herbicides and the risk of developing type 2 diabetes (T2D). The study presents three cases of unrelated agronomists who had used SUs for more than three decades and developed T2D. The objective was to investigate the association between occupational dermal and inhalation exposure to herbicides and T2D. Further studies with a larger sample size are needed to determine the association and to help develop prevention strategies.

Pesticides as endocrine disruptors: programming for obesity and diabetes

PURPOSE

Exposure to pesticides has been associated with obesity and diabetes in humans and experimental models mainly due to endocrine disruptor effects. First contact with environmental pesticides occurs during critical phases of life, such as gestation and lactation, which can lead to damage in central and peripheral tissues and subsequently programming disorders early and later in life.

METHODS

We reviewed epidemiological and experimental studies that associated pesticide exposure during gestation and lactation with programming obesity and diabetes in progeny.

RESULTS

Maternal exposure to organochlorine, organophosphate and neonicotinoids, which represent important pesticide groups, is related to reproductive and behavioral dysfunctions in offspring; however, few studies have focused on glucose metabolism and obesity as outcomes.

CONCLUSION

We provide an update regarding the use and metabolic impact of early pesticide exposure. Considering their bioaccumulation in soil, water, and food and through the food chain, pesticides should be considered a great risk factor for several diseases. Thus, it is urgent to reformulate regulatory actions to reduce the impact of pesticides on the health of future generations.

The Importance of Fostering and Funding Scientific Research, and its Relevance to Environmental Toxicology and Chemistry

What do environmental contaminants and climate change have in common with the virus SARS-CoV-2 and the disease COVID-19? We argue that one common element is the wealth of basic and applied scientific research that provides the knowledge and tools essential in developing effective programs for addressing threats to humans and social-ecological systems. Research on various chemicals, including dichlorodiphenyltrichloroethane and per- and polyfluoroalkyl substances, resulted in regulatory action to protect environmental and human health. Moreover, decades of research on coronaviruses, mRNA, and recently SARS-CoV-2 enabled the rapid development of vaccines to fight the COVID-19 pandemic. In the present study, we explore the common elements of basic and applied scientific research breakthroughs that link chemicals, climate change, and SARS-CoV-2/COVID-19 and describe how scientific information was applied for protecting human health and, more broadly, socio-ecological systems. We also offer a cautionary note on the misuse and mistrust of science that is not new in human history, but unfortunately is surging in modern times. Our goal was to illustrate the critical role of scientific research to society, and we argue that research must be intentionally fostered, better funded, and applied appropriately. To that end, we offer evidence that supports the importance of investing in scientific research and, where needed, ways to counter the spread of misinformation and disinformation that undermines legitimate discourse. Environ Toxicol Chem 2023;42:581-593. © 2022 SETAC.

Arsenic and Diabetes Mellitus: A Putative Role for the Immune System

Diabetes mellitus (DM) is an enormous public health issue worldwide. Recent data suggest that chronic arsenic exposure is linked to the risk of developing type 1 and type 2 DM, albeit the underlying mechanisms are unclear. This review discusses the role of the immune system as a link to possibly explain some of the mechanisms of developing T1DM or T2DM associated with arsenic exposure in humans, animal models, and in vitro studies. The rationale for the hypothesis includes: (1) Arsenic is a well-recognized modulator of the immune system; (2) arsenic exposures are associated with increased risk of DM; and (3) dysregulation of the immune system is one of the hallmarks in the pathogenesis of both T1DM and T2DM. A better understanding of DM in association with immune dysregulation and arsenic exposures may help to understand how environmental exposures modulate the immune system and how these effects may impact the manifestation of disease.

Mannosylerythritol lipids as green pesticides and plant biostimulants

Biosurfactants can be applied in the formulation of personal care products, as food additives, and as biocontrol agents in the agricultural sector. Glycolipids and lipopeptides represent an important group of microbial-based biosurfactants with biostimulating properties. Among them, the mannosylerythritol lipids also presented antimicrobial activity, mostly against Gram-positive bacteria and phytopathogenic fungi. In this sense, mannosylerythritol lipids are a potential safer green alternative for partially replacing synthetic pesticides. This review aimed to critically discuss the current state of the art and future trends of mannosylerythritol lipids as green pesticides and biostimulants for seed germination and plant growth. Due to their chemical structure, mannosylerythritol lipids are likely related to energy pathways such as glycolysis and Krebs cycle, i.e. a direct cellular biostimulant potential. In this case, experimental evidence from other glycolipids indicated that structural and chemical changes as a potential drug vehicle due to morphological changes caused by biosurfactant-membrane interaction. In addition, like other biosurfactants, mannosylerythritol lipids can trigger self-defense mechanisms, leading to a lower frequency of phytopathogen infections. Therefore, mannosylerythritol lipids have the potential for biostimulation and antiphytopathogenic action, despite that to date no data are available on mannosylerythritol lipids as biostimulants and green pesticides simultaneously. Based on the current state of the art, mannosylerythritol lipids have great potential for a biotechnological advance toward more sustainable agriculture. © 2022 Society of Chemical Industry.

1. Improving Care and Promoting Health in Populations: Standards of Care in Diabetes-2023

The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.

Association of occupational exposure to pesticides with overweight and abdominal obesity in family farmers in southern Brazil

The association of chronic exposure to pesticides with overweight and abdominal obesity in adult farmers was investigated. This cross-sectional study included a random sample of 122 farmers and their family members of both sexes (61% were male), living in the municipality of Farroupilha, southern Brazil. Pesticide groups and their individual compounds were self-reported and classified according to major functional and chemical classes (never used, 1-20 years, or > 20 years of use). Abdominal obesity and overweight were the outcomes of interest. A multivariate Poisson regression model was analyzed. After confounding factors were controlled, chronic use (>20 years) of insecticides (PR: 1.45; 95% CI: 1.00-2.10) and organophosphorus pesticides (PR: 1.48, 95% CI: 1.02-2.12) was associated with a higher prevalence of overweight but not abdominal obesity. Additional studies are needed to confirm our findings and clarify the specific mechanisms of these pollutants in the etiology of obesity.

Enantioselective aquatic toxicity and degradation in soil of the chiral fungicide oxathiapiprolin

Oxathiapiprolin is an efficient and chiral fungicide for peronosporomycetes. The enantioselective environmental behavior and ecotoxicity of oxathiapiprolin are still unclear. The enantioselectivity of oxathiapiprolin enantiomers was explored, including their acute toxicity toward aquatic plants (Auxenochlorella pyrenoidosa and Soirodela polyrhiza) along with their influence on photosynthetic pigment production, the acute toxicity and morphological differences for the embryos, larvae and adult stages of zebrafish (Danio rerio), and the degradation in four typical soils (aerobic, anaerobic and sterilized conditions). The enantioselective toxicity of oxathiapiprolin showed that the toxicity of R-oxathiapiprolin was 1.8-2.1 times higher than that of S-oxathiapiprolin toward the two aquatic plants. In particular, the content of photosynthetic pigments decreased significantly stronger after exposure to R-oxathiapiprolin compared with S-oxathiapiprolin. The LC₅₀ values of R-oxathiapiprolin in zebrafish in the different life stages were 1.6-2.1 times higher than those of S-oxathiapiprolin. The zebrafish embryos were most sensitive to the oxathiapiprolin enantiomers. After exposure to R-oxathiapiprolin, zebrafish embryos showed noticeable hatching delays, inhibition or deformation. R-oxathiapiprolin degraded preferentially in all four soils, with an enantiomeric fraction (EF) ranging from 0.28 to 0.42 under aerobic conditions. Enantioselective degradation was not found under anaerobic and sterilized conditions. The enantioselectivity of new chiral pesticides should be fully considered in risk assessments to provide a basis for the development and preparation of pure optical enantiomers.

Association between exposure to organophosphorus pesticides and the risk of diabetes among US Adults: Cross-sectional findings from the National Health and Nutrition Examination Survey

OBJECTIVE

Organophosphorus pesticides (OPPs) are commonly used pesticides across the world, however there is little epidemiological evidence linking their exposure to diabetes. Hence, this study aimed at investigating the effect of OPP exposure on the prevalence of diabetes in American adults.

METHODS

Adults (≥20 years old) were eligible for this study from the National Health and Nutrition Examination Survey (NHANES). Multivariate logistic regression model was employed to explore the associations of six main urinary OPPs metabolites with diabetes. Subgroup analyses were performed by age and gender. Combined effect of OPPs metabolites on the overall association with diabetes was evaluated by weighted quantile sum regression (WQS). Furthermore, Bayesian kernel machine regression (BKMR) model was implemented to explore joint effect of multiple OPPs metabolites on diabetes.

RESULTS

Ultimately, 6,593 adults were included in our analysis. Of them, 1,044 participants were determined as diabetes patients. The results of logistic regression shown that urinary OPPs metabolites concentrations, whether taken as continuous variables or quantiles, were in positive correlation with diabetes. Notably, the p for trend of diethylphosphate (DEP), a kind of OPPs metabolites, was less than 0.05 indicated that a linear trend may exist between levels of DEP and prevalence of diabetes among adults while this trend was not obversed in other OPPs metabolites. In the WQS model, combined exposure of OPPs metabolites had a significantly positive association with diabetes (OR: 1.057; 95% CI: 1.002, 1.114) and diethylphosphate (36.84%) made the largest contributor to the WQS index. The result of BKMR also suggested a positive trend of association between mixed OPPs metabolites and diabetes.

CONCLUSION

Our results add credibility to the argument that OPP exposure might trigger diabetes. Certainly, prospective data are required to corroborate our findings.

An Overview of Diabetes Mellitus in Egypt and the Significance of Integrating Preventive Cardiology in Diabetes Management

In Egypt, diabetes mellitus (DM) is a significant public health concern, and the disease is considered a modern pandemic throughout the world. The incidence of diabetes is steadily climbing, which is causing grave concern. As a result, it is essential to take into consideration the risk factors that are pervasive in Egyptian society and have led to the worsening of this problem. These risk factors include sedentary lifestyles, obesity, hepatitis C infections, pesticides, smoking, and bad cultural habits. In this review, we aim to demonstrate the possible solutions to fight diabetes mellitus and overcome its serious health and socioeconomic burdens in Egypt. A multidisciplinary, team-based approach is highly recommended in diabetes management. Primary care physicians, endocrinologists, nephrologists, and preventive cardiologists all play a crucial role in providing the highest possible level of care to diabetic patients by collaborating closely with one another. The assessment of cardiovascular risk and the prevention of life-threatening cardiovascular events, common among diabetic patients, warrant the introduction of preventive cardiology, a new and significant concept in diabetes care that demands adoption. The integration of preventive cardiology into the treatment of diabetic patients is expected to significantly cut down the morbidity and mortality rates associated with diabetes mellitus and provide them with a better quality of life.

Metabolic syndrome and pesticides: A systematic review and meta-analysis

The relation between pesticides exposure and metabolic syndrome (MetS) has not been clearly identified. Performing a systematic review and meta-analysis, PubMed, Cochrane Library, Embase, and ScienceDirect were searched for studies reporting the risk of MetS following pesticides exposure and their contaminants. We included 12 studies for a total of 6789 participants, in which 1981 (29.1%) had a MetS. Overall exposure to pesticides and their contaminants increased the risk of MetS by 30% (95CI 22%-37%). Overall organochlorine increased the risk of MetS by 23% (14-32%), as well as for most types of organochlorines: hexachlorocyclohexane increased the risk by 53% (28-78%), hexachlorobenzene by 40% (0.01-80%), dichlorodiphenyldichloroethylene by 22% (9-34%), dichlorodiphenyltrichloroethane by 28% (5-50%), oxychlordane by 24% (1-47%), and transnonchlor by 35% (19-52%). Sensitivity analyses confirmed that overall exposure to pesticides and their contaminants increased the risk by 46% (35-56%) using crude data or by 19% (10-29%) using fully-adjusted model. The risk for overall pesticides and types of pesticides was also significant with crude data but only for hexachlorocyclohexane (36% risk increase, 17-55%) and transnonchlor (25% risk increase, 3-48%) with fully-adjusted models. Metaregressions demonstrated that hexachlorocyclohexane increased the risk of MetS in comparison to most other pesticides. The risk increased for more recent periods (Coefficient = 0.28, 95CI 0.20 to 0.37, by year). We demonstrated an inverse relationship with body mass index and male gender. In conclusion, pesticides exposure is a major risk factor for MetS. Besides organochlorine exposure, data are lacking for other types of pesticides. The risk increased with time, reflecting a probable increase of the use of pesticides worldwide. The inverse relationship with body mass index may signify a stockage of pesticides and contaminants in fat tissue.