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Table 1 Cross sectional studies of the association of POP with diabetes risk

From: Persistent organic pollutants as risk factors for type 2 diabetes

Reference Location Population/ setting Age (years) Diagnostic criteria of diabetes Confounders Total population Diabetic population Proportion of men % Compounds measured Compounds with statistical significant difference  
           PCBs Dioxins OC pesticides others
[20] Sweden Fishermen and their wives from the Swedish east coast 66.5 Self-reported physician-diagnosed diabetes Age, sex, BMI 380 22 51.6 PCB-153,p,p ′ -DDE PCB-153 OR = 1.16, 95% CI (1.03-1.32)   p,p'-DDE OR = 1.05, 95% CI 1.01- 1.09).  
[8] USA NHANES (1999 – 2002) ≥20 FPG ≥ 126 mg/dl, Non-fasting glucose ≥200 mg/dl, Self-reported physician-diagnosed diabetes Age, sex, BMI, race/ethnicity, poverty income ratio, WC 2,016 217 NA PCB-153, HpCDD, OCDD, oxychlordane, DDE, trans-nonachlor PCB-153 OR = 6.8, 95% CI (3.0–15.5) HpCDD OR = 2.7, 95% CI (1.3–5.5) Oxychlordane OR = 6.5 (2.0–21.4) DDE OR = 4.3, 95% CI (1.8–10.2);trans- nonachlor OR = 11.8, 95%CI (4.4–31.3)  
[9] USA Mohawk adults (one adult/ household) 57.5 FPG >125 mg/dl, Taking prescribed glucose-lowering medication Age, sex, BMI, serum lipid levels, smoking history 352 71 38.1 Total PCB, PCB-153, PCB-74, DDE, HCB, mirex , Total PCB, OR = 3.9,95% CI (1.5–10.6). PCB-153 OR = 3.2, 95% CI (1.3–8.2) PCB-74 OR = 4.9, 95% CI (1.7–13.7)   DDE, OR = 6.4, 95%CI (2.2–18.4) HCB OR = 6.2, 95%CI (2.3–16.9)  
[21] USA NHANES (1982– 1984), Hispanic Americans 47 Self-reported physician diagnosed diabetes Age, sex, BMI, place of birth, education, poverty index 1,303 89 40.5 p,p ′ -DDT, p,p ′ -DDE, dieldrin, oxychlordane, β -HCH, HCB, trans-nonachlor    p,p ′ -DDT (OR = 2.3,95% CI(1.1–5.0) , p,p ′ -DDE, OR = 2.63, 95% CI (1.2–5.8) β -HCH, OR = 2.7, 95% CI (0.9–8.2), oxy chlordane OR = 3.3, 95% CI (1.2–8.7) trans nonachlor OR = 3.4, 95% CI (1.4–7.9)  
Lee et al. [61] USA NHANES (1999 – 2002) ≥20 FPG ≥ 126 mg/dl, non-fasting glucose ≥ 200 mg/dl, Self-reported physician-diagnosed diabetes Age, sex, BMI, race/ethnicity, poverty income ratio, WC 1,721 179 NA PCDDs (3), PCDFs (3), dioxin-like PCBs (4), nondioxin-like PCBs (5),OC pesticides (4) Dioxin-like PCBs OR = 15.7, 95% CI (3.4–71.2)   Oxychlordane, OR = 4.6, 95% CI (2.0–10.4),trans nonachlor, β –HCH Or = 7.0, 95% CI (2.7–18.1); DDT OR = 2.9, 95% CI (1.5–5.6),  
[23] Sweden Swedish fishermen’s wives 44 Self-reported diabetes Age and BMI 544 women 16 0.0 CB-153 and p,p-DDE    CB-153; OR = 1.6, 95% CI (1. 0–2. 7) and p,p-DDE OR = 1.3, 95% CI (1. 1–1.6)  
[7] USA National Health and Nutrition Examination Survey 2003–2004 69 Fasting plasma glucose ≥126 mg/dl non-fasting plasma glucose ≥200 mg/dl , taking insulin or an oral agent. Age, sex, race, poverty income ratio, and BMI 1,367 156 47.3 PBB-153 PBDE-28 PBDE-47 PBDE-99 PBDE-100 PBDE-153     PBB-153 OR = 1.9, 95% CI (0.9–4.0)
[26] Japan Survey (2002 – 2006) 44 Self-reported physician diagnosed diabetes, non-diagnosed participants with plasma HbA 1c >6.1% age, gender, log (BMI), smoking habit, regional block, residential area, and survey year 1374 65 45.6 7 PCDDs, 10 PCDFs, 12 dioxin-like PCBs 12 dioxin-like PCBs OR = 6.82, 95% CI (2.59–20.1) 7 PCDDs,10 PCDFs OR = 2.21, 95% CI (1.02–5.04),   
[30] Taiwan Yu Cheng cohort (1993 – 2003) 55.5 Self-reported physician-diagnosed diabetes age, BMI, cigarette smoking, and alcohol intake 748 144 41.0 Total PCB Total PCB in women [OR 2.1,95% CI (1.1– 4.5)    
[62] South Korea Community-based health survey 55.6 FPG ≥ 126 mg/dL, taking antidiabetic medication age, sex, BMI, alcohol consumption, and cigarette smoking. 80 40 52.5 β-hexachlorocyclohexane, HCB, heptachlor epoxide, p,p′-DDE, p,p′-DDD, p,p′-DDT, o,p′-DDT, oxychlordane, trans-nonachlor, and mirex    p,p′-DDE OR = 12.7, 95% CI (1.9–83.7),p,p′-DDT OR = 10.6, (1.3–84.9), o,p′-DDT OR = 12.3, 95% CI (1.3–113.2);oxychlordane, OR = 26.0, 95% CI (1.3–517.4); trans-nonachlor OR = 8.1, 95% CI (1.2–53.5) and heptachlor epoxide OR = 3.1, 95% CI (0.8–12.1)  
[19] Slovakia heavily polluted Slovakian district of Michalovce and two reference districts (Svidnik and Stropkov) 48 FPG >7.0 mmol/l (all participants) and 2 h glucose >11.1 mmol/l (OGTT, 60% of participants) Age, sex, BMI 2,047 296 40.8 PCBs (15), p,p ′ -DDE, p,p ′ -DDT, HCB, β -HCH Total PCBs OR = 2.74,95% CI (1.92 – 3.90)   p,p ′ -DDE, OR = 1.86,95% CI (1.17 – 2.95);p,p ′ -DDT OR = 2.48,95% CI (1.77–3.48)  
[24] Finland Helsinki Birth Cohort Study representing a general adult urban Finnish population 63.5 fasting plasma glucose ≥7.0 mmol/L or 2-h plasma glucose ≥11.1 mmol/L or on anti-diabetic medication. Sex, age, WC and mean arterial pressure 1,988 308 46.3 oxy-chlordane, trans nonachlor, p,p’ -DDE, PCB 153, BDE 47, and BDE153 PCB 153 OR = 1.64 (0.92 – 2.93) P = 0.050   Oxy chlordane OR = 2.08, 95% CI (1.18 – 3.69); trans nonachlor OR = 2.24, 95% CI (1.25 – 4.03); DDE OR = 1.75, 95% CI (0.96 – 3.19)  
[25] Japan Participants in the Saku Control Obesity Program. 52 HbA1c level ≥ 6.9% ,taking medication for diabetes, fasting plasma glucose ≥ 126 mg/dL, or a history of doctor-diagnosed diabetes Sex, age, BMI and total lipids. 117 32 50.4 PCB 74, 99, 118, 138, 146, 153, 156, 163/164, 170, 180 and 182/187 PCB 146, OR = 2.46, 95% CI (1.09-5.59) PCB 180 OR = 1.39, 95% CI (1.10-1.76)    
[34] Denmark The Gentofte population and Odense population 52.2 FPG ≥ 7.0 mmol/liter on two occasions, absence of anti-glutamic acid decarboxylase 65 antibodies, and no need for insulin therapy Age, sex, and percent body fat, study site 148 31 64.3 HCB, HCH, p’p’-DDE, op’-DDE, p’p’-DDT, PCB-105, 118 and 156, PCB-101, 138, 153 and 180 PCB-105 OR = 3.8, 95% CI (3.0–4.9) PCB 118 OR = 14.2, 95% CI (10.2–21.0)   organochlorine HCB, OR = 28.0, 95% CI (20.0–39.7);p’,p’-DDE OR = 139.4,95% CI (73.6–288.4)  
[63] Spain Participants of the Catalan Health Interview Survey (CHIS) 46 FPG ≥ 126 mg/dL, reported physician diagnosed diabetes and current use of insulin or antidiabetic medication age, sex, and BMI,total cholesterol and triglycerides 886 143 42.9 op-‘-DDT, p,p ′ -DDT, o,p′ -DDE, p,p ′ -DDE, o,p′ -DDD, p,p ′ -DDD; PCB28, 52, 101, 118, 138, 153, and 180, PeCB, HCB, α –HCH, β -HCH, γ -HCH, and δ -HCH Non dioxin like PCBs (PCB28, 52, 101, 118, 138, 153, and 180,) OR = 1.8, 95% CI (1.2 − 2.7)   op-‘-DDT, o,p ′ -DDE, o,p ′ -DDD, p,p ′ -DDD; HCB, α –HCH,, γ -HCH, and δ –HCH OR = 1.8, 95% CI (1.0 − 3.2)  
[6] USA Employed at the La Salle Electrical Utilities Company in illinios and local residents not previously employed 57 self-reported diagnosed diabetes, and/or fasting glucose ≥ 126 mg/dL age, BMI, alcohol use, smoking, high blood pressure, total lipids, medication use 63 7 100 6 dioxin-like PCBs and 33 non dioxin like PCBs All PCBs OR = 3.0, 95% CI (1.3-7.2)    
[18] USA Anniston, Alabama general population 55.5 fasting glucose values > 125 mg/dL, self-reported or physician diagnosed diabetes Age, sex, race/ ethnicity, or BMI 774 207 30.0 35 PCB ortho-substituted congeners, DDE All PCBs 2.78,95% CI(1.00-7.73)   DDE OR = 1.22, 95% CI(0.85-1.46)  
[64] Spain San Cecilio University Hospital in thecity of Granada and Santa Ana Hospital in the town of Motril 55 self-reported information and clinical records showing a fasting glucose level Z 126 mg/dL in the routine analyses Adipose tissue origin , sex, age, and BMI 386 34 51.0 PCB-138, PCB-153, PCB-180, HCB, b-HCH, p,p’-DDE,    p,p‘-DDE OR = 4.4, 95% CI (1.0–21.0)  
[65] Canada Wapekeka and Kasabonika two of the five Shibogama communities in northern Ontario 44.5 resting plasma glucose >7.0 mmol/L and/or a post-prandial level (2 hours after glucose ingestion) > 11.0 mmol/L Age, BMI and smoking status 72 26 43.1 Aroclor 1260, PCB28, 52, 99, 101, 105, 118, 128, 138,153, 156, 163, 170, 180,183,187,aldrin, − αchlordane, β-chlordane, − β-HCH, cis-nonachlor, trans-nonachlor, DDE, DDT, HCB,mirex, oxychlordane, PBB153, PBDE47, 99, 100,153, Parlar26, and Parlar50. PCB28, 52, 99, 101, 118, 128, 138, 153, 156, 163, 170, 180, 183,187,   Trans nonachlor, DDE, oxychlordane, all p < 0.05  
[66] South Korea NA NA FPG ≥ 126 mg/dL, reported history of physician-diagnosed diabetes age , sex, alcohol consumption , cigarette smoking and BMI 50 25 48.0 14 OC pesticides, 22 PCB congeners    DDTs in VAT, OR = 9.0,95% CI(1.3–62.9)  
  South Korea Community-based health survey 55.6 FPG ≥ 126 mg/dL, taking antidiabetic medication age, sex, BMI, alcohol consumption, and cigarette smoking. 80 40 52.5 β-hexachlorocyclohexane, HCB, heptachlor epoxide, p,p′-DDE, p,p′-DDD, p,p′-DDT, o,p′-DDT, oxychlordane, trans-nonachlor, and mirex    p,p′-DDE OR = 12.7, 95% CI (1.9–83.7);p,p′-DDT OR = 10.6, 95% CI (1.3–84.9);o,p′-DDT OR = 12.3, 95% CI (1.3–113.2);oxychlordane, OR = 26.0, 95% CI (1.3–517.4); trans-nonachlor OR = 8.1, 95% CI (1.2–53.5) and heptachlor epoxide OR = 3.1, 95% CI (0.8–12.1)  
  1. 2,2,4,4,5,5-hexabromophenyl (PBB-153), heptachlorodibenzo-p-dioxin (HpCDD), octachlorodibenzo-p-dioxin (OCDD), dichlorodiphenyldichloroethylene (DDE), 2,2′-bis(4-chlorophenyl)-1,1-dichloroethylene (p,p′-DDE), hexachlorobenzene (HCB), hexa-chlorocyclohexane (HCH), polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), organochlorine (OC), 2,2',4,4'-tetrabromodiphenyl ether (BDE 47), 2,2',4,4',5,5'–hexabromodiphenyl ether (BDE 153), 2,2,4,4,5,5-hexabromophenyl (PBB-153), 2,4,4-tribromodiphenyl ether (PBDE-28), 2,2,4,4 tetrabromodiphenyl ether (PBDE-47), 2,2,4,4 ,5-pentabromodiphenylether (PBDE-99), 2,2,4,4,6-pentabromodiphenyl ether (PBDE-100), 2,2,4,4,5,5-hexabromodiphenyl ether (PBDE-153), 2,2 ′ -bis(4-chlorophenyl)-1,1,1-trichloro-ethane (p,p ′ -DDT), 2,2′-bis(4-chlorophenyl)-1,1-dichloroethylene (p,p′-DDE), di-chlorodiphenyl-dichloro-ethane (o,p′-DDD ), pentachlorobenzene (PeCB), body mass index (BMI), confidence interval (CI), fasting plasma glucose (FPG), oral glucose tolerance test (OGTT), odd ratio (OR),waist circumference (WC).