Persistent organic pollutants and the burden of diabetes

Persistent organic pollutants disrupt the oxidant/antioxidant balance of INS-1E pancreatic β-cells causing their physiological dysfunctions

BACKGROUND

Persistent organic pollutants (POPs) have emerged as potent diabetogenic agents, but their mechanisms of action remain poorly identified.

OBJECTIVES

In this study, we aim to determine the mechanisms regulating the damaging effects of POPs in pancreatic β-cells, which have a central role in the development of diabetes.

METHODS

We treated INS-1E pancreatic β-cells with PCB-153, p,p'-DDE, PCB-126, or TCDD at doses ranging from 1 × 10-15to 5 × 10-6M. We measured insulin content and secretion, cell viability and assessed the mRNA expression of the xenobiotic nuclear receptors Nr1i2 and Nr1i3, and the aryl hydrocarbon receptor (Ahr). In addition, we evaluated the antioxidant defense and production of reactive oxygen species (ROS). Finally, we studied the ability of the antioxidant N-acetyl-L-cysteine (NAC) to counteract the effects of POPs in INS-1E cells.

RESULTS

When exposed to environmental POP levels, INS-1E cells had impaired production and secretion of insulin. These defects were observed for all tested POPs and were paralleled by reduced Ins1 and Ins2 mRNA expression. While POP treatment for 3 days did not affect INS-1E cell viability, longer treatment progressively killed the cells. Furthermore, we found that the xenobiotic detoxification machinery is poorly expressed in the INS-1E cells, as characterized by the absence of Nr1i2 and Nr1i3 and their respective downstream targets Cyp3a1/Cyp3a2 and Cyp2b1/Cyp2b3, and the weak functionality of the Ahr/Cyp1a1 signaling. Interestingly, POPs dysregulated key antioxidant enzymes such as glutathione peroxidases, peroxiredoxins, thioredoxins, and catalases. In parallel, the production of intracellular ROS, including superoxide anion (O2•-) and hydrogen peroxide (H2O2), was increased by POP exposure. Improving the oxidant scavenging capacity of INS-1E cells by NAC treatment restored the production and secretion of insulin.

CONCLUSION

By promoting oxidative stress and impairing the ability of INS-1E cells to produce and secrete insulin, this study reveals how POPs can mechanistically act as diabetogenic agents, and provides new scientific evidence supporting the concept that POPs are fueling the diabetes epidemics.

Serum concentration of polychlorinated biphenyls and the risk of type 2 diabetes: a 10-year follow-up historical cohort study

This study investigated the association between serum concentrations of Polychlorinated Biphenyls (PCBs) and the risk of type 2 diabetes within the general population. A ten-year follow-up historical cohort study was conducted during 2009-2019 as part of the Bushehr MONICA cohort study in Iran. Of 893 non-diabetes participants at base line, 181 individuals were included in the study. The concentration of nine PCB congeners was measured in individuals' serum samples at baseline, and the risk of type 2 diabetes was determined based on fasting blood sugar at the end of follow-up. Multiple logistic regression models were used to assess the study outcomes after adjusting for covariates. This study included 59 diabetes individuals (32.6%; mean [SD] age: 58.64 [8.05]) and 122 non-diabetes individuals (67.4%; mean [SD] age: 52.75 [8.68]). Multivariable analysis revealed that a one-tertile increase (increasing from 33rd centile to 67th centile) in Σ non-dioxin-like-PCBs (OR 2.749, 95% CI 1.066-7.089), Σ dioxin-like-PCBs (OR 4.842, 95% CI 1.911-12.269), and Σ PCBs (OR 2.887, 95% CI 1.120-7.441) significantly associated with an increased risk of type 2 diabetes. The strongest association was obtained for dioxin-like PCBs. The results highlight a significant correlation between PCB exposure and an increased risk of type 2 diabetes. The evidence suggests that additional epidemiological studies are necessary to clarify the link between PCBs and diabetes.

Assessing the risk of diabetes in participants with DDT DDE exposure- A systematic review and meta-analysis

We have performed a systematic review and meta-analysis of the association between DDT/DDE and diabetes, searching PubMed, Embase, and Cochrane for relevant articles published up to August 30, 2021, and eventually including 43 publications. Our researchers evaluate included studies' quality and risk of bias via the recommended tool. This study uses meta-analyses of random effects of each exposure and outcome to estimate combined odds ratios (ORs) and 95% confidence intervals (CIs). Our research identified 43 cross-sectional, case-control, and cohort studies, including 40,141 individuals in America, Europe, Asia, and Africa. The summary ORs (95% CIs) of incident diabetes were 1.61 (1.10-2.39) for DDT, 1.67 (1.41-1.98) for DDE. The subgroup analysis indicated that the association is significantly higher in the region of Asia for both DDT (OR = 2.73) and DDE (OR = 2.62). Besides, we also tried various types of stratification to identify the more influential confounding factors, among which regional factors have a significant influence. Study evidence suggests that exposure to DDT and its breakdown product, DDE, might be associated with the risk of incident diabetes. Among Asian patients, DDT/DDE concentrations are more closely associated with diabetes. Further studies in specific regions will be considered in the future.

Exposure to the pesticide DDT and risk of diabetes and hypertension: Systematic review and meta-analysis of prospective studies

BACKGROUND

Experimental evidence suggests that p,p'-DDE might be involved in the development of diabetes and hypertension (HTN); however, the evidence in humans is inconclusive.

OBJECTIVE

To summarize the epidemiological evidence for the association of p,p'-DDT exposure and its breakdown products with the risk of diabetes and HTN from prospective studies.

METHODS

We performed a systematic review and meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Eligible studies (prospective) were search in PubMed, Web of Science, EBSCO, and SciELO databases (July 11, 2020). Different search algorithms were used for diabetes and HTN. Pooled odds ratios (ORs) were estimated from meta-analysis with random effects for each exposure and outcome.

RESULTS

A total of 23 prospective studies were included in this review, 16 assessed diabetes and seven HTN; very few measured p,p'-DDT. Exposure to p,p'-DDE was associated with a slightly increased risk of type 2 diabetes (T2D) (pooled OR = 1.44; 95%CI: 1.00, 2.07; p = 0.049) and HTN (pooled OR = 1.21; 95%CI: 1.07, 1.38). Dose-response meta-analysis suggested a non-linear relation between p,p'-DDE and T2D. Exposure to p,p'-DDE was not associated with gestational diabetes (pooled OR = 1.01; 95%CI: 0.94, 1.09); similarly, p,p'-DDT was not associated with T2D (pooled OR = 1.03; 95%CI: 0.79, 1.35).

CONCLUSIONS

Evidence from prospective studies suggests that exposure to p,p'-DDE, the main breakdown product of p,p'-DDT, might increase the risk of developing T2D; such increase may be apparent only at low levels. Exposure to p,p'-DDE may also increase the risk of having HTN; however, further evidence is required.

PCB cause global DNA hypomethylation of human peripheral blood monocytes in vitro

We have recently reported significant associations between exposure to polychlorinated biphenyls (PCB) and alterations on genome-wide methylation of leukocyte DNA of healthy volunteers and provided evidence in support of an etiological link between the observed CpG methylation variations and chronic lymphocytic leukemia. The present study aimed to elucidate the effects of PCB in human lymphocytes' methylome in vitro. Therefore, U937 cells and human peripheral blood monocytes (PBMC) were exposed in vitro to the dioxin-like PCB-118, the non-dioxin-like PCB-153, and hexachlorobenzene (HCB) and thorough cytotoxicity, genotoxicity and global CpG methylation analyses were performed. All compounds currently tested did not show any consistent significant genotoxicity at all exposure periods and concentrations used. On the contrary, extensive dose-dependent hypomethylation was observed, even at low concentrations, in stimulated PBMC treated with PCB-118 and PCB-153 as well as a small but statistically significant hypomethylation in HCB-treated stimulated cells.

Adipose Tissue Levels of DDT as Risk Factor for Obesity and Type 2 Diabetes Mellitus

BACKGROUND

Exposure to dichlorodiphenyltrichloroethane (DDT), a potent lipophilic organochlorine pesticide, has long been linked as a risk factor for type 2 diabetes mellitus (T2DM). However, its presence in the adipose tissues of the T2DM subjects has not been explored in the Indian population, where this long-banned pesticide is still in use. The present study was conducted to evaluate the possible association of DDT and its metabolites in obese and non-obese T2DM subjects.

METHODS

Subjects with normal glucose tolerance (n = 50) and T2DM (n = 50) were divided into equal numbers in obese and non-obese groups. Their plasma glucose levels, HbA₁c, and lipid profile were measured. The adipose tissues were collected intraoperatively, and DDT and its metabolites were measured using a gas chromatograph equipped with an electron capture detector.

RESULTS

Obese subjects, irrespective of their glycemic status, and T2DM subjects had higher concentrations of DDT. p, p' DDT was found to increase the odds for diabetes, and o, p' DDT for central obesity. p, p' DDD was also strongly correlated with central obesity, glycemic parameters, and triglycerides.

CONCLUSION

The excess deposition of p, p' DDD, o, p' DDT, and p, p' DDT in obese subjects may proceed to T2DM by disrupting triglycerides and glycemic parameters.

Associations of residential and occupational history with the distribution of persistent pollutant mixtures in adipose tissue samples

This research aims to explore clusters of a mixture of 15 Persistent Toxic Substances (PTSs) in the adipose tissue of 227 individuals of an adult cohort from Granada Province (Southern Spain). Information about residence and occupation during participants lifetime was gathered by means of validated questionnaires. Clusters of pollutants in the study population were identified by Principal Component Analyses (PCA). PCA analyses revealed three major clusters of pollutants: PC1, representing predominantly an assortment of metal(loid)s, namely aluminium, arsenic, chromium, nickel and lead; PC2, including mostly Organochlorine Pesticides (OCPs), such as HCB, β-HCH and p,p'-DDE; and PC3, gathering mainly a mixture of Polychlorinated Biphenyls (PCB-138, PCB-153 and PCB-180) and metals (cadmium, cobalt and chromium). The patterns of distribution of individual pollutants and their mixtures were explored through Geographic Information Systems and multivariable linear regression models. Living in rural areas was associated with decreased levels of the mixture of PCBs and metals. Residents of industrial and heavy traffic areas showed increased levels of the mixture of metal(loid)s. Those living in rural and semi-rural areas at recruitment had decreased levels of the OCP mixture. Occupational history related to agriculture and food industry was associated with increased levels of the mixture of metal(loid)s, whereas those who had been involved in motor and industrial activities showed increased levels of the OCP mixture. Participants who had worked in cleaning and housekeeping activities for long periods showed decreased levels of the mixture of PCBs and metals. Our research revealed suggestive clusters of exposure, that emphasized the need for further epidemiological studies to address the effect of environmental pollutants from a mixture perspective. Results also highlight the potential of adipose tissue as a matrix for exposure assessment to combinations of different families of contaminants.

Human Pluripotent Stem Cells: A Unique Tool for Toxicity Testing in Pancreatic Progenitor and Endocrine Cells

Diabetes prevalence is increasing worldwide, and epidemiological studies report an association between diabetes incidence and environmental pollutant exposure. There are >84,000 chemicals in commerce, many of which are released into the environment without a clear understanding of potential adverse health consequences. While in vivo rodent studies remain an important tool for testing chemical toxicity systemically, we urgently need high-throughput screening platforms in biologically relevant models to efficiently prioritize chemicals for in depth toxicity analysis. Given the increasing global burden of obesity and diabetes, identifying chemicals that disrupt metabolism should be a high priority. Pancreatic endocrine cells are key regulators of systemic metabolism, yet often overlooked as a target tissue in toxicology studies. Immortalized β-cell lines and primary human, porcine, and rodent islets are widely used for studying the endocrine pancreas in vitro, but each have important limitations in terms of scalability, lifespan, and/or biological relevance. Human pluripotent stem cell (hPSC) culture is a powerful tool for in vitro toxicity testing that addresses many of the limitations with other β-cell models. Current in vitro differentiation protocols can efficiently generate glucose-responsive insulin-secreting β-like cells that are not fully mature, but still valuable for high-throughput toxicity screening in vitro. Furthermore, hPSCs can be applied as a model of developing pancreatic endocrine cells to screen for chemicals that influence endocrine cell formation during critical windows of differentiation. Given their versatility, we recommend using hPSCs to identify potential β-cell toxins, which can then be prioritized as chemicals of concern for metabolic disruption.

Factors associated with partitioning behavior of persistent organic pollutants in a feto-maternal system: A multiple linear regression approach

Prenatal exposure to persistent organic pollutants (POPs) has been a matter of particular concern because such exposure can severely affect the health of the fetus. The mechanistic understanding of the partitioning behavior of POPs in the feto-maternal system and the associated factors, however, have rarely been studied. Here, we employed a new approach based on multiple linear regression (MLR) analysis to predict the feto-maternal ratio (FM-ratio) of POPs and to assess the factors associated with feto-maternal partitioning behavior. Two preliminary exploratory MLR models were built using physiological conditions of the participants, and molecular descriptors were calculated with a computational model. The FM-ratio was calculated from the concentrations of polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins and furans (PCDD/Fs), and polybrominated diphenyl ethers (PBDEs) in 20 pairs of maternal and cord blood. The models showed that the lipids and cholesterols in the maternal and cord blood and the placenta significantly influence the partitioning of POPs. The body mass index (BMI) change during pregnancy was also related to the FM-ratio. The physicochemical properties associated with lipophilicity and molecular size were also related to the FM-ratio. Even though the results should be interpreted with caution, the preliminary MLR models illustrate that feto-maternal partitioning is governed by transplacental transporting mechanisms, toxicokinetics, and the molecular physicochemical properties of POPs. Overall, the new approach used in this study can improve our understanding of the partitioning behavior in the feto-maternal system.

Influence of KRAS mutations, persistent organic pollutants, and trace elements on survival from pancreatic ductal adenocarcinoma

INTRODUCTION

Reasons why pancreatic ductal adenocarcinoma (PDAC) continues to have poor survival are only partly known. No previous studies have analyzed the combined influence of KRAS mutations, persistent organic pollutants (POPs), and trace elements upon survival in PDAC or in any other human cancer.

OBJECTIVE

To analyze the individual and combined influence of KRAS mutations, POPs, and trace elements upon survival from PDAC.

METHODS

Incident cases of PDAC (n = 185) were prospectively identified in five hospitals in Eastern Spain in 1992-1995 and interviewed face-to-face during hospital admission. KRAS mutational status was determined from tumour tissue through polymerase chain reaction and artificial restriction fragment length polymorphism. Blood and toenail samples were obtained before treatment. Serum concentrations of POPs were analyzed by high-resolution gas chromatography with electron-capture detection. Concentrations of 12 trace elements were determined in toenail samples by inductively coupled plasma mass spectrometry. Multivariable Cox proportional hazards regression was used to assess prognostic associations.

RESULTS

Patients with a KRAS mutated tumor had a 70% higher risk of early death than patients with a KRAS wild-type PDAC (hazard ratio [HR] = 1.7, p = 0.026), adjusting for age, sex, and tumor stage. KRAS mutational status was only modestly and not statistically significantly associated with survival when further adjusting by treatment or by treatment intention. The beneficial effects of treatment remained unaltered when KRAS mutational status was taken into account, and treatment did not appear to be less effective in the subgroup of patients with a KRAS mutated tumor. POPs did not materially influence survival: the adjusted HR of the highest POP tertiles was near unity for all POPs. When considering the joint effect on survival of POPs and KRAS, patients with KRAS mutated tumors had modest and nonsignificant HRs (most HRs around 1.3 to 1.4). Higher concentrations of lead, cadmium, arsenic, vanadium, and aluminium were associated with better survival. When KRAS status, POPs, and trace elements were simultaneously considered along with treatment, only the latter was statistically significantly related to survival.

CONCLUSIONS

In this study based on molecular, clinical, and environmental epidemiology, KRAS mutational status, POPs, and trace elements were not adversely related to PDAC survival when treatment was simultaneously considered; only treatment was independently related to survival. The lack of adverse prognostic effects of POPs and metals measured at the time of diagnosis provide scientific and clinical reassurance on the effects of such exposures upon survival of patients with PDAC. The weak association with KRAS mutations contributes to the scant knowledge on the clinical implications of a genetic alteration highly frequent in PDAC.

Targeting Glycoproteins as a therapeutic strategy for diabetes mellitus and its complications

OBJECTIVES

Glycoproteins are organic compounds formed from proteins and carbohydrates, which are found in many parts of the living systems including the cell membranes. Furthermore, impaired metabolism of glycoprotein components plays the main role in the pathogenesis of diabetes mellitus. The aim of this study is to investigate the influence of glycoprotein levels in the treatment of diabetes mellitus.

METHODS

All relevant papers in the English language were compiled by searching electronic databases, including Scopus, PubMed and Cochrane library. The keywords of glycoprotein, diabetes mellitus, glycan, glycosylation, and inhibitor were searched until January 2019.

RESULTS

Glycoproteins are pivotal elements in the regulation of cell proliferation, growth, maturation and signaling pathways. Moreover, they are involved in drug binding, drug transportation, efflux of chemicals and stability of therapeutic proteins. These functions, structure, composition, linkages, biosynthesis, significance and biological effects are discussed as related to their use as a therapeutic strategy for the treatment of diabetes mellitus and its complications.

CONCLUSIONS

The findings revealed several chemical and natural compounds have significant beneficial effects on glycoprotein metabolism. The comprehension of glycoprotein structure and functions are very essential and inevitable to enhance the knowledge of glycoengineering for glycoprotein-based therapeutics as may be required for the treatment of diabetes mellitus and its associated complications. Graphical abstract.

Functional cytochrome P450 1A enzymes are induced in mouse and human islets following pollutant exposure

AIMS/HYPOTHESIS

Exposure to environmental pollution has been consistently linked to diabetes incidence in humans, but the potential causative mechanisms remain unclear. Given the critical role of regulated insulin secretion in maintaining glucose homeostasis, environmental chemicals that reach the endocrine pancreas and cause beta cell injury are of particular concern. We propose that cytochrome P450 (CYP) enzymes, which are involved in metabolising xenobiotics, could serve as a useful biomarker for direct exposure of islets to pollutants. Moreover, functional CYP enzymes in islets could also impact beta cell physiology. The aim of this study was to determine whether CYP1A enzymes are activated in islets following direct or systemic exposure to environmental pollutants.

METHODS

Immortalised liver (HepG2) and rodent pancreatic endocrine cell lines (MIN6, βTC-6, INS1, α-TC1, α-TC3), as well as human islets, were treated in vitro with known CYP1A inducers 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and 3-methylcholanthrene (3-MC). In addition, mice were injected with either a single high dose of TCDD or multiple low doses of TCDD in vivo, and islets were isolated 1, 7 or 14 days later.

RESULTS

CYP1A enzymes were not activated in any of the immortalised beta or alpha cell lines tested. However, both 3-MC and TCDD potently induced CYP1A1 gene expression and modestly increased CYP1A1 enzyme activity in human islets after 48 h. The induction of CYP1A1 in human islets by TCDD was prevented by cotreatment with a cytokine mixture. After a systemic single high-dose TCDD injection, CYP1A1 enzyme activity was induced in mouse islets ~2-fold, ~40-fold and ~80-fold compared with controls after 1, 7 and 14 days, respectively, in vivo. Multiple low-dose TCDD exposure in vivo also caused significant upregulation of Cyp1a1 in mouse islets. Direct TCDD exposure to human and mouse islets in vitro resulted in suppressed glucose-induced insulin secretion. A single high-dose TCDD injection resulted in lower plasma insulin levels, as well as a pronounced increase in beta cell death.

CONCLUSIONS/INTERPRETATION

Transient exposure to TCDD results in long-term upregulation of CYP1A1 enzyme activity in islets. This provides evidence for direct exposure of islets to lipophilic pollutants in vivo and may have implications for islet physiology.

Oral intake exposure to phthalates in vegetables produced in plastic greenhouses and its health burden in Shaanxi province, China

Phthalate exposure from Vegetables grown in Plastic Greenhouses (VPGs) represents an important source of total daily phthalate exposure in China. However, quantified health risks of phthalates attributable to VPG intake have not been documented. To fill this gap, this study estimates phthalate exposure from VPG intake in western China and calculates the first assessment of the disease burden associated with phthalate exposure from VPG intake in China based on a simple steady-state exposure model and a linear dose-response function between human bio-monitoring phthalates and Type 2 Diabetes (T2D) prevalence. What we present in this paper is a problem identification and screening level risk assessment. We chose Shaanxi province as the research field site due to its large contribution to the total vegetable yield and consumption in western China. Phthalate concentration in VPG samples, phthalate exposure levels from VPG intake, and the T2D burden caused by phthalate attributable to VPG intake for adults were measured or calculated. Di-2-ethylhexyl phthalate (DEHP) was found to represent over 55% of the total phthalate concentration in VPGs, followed by di-n-butyl phthalate (DnBP) and di-isobutyl phthalate (DiBP). Phthalate exposure from VPG intake for urban adults was higher than the level for rural adults. The share of DEHP exposure from VPG intake to urinary total DEHP metabolites were nearly 8% and 15%, and the share of DnBP exposure caused by VPG intake to total daily DnBP metabolites were nearly 4% and 7%, for rural and urban adult populations in Shaanxi, respectively. The adult population with T2D attributable to phthalate exposure from VPG intake was 2561, nearly 6.4% to the T2D burden attributable to total phthalate exposure, and 0.4% to the total adult population with T2D in Shaanxi. The authors recommend policy interventions to protect populations from future risk of phthalate exposure.

Persistent organic pollutants and the incidence of type 2 diabetes in the CARLA and KORA cohort studies

BACKGROUND

Associations between several persistent organic pollutants (POPs) and type 2 diabetes have been found in humans, but the relationship has rarely been investigated in the general population. The current nested case-control study examined internal exposure to polychlorinated biphenyls (PCB) and pesticides and the incidence of type 2 diabetes among participants of two population-based German cohort studies.

METHODS

We retrospectively selected 132 incident cases of type 2 diabetes and 264 age- and sex-matched controls from the CARdiovascular Living and Aging in Halle (CARLA) study (2002-2006, East Germany) and the Cooperative Health Research in the Region of Augsburg (KORA) study (1999-2001, South Germany) based on diabetes status at follow-up examinations in 2007-2010 and 2006-08, respectively (60% male, mean age 63 and 54 years). We assessed the association between baseline POP concentrations and incident diabetes by conditional logistic regression adjusted for cohort, BMI, cholesterol, alcohol, smoking, physical activity, and parental diabetes. Additionally, we examined effect modification by sex, obesity, parental diabetes and cohort.

RESULTS

In both cohorts, diabetes cases showed a higher BMI, a higher frequency of parental diabetes, and higher levels of POPs. We observed an increased chance for incident diabetes for PCB-138 and PCB-153 with an odds ratio (OR) of 1.50 (95%CI: 1.07-2.11) and 1.53 (1.15-2.04) per interquartile range increase in the respective POP. In addition, explorative results suggested higher OR for women and non-obese participants.

CONCLUSIONS

Our results add to the evidence on diabetogenic effects of POPs in the general population, and warrant both policies to prevent human exposure to POPs and additional research on the adverse effects of more complex chemical mixtures.

Association of serum levels of p,p'- Dichlorodiphenyldichloroethylene (DDE) with type 2 diabetes in African American and Caucasian adult men from agricultural (Delta) and non-agricultural (non-Delta) regions of Mississippi

Epidemiological associations were reported in several studies between persistent organochlorine organic pollutants and type 2 diabetes mellitus (T2D). Mississippi is a highly agricultural state in the USA, particularly the Delta region, with previous high usage of organochlorine (OC) insecticides such as p,p'- dichlorodiphenyltrichloroethane (DDT). In addition, there is a high proportion of African Americans who display elevated prevalence of T2D. Therefore, this State provides an important dataset for further investigating any relationship between OC compounds and metabolic diseases. The aim of this study was to assess whether soil and serum levels of OC compounds, such as p,p'- dichlorodiphenyldichloroethylene (DDE), arising from the heavy historical use of legacy OC insecticides, might serve as an environmental public health indicator for T2D occurrence. Soil samples from 60 Delta and 60 non-Delta sites randomly selected were analyzed for the presence of OC compounds. A retrospective cohort study of adult men (150 from each region) was recruited to provide a blood sample for OC compound quantitation and select demographic and clinical information including T2D. Using multivariable logistic regression, an association was found between increasing serum DDE levels and T2D occurrence in non-Delta participants (those subjects with lower serum DDE levels), as opposed to Delta participants (individuals with higher serum DDE levels). Thus, while there was a relationship between serum DDE levels and T2D in those with lower burdens of DDE, the lack of association in those with higher levels of DDE indicates a complex non-monotonic correlation between serum DDE levels and T2D occurrence complicating the goal of finding a public health marker for T2D. Abbreviations: BMI, body mass index; CVD, cardiovascular disease; CDC, Center for Disease Control, United States of America; DDE, p,p'- dichlorodiphenyldichloroethylene; DDT, p,p'- dichlorodiphenyltrichloroethane; GC/MS, gas chromatography/mass spectrometry; GIS, geographic information system; GPS, global positioning system; HDL, high-density lipoprotein; HTN, hypertension; IDW, inverse distance weighting; IRB, Institutional Review Board; LDL, low-density lipoprotein; LOQ, limit of quantitation; NHANES, National Health and Nutrition Examination Surveys; POPs, persistent organic pollutants; OC, organochlorine; PCB, polychlorinated biphenyl; SIM, single-ion monitoring; T2D, type 2 diabetes mellitus; USA, United States of America.

Unravelling the Effect of p,p'-Dichlorodiphenyldichloroethylene (DDE) in Hypertension of Wistar Rats

Hypertension is a multifactorial disease with limited knowledge of the involved mechanisms. p,p'-DDE ( p,p'-dichlorodiphenyldichloroethylene) is a pollutant commonly found in tissues that interferes with endocrine signaling. This study aimed to evaluate the mechanism of hypertension triggered by p,p'-DDE exposure in the presence or absence of a HF (high-fat) diet in rats. The renin-angiotensin system (RAS) was evaluated by qPCR in liver and adipose tissue (AT), and a transcriptome analysis comparing visceral AT of HF diet and HF/DDE groups was performed. HF diet influenced RAS, but the p,p'-DDE effect was more evident in liver than in AT (interaction between the diet and p,p'-DDE treatment affected aldosterone receptor and angiotensin converting enzyme 2 expression in liver, p < 0.05, two-way ANOVA). p,p'-DDE induced a decrease in the expression of genes involved in the retinoid acid biosynthesis pathway (Crabp1; -2.07-fold; p = 0.018), eNOS activation (Nos1; -1.64-fold; p = 0.012), and regulation and urea cycle (Ass1; -2.07-fold; p = 0.02). This study suggested that p,p'-DDE may play a fundamental role in the pathogenesis of hypertension, not exclusively in RAS but also by induction of hyperuricemia and increased oxidative stress, which may lead to endoplasmic reticulum stress and vascular injury.

Exposure to pesticides and the prevalence of diabetes in a rural population in Korea

BACKGROUND

Among the adverse health effects of exposure to pesticides, an association with diabetes has been reported. However, there is a lack of epidemiologic studies on the health effects of exposure to pesticides, particularly investigating the association between occupational pesticide exposure and diabetes prevalence.

PURPOSE

The present study examined the association between pesticide exposure and prevalence of diabetes in a rural population in Korea.

METHODS

This cross-sectional study used data from the Korea Farmers Cohort study, and included 2559 participants in the baseline survey between November 2005 and January 2008. We performed a clinical examination including blood sampling and assessed data on diabetes diagnosis, demographics, and pesticide exposure. Logistic regression was performed to evaluate the association between pesticide exposure and diabetes prevalence, adjusting for age, sex, monthly income, and marital status. In addition, a stratified analysis by body mass index (BMI) was conducted, with two categories: normal weight (<25 kg/m²) and overweight or obese (≥25 kg/m²).

RESULTS

At baseline, the prevalence of diabetes was 9.30%. Pesticide exposure was associated with the risk of diabetes after adjustment for covariates. In the analysis stratified by BMI, all the variables related to pesticide exposure were associated with prevalence of diabetes in the overweight or obese group, whereas no significant association was found in the normal weight group.

CONCLUSION

Exposure to pesticides was associated with diabetes, and this association was stronger in overweight or obese individuals than in normal weight individuals. Further longitudinal studies that consider information on BMI are necessary.

Microcystis bloom containing microcystin-LR induces type 2 diabetes mellitus

Epidemiological data from Lake Taihu showed significantly higher incidences of type 2 diabetes mellitus (T2DM) than in other areas of China. This may be related to the occurrence of a Microcystis bloom in Lake Taihu in the summer and autumn every year. The objective of this study is to investigate whether the contaminated water from the Microcystis bloom and the derivative pollutant microcystin-LR (MC-LR) can explain the higher incidences of T2DM. Healthy male mice were fed with water from different regions of Lake Taihu, and were either acutely or chronically exposed to MC-LR through oral administration or intraperitoneal injection. Serum lipid profiles were determined, and the effects on T2DM-related gene expression and insulin receptor signaling pathway were investigated. Intraperitoneal glucose tolerance (IPGTT) and insulin resistance (IRT) tests were implemented, and the functions of pancreatic islet and β-cell were also evaluated. The results showed that both water sampled from the region with a Microcysis bloom and those containing MC-LR altered the serum glucide and lipid profiles in mice after exposure. The exposure to a Microcysis bloom water affected the expression T2DM-related genes: up-regulated the mRNA levels of FASn, ACACA, G6pc, LPL, and Insig2, and down-regulated the mRNA level of PEPCK and Gsk-3β. Both acute and chronic exposure of MC-LR, even at very low concentrations (1 μg/L), impaired the insulin receptor signalling pathway and induced hyperinsulinemia and insulin resistance in mice. In this study, the most important intracellular target of MC-LR was found to be hetapocellular mitochondria. Thus, exposure to Microcystis bloom water containing microcystin-LR can induce the incidence of T2DM, by impairing the function of mitochondria by microcystin-LR. The study suggests a review of the risk assessment concerning 1 μg/L MC-LR as the reference dose in surface water.

Persistent organic pollutants in adipose tissue should be considered in obesity research

Although low doses of persistent organic pollutants (POPs), strong lipophilic chemicals with long half-lives, have been linked to various endocrine, immune, nervous and reproductive system diseases, few obesity studies have considered adipose tissue as an important POPs exposure source. Because the toxicodynamics of POPs relate directly to the dynamics of adiposity, POPs might explain puzzling findings in obesity research. In two people exposed to the same amounts of environmental POPs, the one having more adipose tissue may be advantaged because POPs storage in adipose tissue can reduce burden on other critical organs. Therefore, adipose tissue can play a protective role against the POPs effects. However, two situations increase the POPs release from adipose tissue into the circulation, thereby increasing the risk that they will reach critical organs: (i) weight loss and (ii) insulin resistance. In contrast, weight gain reduces this possibility. Therefore, avoiding harmful health effects of POPs may mostly contradict conventional judgments about obesity and weight change. These contradictory situations can explain the obesity paradox, the adverse effects of intensive intentional weight loss and the protective effects of obesity against dementia. Future studies should consider that adipose tissue is widely contaminated with POPs in modern society.

Increased blood levels of persistent organic pollutants (POP) in obese individuals after weight loss-A review

Lipophilic persistent organic pollutants (POP) are stored in adipose tissue. Following rapid weight loss such as when induced by bariatric surgery, an increased release of potential harmful lipophilic compounds into the blood circulation may occur. Weight reduction is recommended for overweight and obese individuals in order to decrease risk of weight-related health problems. However, in cases of significant weight reduction POP become mobilized chemicals and consequently may adversely affect health, including endocrine disruption. The objective of the present investigation was to estimate quantitatively the level of mobilization of POP following weight loss over time. According to literature search criteria, 17 studies were identified with 2061 participants. Data from 5 of the studies with 270 participants were used to assess the change in blood levels of POP in percent per kilogram weight loss. Weight loss in the included studies varied from 4.4 to 64.8 kg. In all studies, the majority of POP concentrations in blood were found to rise following weight reduction. Blood concentrations following weight reduction were elevated by 2-4% per kilogram weight loss for most POP examined. The increased POP levels were still elevated 12 mo after intervention. Most research in this field, including animal studies, is carried out on a single compound or group of selected compounds, not taking the "cocktail effect" into consideration. This does not reflect the true range of POP to which humans are actually exposed. Few chronic investigations have been published and, in particular, few studies were available that compared the increase in POP concentrations with clinical consequences as individuals lost weight. These limitations call for caution in interpreting results. The benefits of losing weight still far outweigh the potential adverse health risks. However, further studies are recommended to determine the clinical significance of increased blood levels of POPs following rapid and excessive weight loss, particularly for women attending weight reduction treatment before pregnancy.

Umbilical cord blood PBDEs concentrations are associated with placental DNA methylation

BACKGROUND

In utero polybrominated diphenyl ethers (PBDEs) exposure has been associated with adverse fetal growth. Alterations in placental DNA methylation might mediate those adverse effects.

OBJECTIVES

To examine the associations between in utero PBDEs exposure and DNA methylation in human placenta.

METHODS

Eighty apparently healthy mother-newborn pairs delivering at the Second Affiliated Hospital of Wenzhou Medical College were enrolled in this study. Placental DNA methylation of LINE1, NR3C1 and IGF2 was measured by quantitative polymerase chain reaction-pyrosequencing. In utero PBDEs exposure was assessed by measuring umbilical cord blood PBDEs concentrations.

RESULTS

For LINE-1, higher levels of BDE-66 exposure were associated with decreased DNA methylation (β=-0.9, 95% CI, -1.8 to -0.1); For NR3C1, BDE-153 concentrations was significantly inversely associated with DNA methylation (β=-2.0, 95% CI, -3.7 to -0.2); For IGF2, elevated concentrations of both BDE-153 (β=-1.7; 95% CI, -3.0 to -0.4) and BDE-209 (β=-1.0; 95% CI, -1. 9 to -0.1) were significantly associated with decreased DNA methylation.

CONCLUSIONS

We found that placental DNA methylation is associated with in utero PBDEs exposure. Changes in placental DNA methylation might be part of the underlying biological pathway between in utero PBDEs exposure and adverse fetal growth.

Disruption of iron homeostasis and resultant health effects upon exposure to various environmental pollutants: A critical review

Environmental pollution has become one of the greatest problems in the world, and the concerns about environmental pollutants released by human activities from agriculture and industrial production have been continuously increasing. Although intense efforts have been made to understand the health effects of environmental pollutants, most studies have only focused on direct toxic effects and failed to simultaneously evaluate the long-term adaptive, compensatory and secondary impacts on health. Burgeoning evidence suggests that environmental pollutants may directly or indirectly give rise to disordered element homeostasis, such as for iron. It is crucially important to maintain concerted cellular and systemic iron metabolism. Otherwise, disordered iron metabolism would lead to cytotoxicity and increased risk for various diseases, including cancers. Thus, study on the effects of environmental pollutants upon iron homeostasis is urgently needed. In this review, we recapitulate the available findings on the direct or indirect impacts of environmental pollutants, including persistent organic pollutants (POPs), heavy metals and pesticides, on iron homeostasis and associated adverse health problems. In view of the unanswered questions, more efforts are warranted to investigate the disruptive effects of environmental pollutants on iron homeostasis and consequent toxicities.

Serum aryl hydrocarbon receptor ligand activity is associated with insulin resistance and resulting type 2 diabetes

AIMS

Dioxin or dioxin-like compounds are ligands of the aryl hydrocarbon receptor (AhR), which is a ligand-activated nuclear transcription factor. There are limited studies about the association of serum AhR ligand activities and T2DM. Our objective was to investigate the association of serum AhR ligand activities with T2DM and its related metabolic parameters.

METHODS

This case-control study involved 83 subjects with T2DM as well as age-, sex-, and body mass index (BMI)-matched subjects with impaired glucose tolerance (IGT, n = 130) and normal glucose tolerance (NGT, n = 83). Serum AhR ligand activities were measured using a cell-based AhR ligand assay and standardized as 2,3,7,8-tetrachlorodibenzo-p-dioxin equivalents (TCDDeq, pmol/l).

RESULTS

The T2DM group had the highest AhR ligand activities compared to the IGT and NGT groups [median (interquartile range), 68.1 (53.1, 81.5), 60.2 (45.8, 75.1), and 53.3 (46.1, 63.7) pmol/l, respectively; P = 0.003]. In the multivariate analysis, the log2-transformed TCDDeq levels were significantly associated with the risk of T2DM after adjusting for age, sex, and BMI (odds ratio 2.26, 95 % confidence interval 1.34-3.82; P = 0.002). In nondiabetic subjects, serum AhR ligand activities showed a positive correlation with fasting glucose and insulin concentrations and the homeostasis model assessment of insulin resistance, but showed a negative correlation with adiponectin concentrations.

CONCLUSIONS

Serum AhR ligand activities were higher in the T2DM group and were correlated with the parameters of insulin resistance. Further investigation is required to elucidate the causal relationship between AhR ligand activity and T2DM.

Obesity, diabetes, and associated costs of exposure to endocrine-disrupting chemicals in the European Union

CONTEXT

Obesity and diabetes are epidemic in the European Union (EU). Exposure to endocrine-disrupting chemicals (EDCs) is increasingly recognized as a contributor, independent of diet and physical activity.

OBJECTIVE

The objective was to estimate obesity, diabetes, and associated costs that can be reasonably attributed to EDC exposures in the EU.

DESIGN

An expert panel evaluated evidence for probability of causation using weight-of-evidence characterization adapted from that applied by the Intergovernmental Panel on Climate Change. Exposure-response relationships and reference levels were evaluated for relevant EDCs, and biomarker data were organized from peer-reviewed studies to represent European exposure and burden of disease. Cost estimation as of 2010 utilized published cost estimates for childhood obesity, adult obesity, and adult diabetes. Setting, Patients and Participants, and Intervention: Cost estimation was performed from the societal perspective.

RESULTS

The panel identified a 40% to 69% probability of dichlorodiphenyldichloroethylene causing 1555 cases of overweight at age 10 (sensitivity analysis: 1555-5463) in 2010 with associated costs of €24.6 million (sensitivity analysis: €24.6-86.4 million). A 20% to 39% probability was identified for dichlorodiphenyldichloroethylene causing 28 200 cases of adult diabetes (sensitivity analysis: 28 200-56 400) with associated costs of €835 million (sensitivity analysis: €835 million-16.6 billion). The panel also identified a 40% to 69% probability of phthalate exposure causing 53 900 cases of obesity in older women and €15.6 billion in associated costs. Phthalate exposure was also found to have a 40% to 69% probability of causing 20 500 new-onset cases of diabetes in older women with €607 million in associated costs. Prenatal bisphenol A exposure was identified to have a 20% to 69% probability of causing 42 400 cases of childhood obesity, with associated lifetime costs of €1.54 billion.

CONCLUSIONS

EDC exposures in the EU contribute substantially to obesity and diabetes, with a moderate probability of >€18 billion costs per year. This is a conservative estimate; the results emphasize the need to control EDC exposures.

Effects of environmental organochlorine pesticides on human breast cancer: putative involvement on invasive cell ability

Human exposure to persistent organic pollutants (POPs) is a certainty, even to long banned pesticides like o,p'-dichlorodiphenyltrichloroethane (o,p'-DDT), and its metabolites p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE), and p,p'-dichlorodiphenyldichloroethane (p,p'-DDD). POPs are known to be particularly toxic and have been associated with endocrine-disrupting effects in several mammals, including humans even at very low doses. As environmental estrogens, they could play a critical role in carcinogenesis, such as in breast cancer. With the purpose of evaluating their effect on breast cancer biology, o,p'-DDT, p,p'-DDE, and p,p'-DDD (50-1000 nM) were tested on two human breast adenocarcinoma cell lines: MCF-7 expressing estrogen receptor (ER) α and MDA-MB-231 negative for ERα, regarding cell proliferation and viability in addition to their invasive potential. Cell proliferation and viability were not equally affected by these compounds. In MCF-7 cells, the compounds were able to decrease cell proliferation and viability. On the other hand, no evident response was observed in treated MDA-MB-231 cells. Concerning the invasive potential, the less invasive cell line, MCF-7, had its invasion potential significantly induced, while the more invasive cell line MDA-MB-231, had its invasion potential dramatically reduced in the presence of the tested compounds. Altogether, the results showed that these compounds were able to modulate several cancer-related processes, namely in breast cancer cell lines, and underline the relevance of POP exposure to the risk of cancer development and progression, unraveling distinct pathways of action of these compounds on tumor cell biology.

Associations of accumulated exposure to persistent organic pollutants with serum lipids and obesity in an adult cohort from Southern Spain

The aim of this research was to study the association of the accumulated human exposure to persistent organic pollutants with serum lipid levels and obesity, in a cohort of 298 adults. In the multivariable analyses, HCB concentrations evidenced a significant quadratic association with levels of total cholesterol, HDL, LDL, and total serum lipids. Likewise, PCBs 138 and 180 were associated with triglycerides and total serum lipids, and PCB 153 with LDL. HCB, p,p'-DDE, and β-HCH showed quadratic associations with BMI. All quadratic models showed a positive trend at low exposure levels, while the slope decreased or even became negative at higher exposure levels. Additionally, PCB 138 was positively associated with BMI but in a linear manner. Our results suggest a potential relationship between historical POP exposure and serum lipids/obesity, which followed a non-linear pattern in most cases.

Serum PCB levels in a representative sample of the Spanish adult population: the BIOAMBIENT.ES project

This manuscript presents the levels of six indicator polychlorinated biphenyl (PCB) congeners (IUPAC nos. 28, 52, 101, 138, 153 and 180) in the serum of 1880 individuals from a representative sample of the Spanish working population recruited between March 2009 and July 2010. Three out of the six PCBs studied (180, 153 and 138) were quantified in more than 99% of participants. PCB 180 was the highest contributor, followed by PCBs 153 and 138, with relative abundances of 42.6%, 33.2% and 24.2%, respectively. In contrast, PCBs 28 and 52 were detected in only 1% of samples, whereas PCB 101 was detectable in 6% of samples. The geometric mean (GM) for ΣPCBs138/153/180 was 135.4 ng/g lipid (95% CI: 121.3-151.2 ng/g lipid) and the 95th percentile was 482.2 ng/g lipid. Men had higher PCB blood concentrations than women (GMs 138.9 and 129.9 ng/g lipid respectively). As expected, serum PCB levels increased with age and frequency of fish consumption, particularly in those participants younger than 30 years of age. The highest levels we found were for participants from the Basque Country, whereas the lowest concentrations were found for those from the Canary Islands. The Spanish population studied herein had similar levels to those found previously in Greece and southern Italy, lower levels than those in France and central Europe, and higher PCB levels than those in the USA, Canada and New Zealand. This paper provides the first baseline information regarding PCB exposure in the Spanish adult population on a national scale. The results will allow us to establish reference levels, follow temporal trends and identify high-exposure groups, as well as monitor implementation of the Stockholm Convention in Spain.

High serum organochlorine pesticide concentrations in diabetics of a cotton producing area of the Benin Republic (West Africa)

The Borgou region of northern Benin is a major cotton producing area and consistently uses higher amounts of pesticides than other areas of the country. Organochlorine pesticides (OCPs), poorly handled, have been widely used and are still illegally present. We therefore hypothesized that serum OCP levels would be high in Borgou. As part of a case-control study on diabetes status and pesticide exposure, we measured the distribution of serum concentrations of 14 OCPs by gas chromatography with mass spectrometry. A sample of 118 diabetic subjects was selected using a four-stage cluster sampling with 54.2% of men and 45.8% of women; 43% lived in urban areas, 14.4% were obese and 39.8% had high economic status. The four detected OCPs were p,p'-DDT, p,p'-DDE, β-HCH and trans-nonachlor with respective geometric means (geometric standard deviation) of 497.1 (4.5), 20.6 (7.9), 2.9 (3.4), and 2.0 (2.3) ng/g of total serum lipids. OCP levels were significantly higher in obese, wealthier and more educated subjects and in those living in urban areas as compared to the other groups, particularly for p,p'-DDE, p,p'-DDT and β-HCH. Levels of DDT and DDE were higher than reported in other countries where DDT is no longer permitted. The low DDT/DDE ratio of 0.05 suggests past human exposure through food contamination. There is thus a need to reinforce governmental regulations for a more responsible use of pesticides in the country, in order to reduce health risks associated with persistent organic pollutants.

Chlorinated persistent organic pollutants, obesity, and type 2 diabetes

Persistent organic pollutants (POPs) are lipophilic compounds that travel with lipids and accumulate mainly in adipose tissue. Recent human evidence links low-dose POPs to an increased risk of type 2 diabetes (T2D). Because humans are contaminated by POP mixtures and POPs possibly have nonmonotonic dose-response relations with T2D, critical methodological issues arise in evaluating human findings. This review summarizes epidemiological results on chlorinated POPs and T2D, and relevant experimental evidence. It also discusses how features of POPs can affect inferences in humans. The evidence as a whole suggests that, rather than a few individual POPs, background exposure to POP mixtures-including organochlorine pesticides and polychlorinated biphenyls-can increase T2D risk in humans. Inconsistent statistical significance for individual POPs may arise due to distributional differences in POP mixtures among populations. Differences in the observed shape of the dose-response curves among human studies may reflect an inverted U-shaped association secondary to mitochondrial dysfunction or endocrine disruption. Finally, we examine the relationship between POPs and obesity. There is evidence in animal studies that low-dose POP mixtures are obesogenic. However, relationships between POPs and obesity in humans have been inconsistent. Adipose tissue plays a dual role of promoting T2D and providing a relatively safe place to store POPs. Large prospective studies with serial measurements of a broad range of POPs, adiposity, and clinically relevant biomarkers are needed to disentangle the interrelationships among POPs, obesity, and the development of T2D. Also needed are laboratory experiments that more closely mimic real-world POP doses, mixtures, and exposure duration in humans.

Adipose tissue concentrations of persistent organic pollutants and prevalence of type 2 diabetes in adults from Southern Spain

There is increasing evidence that environmental factors play an important role in the development of type 2 diabetes. Several persistent organic pollutants are suspected to contribute to the increasing prevalence and risk of type 2 diabetes. The aim of this study was to investigate the association of the body burden of three organochlorine pesticides and three polychlorinated biphenyls and the overall estrogenic activity with the risk of type 2 diabetes in a sample of adults from Southern Spain. Samples of adipose tissue and serum were obtained from 386 subjects undergoing non-cancer-related surgery and were extracted using validated methodologies. Residues of persistent organic pollutants were analyzed by means of high-resolution gas chromatography with a mass spectrometry detector in tandem mode. The overall estrogenicity of the adipose tissue extracts was measured by using the total effective xenoestrogen burden (TEXB) biomarker. Data on lifestyle, dietary habits, and health status were gathered from face-to-face interviews and clinical records. Statistical analyses were performed with unconditional logistic regression and different adjustment levels. In the models adjusted for adipose tissue origin, sex, age, and body mass index, the 2nd and 3rd tertiles of adipose tissue concentrations of p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) were positively associated with the risk of diabetes [odds ratios (95% confidence interval)=3.6 (0.8-17.3) and 4.4 (1.0-21.0), respectively]. A positive association with β-hexachlorocyclohexane was also found when body mass index and adipose tissue origin were removed from the models, with odds ratios (95% confidence interval) of 3.3 (1.0-10.4) and 5.5 (1.7-17.3), for the 2nd and 3rd tertiles of exposure, respectively. In addition, a statistically significant interaction was observed between p,p'-DDE and body mass index, such that the risk of diabetes increased with tertiles of exposure in a linear manner in non-obese subjects but not in the obese, in whom an inverted U-shape pattern was observed.

Developmental origins of obesity and type 2 diabetes: molecular aspects and role of chemicals

Obesity is a leading risk factor for impaired glucose tolerance and type 2 diabetes (T2D). Although the cause of the obesity epidemic is multi-factorial and not entirely clear, the recent acceleration in incidence is too rapid to be accounted for only by genetics, the wide availability of calorie-rich foods, and increasingly sedentary lifestyles. Accumulating data suggest that the important causes of the obesity epidemic may be related to developmental and early life environmental conditions. The concept of the developmental origins of health and disease (DOHaD) suggests that adverse influences early in development, particularly during intrauterine life, may result in permanent changes in the physiology and metabolism of the infant, which in turn result in an increased risk of non-communicable diseases in adulthood. For example, undernutrition during pregnancy and rapid postnatal weight gain are associated with obesity and T2D in the adult offspring. Moreover, increasing evidence suggests that early-life exposure to a wide range of chemicals has a significant impact on the causes of metabolic disorders. Although the underlying molecular mechanisms remain to be determined, these factors can affect epigenetic processes, such as DNA methylation, allowing the developmental environment to modulate gene transcription. The objective of this review article was to summarize recent progress in the biomedical implications of the DOHaD concept, focusing on the pathogenesis of obesity and T2D, and to discuss a future direction for preventive strategies from a public health perspective.

Sucralose, a synthetic organochlorine sweetener: overview of biological issues

Sucralose is a synthetic organochlorine sweetener (OC) that is a common ingredient in the world's food supply. Sucralose interacts with chemosensors in the alimentary tract that play a role in sweet taste sensation and hormone secretion. In rats, sucralose ingestion was shown to increase the expression of the efflux transporter P-glycoprotein (P-gp) and two cytochrome P-450 (CYP) isozymes in the intestine. P-gp and CYP are key components of the presystemic detoxification system involved in first-pass drug metabolism. The effect of sucralose on first-pass drug metabolism in humans, however, has not yet been determined. In rats, sucralose alters the microbial composition in the gastrointestinal tract (GIT), with relatively greater reduction in beneficial bacteria. Although early studies asserted that sucralose passes through the GIT unchanged, subsequent analysis suggested that some of the ingested sweetener is metabolized in the GIT, as indicated by multiple peaks found in thin-layer radiochromatographic profiles of methanolic fecal extracts after oral sucralose administration. The identity and safety profile of these putative sucralose metabolites are not known at this time. Sucralose and one of its hydrolysis products were found to be mutagenic at elevated concentrations in several testing methods. Cooking with sucralose at high temperatures was reported to generate chloropropanols, a potentially toxic class of compounds. Both human and rodent studies demonstrated that sucralose may alter glucose, insulin, and glucagon-like peptide 1 (GLP-1) levels. Taken together, these findings indicate that sucralose is not a biologically inert compound.

Chronic exposure to PCBs (Aroclor 1254) exacerbates obesity-induced insulin resistance and hyperinsulinemia in mice

Evidence from recent epidemiological studies has emerged implicating exposure to environmental toxicants as a novel risk factor for the development of type 2 diabetes (T2D) and the metabolic syndrome in the general population. Humans and other organisms in high trophic levels of the food chain consume persistent organic pollutants (POP) through their diet. Few experimental studies demonstrating cause and effect are available and evidence for a direct association between accumulation of POP and T2D is preliminary; however, the possibility exists that lipophilic chemicals that accumulate in fatty tissue may disrupt cellular function and metabolic homeostasis. Chronic exposure of diabetes-prone C57B/6 mice to a polychlorinated biphenyl (PCB) mixture (Aroclor 1254, 36 mg/kg/wk, 20 wk) alone or in combination with high-fat diet impairs carbohydrate metabolism was compared to vehicle-treated control animals. Specifically, PBC exposure was found to produce hyperinsulinemia in both lean and diet-induced obese mice and exacerbated whole-body insulin resistance in obese mice. These changes in carbohydrate metabolism in response to Aroclor 1254 occurred without marked effect on body weight in both lean and obese mice. Our results demonstrate a causative association between PCB exposure and obesity-induced insulin resistance and hyperinsulinemia independent of body weight changes, an observation that contributes to a growing body of evidence suggesting that exposure to environmental pollutants represents a novel risk factor contributing to the diabetes epidemic.

Serum concentrations of persistent organic pollutants (POPs) in the inhabitants of a Sicilian city

BACKGROUND

Polychlorinated biphenyls (PCBs) and organochlorine pesticides are common environmental contaminants that have been associated with human health problems.

OBJECTIVES

To assess serum concentrations of several organochlorine contaminants in general population living in a city with an ancient agricultural tradition and to identify possible exposure sources in Sicily.

METHODS

A cross-sectional study was conducted on 101 individuals. Each participant answered a face-to-face questionnaire submitted by well-trained personnel and provided a serum sample which was analyzed for the concentrations of PCBs, HCB, HCHs and DDTs by using gas-chromatography coupled with mass spectrometry.

RESULTS

HCB, p,p'-DDE, PCB 138, PCB 153 and PCB 180 were detected in more than 80% of the study participants. The ng g(-1) lipid median concentrations were: 18.6 for HCB; 175.1 for p,p'-DDE; 22. for PCB 138; 32.5 for PCB 153 and 23.0 for PCB 180. PCB 153 and PCB 138, PCB 138 and PCB 180, PCB 153 and PCB 180, and p,p'-DDE and HCB showed a high correlation each other (p<0.05). HCB and p,p'-DDE concentrations were significantly higher in subjects >49 years old (adj-p=0.03 in 50-69 years old and adj-p<0.001 in >69 years old, respectively) whereas PCB 138, PCB 153 and PCB 180 concentrations were higher in males (adj-p=0.03), in subjects >69 years old (adj-p=0.04) and in current smokers (adj-p=0.04).

CONCLUSIONS

The present study shows that serum concentrations of organochlorine compounds detected in subjects living in a small Sicilian city with ancient agricultural tradition are similar to those found in subjects living in urban areas of other countries. However, further investigations are needed to compare data from rural/urban areas in the same country, assessing correlations between serum concentrations of several chemical compounds and potential health effects in general population.

Biochemical study of retired pentachlorophenol workers with and without following dietary exposure to PCDD/Fs

PCDD/Fs are found as impurities in commercial pesticide sodium pentachlorophenol (Na-PCP) salt. We compared, using multivariate logistic regression analysis adjusted for confounding factors, serum PCDD/F levels and biochemical examinations of retired Na-PCP workers and other inhabitants living near a closed Na-PCP plant that discharged PCP-contaminated wastewater into a nearby pond in Tainan, Taiwan. In this cross-sectional study from October 2006 through May 2009, 1167 participants were divided into groups according to their occupational (retired Na-PCP plant workers versus other residents) and dietary exposure (eating polluted fish versus not eating polluted fish) to PCDD/Fs, and a general population from a large-scale survey. Serum PCDD/F levels were significantly different between these groups (range: from 22.9±10.0pg WHO(98)-TEQ(DF) g(-1) lipid in the general population to 109.6±94.5pg WHO(98)-TEQ(DF) g(-1) lipid in retired Na-PCP workers eating polluted seafood; P(trend)<0.001). Distinct patterns of PCDD/Fs congener profiles, showing a significantly higher proportion of 1,2,3,7,8-PeCDD, 1,2,3,6,7,8-HxDD, and less 2,3,4,6,7,8-HpCDF, OCDF, were also found among workers and residents with different serum PCDD/F levels versus the general population. After adjusting for confounding factors, glucose (adjusted odds ratio [AOR] 7.22 [95% CI: 4.04-12.90]), triglycerides (AOR 4.31 [95% CI: 2.57-7.22]), blood urea nitrogen (AOR 2.90 [95% CI: 1.58-5.33]), creatine (AOR 5.83 [95% CI: 1.12-30.30]) and total protein (AOR 3.74 [95% CI: 1.91-7.31]) levels in retired workers were significantly higher than in the reference group. Occupational exposure to PCDD/Fs is associated with biochemical abnormalities that may persist for years after serum PCDD/F levels have declined.

Blood concentrations of persistent organic pollutants and prediabetes and diabetes in the general population of Catalonia

The aim was to analyze the effects of body mass index (BMI), low-dose exposure, mixtures of persistent organic pollutants (POPs), and lipid adjustment on the relationship between POP concentrations and diabetes and prediabetes in the general adult population of Catalonia (Spain). Serum concentrations of POPs were measured by gas chromatography with electron-capture detection in 886 participants in a health interview survey. The highest concentrations of all POPs analyzed were found in subjects who had diabetes. Levels were also higher in individuals with prediabetes than in subjects without the disorder. In models adjusted by age, sex and BMI, the prevalence of diabetes and prediabetes increased in a dose-dependent manner across quartiles of PCBs 118, 138, 153, and 180, and HCB. When models were further adjusted for lipids, the associations were slightly lower and statistically significant, the ORs for the upper quartile ranging from 2.0 to 2.8 (all p-values for linear trend <0.05). Concentrations of p,p'-DDT, p,p'-DDE and β-HCH were not associated with diabetes or prediabetes. Increasing concentrations of PCBs and HCB were positively associated with diabetes and prediabetes. Only part of the association was due to age and BMI. Findings support the hypothesis that exposure to POPs may be a diabetogenic factor in both obese and nonobese individuals.

Genetic and environmental factors associated with type 2 diabetes and diabetic vascular complications

Faced with a global epidemic of type 2 diabetes (T2D), it is critical that researchers improve our understanding of the pathogenesis of T2D and related vascular complications. These findings may ultimately lead to novel treatment options for disease prevention or delaying progression. Two major paradigms jointly underlie the development of T2D and related coronary artery disease, diabetic nephropathy, and diabetic retinopathy. These paradigms include the genetic risk variants and behavioral/environmental factors. This article systematically reviews the literature supporting genetic determinants in the pathogenesis of T2D and diabetic vasculopathy, and the functional implications of these gene variants on the regulation of beta-cell function and glucose homeostasis. We update the discovery of diabetes and diabetic vasculopathy risk variants, and describe the genetic technologies that have uncovered them. Also, genomic linkage between obesity and T2D is discussed. There is a complementary role for behavioral and environmental factors modulating the genetic susceptibility and diabetes risk. Epidemiological and clinical data demonstrating the effects of behavioral and novel environmental exposures on disease expression are reviewed. Finally, a succinct overview of recent landmark clinical trials addressing glycemic control and its impact on rates of vascular complications is presented. It is expected that novel strategies to exploit the gene- and exposure-related underpinnings of T2D will soon result.

Polychlorinated biphenyl (PCB) exposure and diabetes: results from the Anniston Community Health Survey

BACKGROUND

Polychlorinated biphenyls (PCBs) manufactured in Anniston, Alabama, from 1929 to 1971 caused significant environmental contamination. The Anniston population remains one of the most highly exposed in the world.

OBJECTIVES

Reports of increased diabetes in PCB-exposed populations led us to examine possible associations in Anniston residents.

METHODS

Volunteers (n = 774) from a cross-sectional study of randomly selected households and adults who completed the Anniston Community Health Survey also underwent measurements of height, weight, fasting glucose, lipid, and PCB congener levels and verification of medications. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the relationships between PCBs and diabetes, adjusting for diabetes risk factors. Participants with prediabetes were excluded from the logistic regression analyses.

RESULTS

Participants were 47% African American, 70% female, with a mean age of 54.8 years. The prevalence of diabetes was 27% in the study population, corresponding to an estimated prevalence of 16% for Anniston overall; the PCB body burden of 35 major congeners ranged from 0.11 to 170.42 ppb, wet weight. The adjusted OR comparing the prevalence of diabetes in the fifth versus first quintile of serum PCB was 2.78 (95% CI: 1.00, 7.73), with similar associations estimated for second through fourth quintiles. In participants < 55 years of age, the adjusted OR for diabetes for the highest versus lowest quintile was 4.78 (95% CI: 1.11, 20.6), whereas in those ≥ 55 years of age, we observed no significant associations with PCBs. Elevated diabetes prevalence was observed with a 1 SD increase in log PCB levels in women (OR = 1.52; 95% CI: 1.01, 2.28); a decreased prevalence was observed in men (OR = 0.68; 95% CI: 0.33, 1.41).

CONCLUSIONS

We observed significant associations between elevated PCB levels and diabetes mostly due to associations in women and in individuals < 55 years of age.

Interaction Between Persistent Organic Pollutants and C-reactive Protein in Estimating Insulin Resistance Among Non-diabetic Adults

Objectives

Chronic inflammation is now thought to play a key pathogenetic role in the associations of obesity with insulin resistance and diabetes. Based on our recent findings on persistent organic pollutants (POPs) including the lack of an association between obesity and either insulin resistance or diabetes prevalence among subjects with very low concentrations of POPs, we hypothesized that POP concentrations may be associated with inflammation and modify the associations between inflammation and insulin resistance in non-diabetic subjects.

Methods

Cross-sectional associations among serum POPs, C-reactive protein (CRP), and homeostasis model assessment of insulin resistance (HOMA-IR) were investigated in 748 non-diabetic participants aged ≥20 years. Nineteen types of POPs in 5 subclasses were selected because the POPs were detectable in ≥60% of the participants.

Results

Among the five subclasses of POPs, only organochlorine (OC) pesticides showed positive associations with CRP concentrations, while polychlorinated biphenyls (PCBs) showed inverse associations with CRP concentrations. There were statistically significant interactions between CRP and OC pesticides and between CRP and PCBs, in estimating HOMA-IR (P for interaction <0.01 and <0.01, respectively). CRP was not associated with HOMA-IR among subjects with low concentrations of OC pesticides or PCBs, while CRP was strongly associated with HOMA-IR among subjects with high concentrations of these POPs.

Conclusions

In the current study, OC pesticides were associated with increased levels of CRP, a marker of inflammation, and both OC pesticides and PCBs may also modify the associations between CRP and insulin resistance.

Systematic evaluation of environmental factors: persistent pollutants and nutrients correlated with serum lipid levels

Background Both genetic and environmental factors contribute to triglyceride, low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein-cholesterol (HDL-C) levels. Although genome-wide association studies are currently testing the genetic factors systematically, testing and reporting one or a few factors at a time can lead to fragmented literature for environmental chemical factors. We screened for correlation between environmental factors and lipid levels, utilizing four independent surveys with information on 188 environmental factors from the Centers of Disease Control, National Health and Nutrition Examination Survey, collected between 1999 and 2006.

Methods We used linear regression to correlate each environmental chemical factor to triglycerides, LDL-C and HDL-C adjusting for age, age², sex, ethnicity, socio-economic status and body mass index. Final estimates were adjusted for waist circumference, diabetes status, blood pressure and survey. Multiple comparisons were controlled for by estimating the false discovery rate and significant findings were tentatively validated in an independent survey.

Results We identified and validated 29, 9 and 17 environmental factors correlated with triglycerides, LDL-C and HDL-C levels, respectively. Findings include hydrocarbons and nicotine associated with lower HDL-C and vitamin E (γ-tocopherol) associated with unfavourable lipid levels. Higher triglycerides and lower HDL-C were correlated with higher levels of fat-soluble contaminants (e.g. polychlorinated biphenyls and dibenzofurans). Nutrients and vitamin markers (e.g. vitamins B, D and carotenes), were associated with favourable triglyceride and HDL-C levels.

Conclusions Our systematic association study has enabled us to postulate about broad environmental correlation to lipid levels. Although subject to confounding and reverse causality bias, these findings merit evaluation in additional cohorts.

Persistent organic pollutants and obesity-related metabolic dysfunction: focusing on type 2 diabetes

Even though obesity is a well-established risk factor of type 2 diabetes, there is emerging evidence that persistent organic pollutants (POPs), a variety of lipophilic chemicals accumulated in adipose tissue, may be critically involved in the pathogenesis of type 2 diabetes. Among various POPs, serum concentrations of organochlorine pesticides and polychlorinated biphenyls (PCBs) were the most strongly and consistently linked to type 2 diabetes in both cross-sectional and prospective studies. In particular, obesity did not seem to be related to type 2 diabetes among persons with very low serum concentrations of POPs, suggesting a more fundamental role of chlorinated POPs in the pathogenesis of type 2 diabetes. These POPs were also associated with obesity, insulin resistance, and adverse lipid profiles like high triglyceride and low high-density lipoprotein (HDL) cholesterol among persons without diabetes, all metabolic dysfunctions commonly observed before developing type 2 diabetes. Recent animal studies supported the findings from epidemiological studies. If all these findings on POPs are true, it suggests that any effort to reduce the external and internal exposure to POPs would be necessary to decrease the social burden of type 2 diabetes.