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Environ Sci Technol. 2019 Dec 3;53(23):13906-13918. doi: 10.1021/acs.est.9b03373. Epub 2019 Nov 20.

Exposure to Persistent Organic Pollutants (POPs) and Their Relationship to Hepatic Fat and Insulin Insensitivity among Asian Indian Immigrants in the United States.

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Department of Environmental Toxicology , University of California , Davis , California 95616 , United States.
Department of Civil and Environmental Engineering , Tufts University , Medford , Massachusetts 02155 , United States.
Division of Environmental Health Sciences, School of Public Health , University of California , Berkeley , California 94720 , United States.
Departments of Medicine and Preventive Medicine , Northwestern University Feinberg School of Medicine , Chicago , Illinois 60611 , United States.
Division of Life Science and Chemical Analysis , Agilent Technologies , Santa Clara , California 95051 , United States.
Department of Biological Chemistry , The Johns Hopkins University School of Medicine , Baltimore , Maryland 21205 , United States.
School of Engineering , Brown University , Providence , Rhode Island 02912 , United States.
Departments of Medicine, Epidemiology & Biostatistics , University of California , San Francisco , California 94115 , United States.


Persistent organic pollutants (POPs), such as dichlorodiphenyltrichloroethane (DDT) and other organochlorine compounds, are abundant in the environment and in foodstuffs from the Indian subcontinent. These environmental contaminants have been associated with a higher risk of diabetes in numerous studies. Asian Indians are well known to have a high risk of diabetes compared with other populations, and this risk is also found in migrant populations of Asian Indians in the United States, Europe, and elsewhere. We hypothesized that high plasma concentrations of POPs in Asian Indian migrants are linked to a variety of diabetes-related pathologies and explored the mechanism for the induction of these effects. We measured 30 environmental pollutants in plasma samples obtained from 147 participants in the Metabolic syndrome and Atherosclerosis in South Asians Living in America pilot study using a gas chromatography-tandem mass spectrometry analytical method that uses less than 0.5 mL of plasma. We found that plasma levels of o,p'-DDT and p,p'-DDT were independently associated with both body mass index (BMI) and waist circumference. Doubling the levels of the sums of these DDTs was associated with insulin insensitivity (-0.38 Matsuda index, p = 0.001), increased adiposity (1.26 kg/m2 BMI and 3.58 cm waist circumference increase, p < 0.0001), circulating insulin (12.9 mIU/L, p = 0.002), hepatic fat (-0.051 HU, p = 0.001), as well as increased odds of obesity (OR = 2.17, p < 0.001, BMI-based; OR = 2.37, p = 0.001, waist-based), prediabetes (OR = 1.55, p = 0.02), diabetes (OR = 1.72, p = 0.01), and fatty liver (OR = 1.66, p = 0.01) in multivariable models accounting for confounding by age, sex, years in the US, education, and fish protein. Furthermore, levels of DDTs were associated with increased hepatic fat and circulating insulin, independent of obesity and confounders. These findings suggest that exposure to DDTs may contribute to the risk of metabolic disease among Asian Indians by affecting hepatic fat levels independent of obesity.


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