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Association of Organochlorine Pesticides with Peripheral Neuropathy among Patients with Diabetes or Impaired Fasting Glucose

¹Department of Preventive Medicine and Health Promotion Research Center, School of Medicine, Kyungpook National University, Daegu, Korea
²Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
³Department of Nutrition, University of Oslo, Oslo, Norway
⁴Department of Laboratory Medicine and Pathology. University of Minnesota, Minneapolis, MN

Objective: Recent epidemiological studies have shown that background exposure to persistent organic pollutants (POPs), xenobiotics accumulated in adipose tissue, were strongly associated type 2 diabetes. Hyperglycemia is the cause of long-term complications of diabetes as well as diabetes itself and POPs themselves are well-known neurotoxicants. This study was performed to explore if POPs were associated with peripheral neuropathy, a common long-term complication of diabetes, among people with glucose abnormalities.

Research Design and Methods: We studied cross-sectional associations of peripheral neuropathy with 25 POPs each detectable in at least 60% of study subjects among 246 patients aged 40 years with diabetes or impaired fasting glucose using National Health and Nutrition Examination Surveys 1999-2002 datasets.

Results: Among 5 subclasses of POPs, organochlorine (OC) pesticides showed a strong dose-response relation with prevalence of peripheral neuropathy; adjusted ORs were 1.0, 3.6, and 7.3 (P for trend<0.01) across 3 categories of serum concentrations of OC pesticides. Furthermore, when we restricted the analyses to 187 participants with HbA1C<7%, the adjusted ORs were still 1.0, 3.9, and 6.7 (P for trend<0.01). OC pesticides were also strongly associated with the prevalence of HbA1C7%; adjusted ORs were 1.0, 2,5, and 5.0 (P for trend<0.01). Specific POPs belonging to OC pesticides showed similar positive associations.

Conclusions: This study suggested that the background exposure to OC pesticides may be associated with higher risk of peripheral neuropathic complications among those with glucose abnormalities, even beyond the influence of diabetes itself.

Key Words: Persistent Organic Pollutants • Organochlorine Pesticides • HbA1C • diabetes • neuropathy

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