Persistent organic pollutants and diabetes among Inuit in the Canadian Arctic

Type 2 diabetes is a chronic metabolic disease that is of increasing concern in Inuit communities. Behavioural factors such as physical inactivity and poor diet are well-known risk factors. Exposure to persistent organic pollutants (POPs) has emerged as an additional factor in the pathogenesis of diabetes. In this study, association between polychlorinated biphenyls (PCBs) and p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) with diabetes in Canadian Inuit was examined. Data from the Adult Inuit Health Survey (2007-2008) of Inuit participants from the Canadian Arctic were analyzed. Self-reported diabetes (excluding gestational diabetes) and clinical measurement of fasting glucose were examined as outcomes. Association with individual PCB congeners, sum of dioxin-like PCBs (∑DL-PCB), non-dioxin-like PCBs (∑NDL-PCB), total PCBs (∑PCB), and p,p'-DDE were investigated using multiple regression models adjusted for confounding factors. Using different methods to incorporate serum lipids, highest vs. lowest quartile exposures to PCB-105, PCB-118, PCB-153, PCB-156, PCB-170, PCB-180, PCB-183, ∑PCB, and p,p'-DDE were associated with increased risk of diabetes. For these PCBs, odds ratios (ORs) ranged from 1.9-3.5 (lower 95% CI: 0.8-1.4, upper 95% CI: 4.4-9.0) and for p,p'-DDE the OR was 2.5 (lower 95% CI: 1.1-1.2, upper 95% CI: 5.9-6.0). The highest vs. lowest quartile exposure to most PCBs and p,p'-DDE were associated with an increase of fasting glucose by 3-7%. PCBs and p,p'-DDE were associated with increased risk of diabetes and higher fasting glucose level in a cross-sectional survey of Canadian Inuit. Cause-effect relationships of PCBs and p,p'-DDE with diabetes and diabetes-related outcomes need to be further investigated in a cohort study.